3900-PM-BSDW0254q
Instructions
Rev. 7/2013
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF SAFE DRINKING WATER
Remove and recycle these instructions prior to mailing to DEP
BULK WATER LOADING STATIONS
Module 15-B has been developed to provide completeness and uniformity in the submission of information
supporting an application for a public water supply permit for bulk water loading stations.
The permit amendment/approval ensures that (1) the PWS has adequate quantity of water available for
planned sale; (2) adequate measures are taken to prevent potential contamination of public water system
supplies; (3) appropriate security measures are in place and; (4) no adverse impacts on the system operation
will occur with the proposed taking points.
The permit requirements for Public Water Systems (PWS) under Chapter 109 are governed by ownership or
operational control. The following information, including the drawing and associated table, is intended to help
the PWS in determining the need for the required permit authorization associated with potable or non-potable
Bulk Water Loading activity. The term “taking point” used here implies a location of water withdrawal point on
any part of the PWS facility (raw water prior to being sent to a treatment facility, partially treated water, or
finished water ready for human consumption).
Bulk water loading activity has the potential to affect the quantity and/or quality of water served to the public
and requires a minor permit amendment. The level of authorization for taking points is contingent upon
whether the water at the taking point is finished or raw (not ready for human consumption). Permit
amendments are required for taking points for bulk water sales located on any part of the PWS associated
with finished water (ready for human consumption) and that are owned or operated by the PWS. Letter
approvals may be sufficient for taking points for bulk water sales located on the raw water portion of the
system when there are no potential impacts on operations. However, a minor permit amendment is required
when the potential for impacts on operations exists. For example, a permit amendment should be obtained for
taking points located within a treatment plant to ensure that plant hydraulics and/or treatment efficacy are not
adversely impacted.
The diagram and table on pages 3 – 5 provides additional information about the various types of taking points
and the associated permit requirements. For example, taking point #4 in the attached drawing represents one
of the more common situations. In this scenario, a PWS waterline (service line) serves a meter pit (which is
equipped with a water meter, gate valve, backflow preventer device and secure hatch) that is owned and
operated by the bulk water loading customer. The metered waterline feeds the earthen pond which is to
supply water to the non-potable bulk water loading customer. In this situation, no permit for the meter pit is
required. The rational for this decision is based on cross-connection control program requirements under
section 109.709 of DEP regulations. The non-potable bulk water loading customer of the PWS has the
ownership and control of the meter pit and has fulfilled its responsibility by providing adequate backflow
devices to prevent contamination of PWS water supplies. This customer is responsible for proper operation,
maintenance and security of the meter pit.
In the above scenario, if the meter pit was owned or operated by the PWS, a permit amendment would be
required.
If the proposal involves construction of a water line and related appurtenances by someone other than a PWS
for bulk water sale for potable use, or for a combination of potable and non-potable use, a permit will be
required to make the project sponsor a public water supplier.
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3900-PM-BSDW0254q
Instructions
Rev. 7/2013
The PWS may propose the use of fixed or mobile loading stations for potable or non-potable bulk water
loading activity. A mobile bulk water loading station may be used at multiple hydrant locations provided those
hydrant locations are identified in the permit. As per the current Standard Operating Procedure (SOP) for
Chapter 109 Minor Permit Amendment and Permit Transfers, both a construction and operation permit is
required when a permit amendment involves a bulk water loading station. When the use of a mobile bulk
water loading station is proposed, the construction and operation permit in those situations should include
taking point locations.
Once it is determined that a permit amendment is needed, the PWS will need to follow the following
instructions to obtain a permit amendment:
This module has been designed for bulk water loading station taking points located on any part of the public
water system that are owned or controlled by the public water system.
At a minimum, each application for a bulk water loading station must contain the following:
1) An application form (3900-PM-BSDW0002) properly executed by a principal executive officer, general
partner, or the owner of the public water system.
2) A completed copy of Module 15-B for each bulk water loading station.
3) An engineer’s report which describes the taking point and bulk water loading station facility.
Duplicate copies of the above information must be submitted to the appropriate regional office.
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3900-PM-BSDW0254q
Instructions
Rev. 7/2013
Taking Points for Potable or Non-potable Bulk Water Loading
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3900-PM-BSDW0254q
Instructions
Taking
Point
1
Rev. 7/2013
Description of Taking Point
Taking point is outside the
PWS system with
withdrawal from surface or
groundwater.
Ownership/Operation
Requirements
PWS Owns/Operates
The PWS may need to apply for River Basin Commission approval, if applicable
and if selling to gas industry may require an Oil and Gas Water Management Plan
approval as a third party supplier of water.
Non-Potable Bulk
Water Loading
Customer
No permits or amendments required of PWS. Customer may be required to obtain
other authorizations such as Water Management Plan for water sales to gas
industry
Module 15B
2
Taking point is on the raw
water side of the PWS
system.
PWS Owns/Operates
Allocation permit needed by PWS for withdrawal from surface water. Letter
approval for the taking point for bulk water sale assuming no potential impact on
system operation.
3
Taking point is withdrawal
from the PWS treatment
unit.
PWS Owns/Operates
A permit amendment is required for PWS due to the potential impact on
operations.
Yes
PWS Owns/Operates
All Facilities
A permit amendment is required for PWS.
Yes
PWS Operates Meter
Pit only and NonPotable Bulk Water
Loading Customer owns
all facilities
A permit amendment is required for PWS.
Yes
Non-potable Bulk
Water Loading
Customer
Owns/Operates All
Facilities
No SDW permit amendment required of PWS or customer. Customer may be
required to obtain other authorizations such as Water Management Plan for
water sales to gas industry
PWS Owns/Operates
A permit amendment is required for PWS.
4
5
Taking point is on the
finished water side of the
PWS system.
Taking point is a service line
from storage.
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Yes
3900-PM-BSDW0254q
Instructions
Rev. 7/2013
Taking
Point
Description of Taking Point
Ownership/Operation
Requirements
Module 15B
6
Taking point is a fire
hydrant.
PWS Owns/Operates
The PWS needs to apply for and obtain a permit amendment. The permit
amendment will require use of approved mobile loading station and approved
hydrant locations.
Yes
7
Taking point is a bulk
loading station within
system
PWS Owns/Operates
A permit amendment is required for PWS.
Yes
8
Taking point is on the
finished water side of the
PWS system and will be
used for potable purposes
PWS Owns/Operates
A permit amendment is required for PWS.
Yes
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3900-PM-BSDW0254q
Rev. 7/2013
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF SAFE DRINKING WATER
PUBLIC WATER SUPPLY
MODULE 15-B BULK WATER LOADING STATIONS
Date Prepared:
Date Revised:
PERMIT NO. (FOR DEPARTMENT USE ONLY)
A. GENERAL INFORMATION
Design Engineer and Firm:
Public Water System:
PWSID:
Location of Project:
Municipality:
County:
Description of Project:
Justification of Project (Describe the public health and/or economic benefits of the project):
B. DOCUMENTATION REQUIRED (109.503; PWS Manual, Part II, Sections I.B.3.a., III.D.2. and VIIIM)
1.
Have two (2) copies of the Public Water Supply Permit Application (3900-PM-BSDW0002),
including all appropriate signatures and seals, been submitted?
Yes
No
a.
Yes
No
If yes, are the application forms signed and sealed by all appropriate parties?
2.
Have two (2) copies of the design engineer’s report, signed and sealed by a licensed
professional engineer registered to practice in the Commonwealth of Pennsylvania, been
submitted?
Yes
No
3.
Does the front cover or flyleaf or first page of each set of drawings and specifications bear the
signature and embossed seal or reasonable facsimile of the licensed professional engineer,
registered to practice in the Commonwealth of Pennsylvania, by or under whom prepared.
Yes
No
4.
Does each subsequent page or drawing bear an embossed seal or reasonable facsimile of
such seal?
Yes
No
5.
Does the engineer’s report include all applicable items specified in Part II of the Department’s
Public Water Supply Manual?
Yes
No
a.
If no, explain.
15B - 1
3900-PM-BSDW0254q
Rev. 7/2013
PUBLIC WATER SUPPLY
MODULE 15-B BULK WATER LOADING STATIONS
Date Prepared:
Date Revised:
PERMIT NO. (FOR DEPARTMENT USE ONLY)
C. WATER SOURCES
Water Allocation (including subsidiary)
Permit or Order of Confirmation
Information*
Source Type
Source Name
Date of
Last Use
(Well, Spring,
Surface Water,
Interconnections)
Permitted
Capacity
Permit
No.
* If applicable
** DRBC: Delaware River Basin Commission
SRBC: Susquehanna River Basin Commission
1. Has the applicant registered the water sources as required by Chapter 110 regulations?
2.
If yes, is the applicant in compliance with all Chapter 110 reporting requirements?
15B - 2
Permitted
Capacity
Expiration
Date
DRBC or SRBC**
Docket Information*
Permit
No.
Permitted
Capacity
Expiration
Date
Yes
No
Yes
No
3900-PM-BSDW0254q
Rev. 7/2013
PUBLIC WATER SUPPLY
MODULE 15-B BULK WATER LOADING STATIONS
Date Prepared:
Date Revised:
PERMIT NO. (FOR DEPARTMENT USE ONLY)
D. LOCATION AND DESCRIPTION OF EACH BULK WATER LOADING STATION
1.
Identification:
Name of taking point:
Is finished water provided at this taking point?
Yes
No
Yes
No
If no, please describe the type of water being
provided and for what purpose.
2.
Location:
Please provide the lat/long and physical
location of the facility.
Is the loading station located near a storage facility to ensure an adequate supply and maintain
system pressure?
3.
Description:
Please provide a description of the facility.
a.
What is the maximum daily withdrawal over 24 hour period?
GPD
Include a water distribution system map and schematic locating water sources, bulk water loading stations,
storage facilities, treatment facilities, and water monitoring/metering points.
E. MOBILE BULK WATER LOADING STATIONS
1.
Does this application include the use of mobile bulk water loading stations?
Yes
No
2.
Mobile bulk water loading stations shall meet all the same regulatory and design standards as fixed loading
stations. Mobile bulk loading station equipment may only be used at approved taking points. List all taking
points associated with this mobile bulk water loading station.
Include a water distribution system map and schematic locating water sources, mobile bulk water loading
station talking points, storage facilities, treatment facilities, and water monitoring/metering points.
15B - 3
3900-PM-BSDW0254q
Rev. 7/2013
PUBLIC WATER SUPPLY
MODULE 15-B BULK WATER LOADING STATIONS
Date Prepared:
Date Revised:
PERMIT NO. (FOR DEPARTMENT USE ONLY)
F. FACILITY DESIGN STANDARDS
1.
CROSS-CONNECTION CONTROL (109.608; PWS Manual, Part II, Section VIII, M & Part V)
a.
Is cross-connection control provided on the service water supply?
Yes
No
b.
Is an air gap used for cross-connection control?
Yes
No
c.
If a backflow prevention device is used, is it a reduced pressure zone device (RPZD)?
Yes
No
If yes,
d.
2.
3.
1)
Is the RPZD properly sized for the service water flow?
Yes
No
2)
Is the RPZD properly sized for the backpressure to be withstood?
Yes
No
3)
Will the RPZD be periodically tested and maintained?
Yes
No
Describe the tank filling procedures and how the source system is protected from backflow during tank
filling operations.
MATERIALS AND SANITARY MEASURES (109.602; 109.606; PWS Manual, Part II, Section II, J)
a.
Do all materials including pipes, fittings, valves, transfer tubing, etc. conform to the latest
standards issued by AWWA, ANSI/NSF, American Standards Association, and ASTM;
and meet the requirements under 109.602 and 109.606?
Yes
No
b.
Does the piping arrangement prevent contaminants from being transferred from a hauling
vessel to others subsequently using the station?
Yes
No
c.
Are hoses protected from contamination by contact with the ground?
Yes
No
PUMPS (PWS Manual, Part II, Section VI)
a.
Where used, is the transfer pump of a design and constructed of materials which
will not degrade the quality of the water?
Yes
No
N/A
b.
Is the transfer pump enclosed in a cabinet to protect against contamination?
Yes
No
N/A
If no, describe how the pump is protected during use.
4.
SECURITY MEASURES (PWS Manual, Part II, Section II, M)
Describe the security measures in place to prevent unauthorized access or tampering.
15B - 4
3900-PM-BSDW0254q
Date Prepared:
Rev. 7/2013
PUBLIC WATER SUPPLY
MODULE 15-B BULK WATER LOADING STATIONS
Date Revised:
PERMIT NO. (FOR DEPARTMENT USE ONLY)
G. FILLING AND DISPENSING PROCEDURES (109.4; 109.702)
1.
Does the operations and maintenance plan provide detailed instructions on the tank loading
and unloading procedures with emphasis on preventing cross-connections at the fill station and
contamination of the transfer tubing?
2.
Briefly describe the filling and dispensing procedures.
Yes
No
H. MEASURES TO PREVENT ADVERSE IMPACTS (109.4)
1.
I.
J.
Describe the measures to prevent adverse impacts to system pressures or water quality (i.e., depletion of
disinfectant residuals).
MEASURES TO MONITOR AND CONTROL OPERATIONS (109.4)
1.
Describe the measures to monitor and control withdrawals, and respond appropriately during times of high
demand, low flow, drought, fire protection, water line breaks and other water supply emergencies.
2.
Does the water system have a Drought Contingency Plan (DCP)?
If yes, what is the date of most recent update?
If no, consider preparing a DCP.
Note: DCPs should be updated every three years.
Yes
No
CODES (CHAPTER 109. SUBSECTION F. DESIGN AND CONSTRUCTION STANDARDS)
1.
Will the proposed facilities meet the requirements as listed in DEP’s Public Water Supply
Manual, Part II, Section I.D.?
Yes
No
2.
Will all materials and chemicals that come in contact with, or affect the quality of the water be
certified for conformance with ANSI/NSF Standards 60 and 61, as applicable?
Yes
No
K. ORIGINAL SEAL AND SIGNATURE OF PROFESSIONAL ENGINEER
Signature of professional Engineer: ______________________________________________
SEAL
15B - 5