Fla. Admin. Code Ann. R. 40D-1.659 - Forms and Instructions
The following forms and instructions have been approved by the Governing Board and are incorporated by reference into this chapter or into a specific District rule as indicated. Copies of these forms may be obtained from the District offices or the District's website at www.WaterMatters.org.
(1) Ground Water:
(a) Application For a Water Well Contractor's
License, Form No. LEG-R.003.01 (4/09), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03728),
incorporated by reference in subsection
40D-3.037(5),
F.A.C.
(b) Application For Renewal
of a Water Well Contractor's License, Form No. LEG-R.004.02 (4/09), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03729),
incorporated by reference in subsection
40D-3.037(5),
F.A.C.
(c) Proposed Well
Construction Location and Design Form, Form No. LEG-R.006.01 (4/09), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03730),
incorporated by reference in paragraph
40D-2.101(5)(a),
F.A.C.
(d) State of Florida Permit
Application to Construct, Repair, Modify, or Abandon a Well, Form No.
LEG-R.040.01 (6/10), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03731),
incorporated by reference in subsection
40D-3.101(1),
F.A.C.
(e) State of Florida Well
Completion Report, Form No. LEG-R.005.02 (6/10), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03732),
incorporated by reference in paragraph
40D-3.411(1)(a),
F.A.C.
(f) Well
Grouting/Abandonment Form, Form No. LEG-R-041.00 (4/09), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03733),
incorporated by reference in subsection
40D-3.531(5),
F.A.C.
(g) Well Verification for
all Non-Domestic Use Wells Located in the Most Impacted Area of the Southern
Water Use Caution Areas, Form No. LEG-R.016.01 (4/09), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03734),
incorporated by reference in subsection
40D-3.101(1),
F.A.C.
(h) Water Use Permit
Application Form No. LEG-R.100.00 (5/14) (http://www.flrules.org/Gateway/reference.asp?No=Ref-03711),
incorporated by reference in subsection
40D-2.101(1),
F.A.C.
(i) Water Use Permit
Application Agricultural Use - Supplemental Form A, Form No. LEG-R.030.02
(5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03712),
incorporated by reference in subsection
40D-2.101(1),
F.A.C.
(j) Water Use Permit
Application - Industrial/Commercial Use - Supplemental Form B, Form No.
LEG-R.031.01 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03741),
incorporated by reference in subsection
40D-2.101(1),
F.A.C.
(k) Water Use Application -
Landscape/Recreation Use - Supplemental Form C, Form No. LEG-R.034.01 (5/14),
(http://www.flrules.org/Gateway/reference.asp?No=Ref-03742),
incorporated by reference in subsection
40D-2.101(1),
F.A.C.
(l) Water Use Permit
Application - Mining/Dewatering Use - Supplemental Form D, Form No.
LEG-R.112.00 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03743),
incorporated by reference in subsection
40D-2.101(1),
F.A.C.
(m) Water Use Permit
Application - Public Supple Use - Supplemental Form E, Form No. LEG-R.033.02
(5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03744),
incorporated by reference in subsection
40D-2.101(1),
F.A.C.
(n) Water Use Permit
Application - Other Use - Supplemental Form F, Form No. LEG-R.109.00 (5/14),
(http://www.flrules.org/Gateway/reference.asp?No=Ref-03745),
incorporated by reference in subsection
40D-2.101(1),
F.A.C.
(o) Water Use Permit
Application - Institutional Use - Supplemental Form G, Form No. 110.00 (5/14),
(http://www.flrules.org/Gateway/reference.asp?No=Ref-03746),
incorporated by reference in subsection
40D-2.101(1),
F.A.C.
(p) Modification Short Form
Application Form No. LEG-R.035.02 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03747),
incorporated by reference in subsection
40D-2.331(2),
F.A.C.
(q) Annual Crop Summary
Report, Form No. LEG-R.102.00 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03758),
incorporated by reference in subsection
40D-2.091(2),
F.A.C.
(r) Agricultural Water
Allotment Form, Form No. LEG-R.042.00 (4/09), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03845),
incorporated by reference in paragraph
40D-2.101(5)(b),
F.A.C.
(s) Application to Transfer
a Water Use Permit, Form No. LEG-R.002.05 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03759),
incorporated by reference in subsection
40D-2.351(1),
F.A.C.
(t) Supplemental Form -
Southern Water Use Caution Area, Form No. LEG-R.007.03 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03660),
incorporated by reference in subsection
40D-2.101(6),
F.A.C.
(u) Net Benefit Supplemental
Form - Southern Water Use Caution Area, Form No. LEG-R.010.02 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03964),
incorporated by reference in paragraph
40D-2.101(6)(b),
F.A.C.
(v) Southern Water Use
Caution Area Ground Water Replacement Credit Application, Form No. LEG-R.011.03
(5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03661),
incorporated by reference in paragraph
40D-2.101(6)(b),
F.A.C.
(w) Public Supply Well
Information and Classification Form, Form No. LEG-R.015.02 (08/11), (http://www.flrules.org/Gateway/reference.asp?No=Ref-00740),
incorporated by reference in paragraph
40D-3.101(2)(b),
F.A.C.
(x) Irrigation Water Use
Form - Annual Crops, Southern Water Use Caution Area, Form No. LEG-R.017.01
(9/12), (http://www.flrules.org/Gateway/reference.asp?No=Ref-01676),
incorporated by reference in paragraph
40D-2.091(2)(b),
F.A.C.
(y) Irrigation Water Use
Form - Annual Landscape/Recreation, Southern Water Use Caution Area, Form No.
LEG-R.018.02 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03666),
incorporated by reference in paragraph
40D-2.091(2)(c),
F.A.C.
(z) Irrigation Water Use
Form - Summer/Fall Seasonal, Southern Water Use Caution Area, Form No.
LEG-R.019.01 (9/12), (http://www.flrules.org/Gateway/reference.asp?No=Ref-01679),
incorporated by reference in paragraph
40D-2.091(2)(d),
F.A.C.
(aa) Irrigation Water Use
Form - Winter/Spring Seasonal, Southern Water Use Caution Area, Form No.
LEG-R.020.01 (9/12), (http://www.flrules.org/Gateway/reference.asp?No=Ref-01680),
incorporated by reference in paragraph
40D-2.091(2)(e),
F.A.C.
(bb) Public Supply Annual
Report for Individual Permits over 100, 000 GPD Annual Average Quantities, Form
No. LEG-R.103.00 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03662),
incorporated by reference in paragraph
40D-2.091(2)(h),
F.A.C.
(cc) SWFWMD Annual Reclaimed
Water Supplier Report, Form No. LEG-R.026.00 (09/09), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03841),
incorporated by reference in paragraph
40D-2.091(2)(i),
F.A.C.
(dd) Dover/Plant City Water
Use Caution Area Supplemental Form - Form No. LEG-R.050.02 (05/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03965),
incorporated by reference in subsection
40D-2.101(7),
F.A.C.
(ee) Net Benefit
Supplemental Form Dover/Plant City Water Use Caution Area - Form No.
LEG-R.051.01 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03966),
incorporated by reference in subsection
40D-2.101(7),
F.A.C.
(ff) University of Florida's
Institute of Food and Agricultural Science's Department of Fisheries and
Aquatic Sciences Publication "Regulations Pertaining to Non-Native Fish in
Florida Aquaculture" (FA-121) (August 2013) (http://www.flrules.org/Gateway/reference.asp?No=Ref-03844),
referenced in Section 2.4.3.3.3. of the Water Use Permit Applicant's Handbook
Part B.
(gg) Flow Meter
Pre-Installation Information Work Sheet, Form No. LEG-R.052.00 (9/12), (http://www.flrules.org/Gateway/reference.asp?No=Ref-02198),
referenced in Section 3.9.4.4. of the Water Use Permit Applicant's Handbook
Part B.
(hh) Flow Meter
Post-Installation Information Reimbursement Form, Form No. LEG-R.053.00 (9/12),
(http://www.flrules.org/Gateway/reference.asp?No=Ref-02199),
referenced in Section 3.9.4.4. of the Water Use Permit Applicant's Handbook
Part B.
(ii) Flow Meter Accuracy
Report Form, Form No. LEG-R.101.00 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03835),
incorporated by reference in subsection
40D-2.091(2),
F.A.C.
(jj) Crop Protection Report
Form, Form No. LEG-R.104.00 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03836),
incorporated by reference in subsection
40D-2.091(2),
F.A.C.
(kk) Water Use/Pumpage
Report Form, Form No. LEG-R.105.00 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03837),
incorporated by reference in subsection
40D-2.091(2),
F.A.C.
(ll) Water Quality Report
Form, Form No. LEG-R.106.00 (5/14), (http://www.flrules.org/Gateway/reference.asp?No=Ref-03838),
incorporated by reference in subsection
40D-2.091(2),
F.A.C.
(2) Surface Water.
The following forms are for use with grandfathered surface water or
environmental resource permit applications or permits. Activities authorized
pursuant to Chapter 62-330, F.A.C., shall use the forms incorporated therein.
(a) Joint Application For: Environmental
Resource Permit/Authorization to Use State Owned Submerged Lands/Federal Dredge
and Fill Permit, Form No. 547.27/ERP (08/11), incorporated by reference in
paragraph 40D-4.101(1)(b),
F.A.C.
(b) Statement of Completion
and Request for Transfer to Operation Entity, Form No. 547.27/SOC (4/09),
incorporated by reference in subparagraph
40D-4.351(2)(a)
1., F.A.C.
(c) Mitigation Bank
Performance Bond to Demonstrate Construction and Implementation Financial
Assurance, Form No. MB/PB (4/09), incorporated by reference in paragraph
40D-4.091(6)(a),
F.A.C.
(d) Mitigation Bank
Irrevocable Letter of Credit to Demonstrate Construction and Implementation
Financial Assurance, Form No. MB/ILC (4/09), incorporated by reference in
paragraph 40D-4.091(6)(b),
F.A.C.
(e) Mitigation Bank Trust
Fund Agreement to Demonstrate Construction and Implementation Financial
Assurance, Form No. MB/CIFA (4/09), incorporated by reference in paragraph
40D-4.091(6)(c),
F.A.C.
(f) Mitigation Bank Trust
Fund Agreement to Demonstrate Perpetual Management Financial Responsibility,
Form No. MB/PMFA (4/09), incorporated by reference in paragraph
40D-4.091(6)(d),
F.A.C.
(g) Notification and Request
For Transfer of Environmental Resource Permit, Form No. LEG-R.043.01 (9/11),
incorporated by reference in paragraph
40D-4.351(1)(a),
F.A.C.
(h) Statement of Inspection
For Proper Operation and Maintenance, Form No. LEG-R.044.00 (4/09),
incorporated by reference in subsection
40D-4.351(3),
F.A.C.
(i) Environmental Resource
Permit Modification Short Form, Form No. LEG-R.013.02 (08/11), incorporated by
reference in paragraph
40D-4.331(2)(b),
F.A.C.
(3) Other:
(a) Electronic Transaction Agreement, Form
No. LEG-R.014.00 (4/08)
(b)
Facilitating Agricultural Resource Management Systems (FARMS) Program Funding
Application Form, Form No. LEG-R.22.02 (8/10), incorporated by reference in
subsection 40D-26.201(2),
F.A.C.
(c) Flow Meter Accuracy
Verification Form, Form No. LEG-R.021.01 (4/09), incorporated by reference in
paragraph 40D-2.091(2)(a),
F.A.C.
(d) Applicant transmittal
Form, Form No. LEG-R.046.01 (08/11), incorporated by referenced in paragraph
40D-1.6051(1)(a),
F.A.C.
(e) Petition For Variance or
Waiver, Form No. LEG-R.42.00-058 (11/15),
http://www.flrules.org/Gateway/reference.asp?No=Ref-06054,
incorporated by reference in subsection
40D-1.1002(1)
and Rule 40D-22.303, F.A.C.
(f) Flow Meter Pre-Installation Information
Work Sheet, Form No. LEG-R.052.00 (9/12), incorporated by reference in
paragraph 40D-2.091(2)(n),
F.A.C.
(g) Flow Meter Post-Installation
Reimbursement Form, Form No. LEG-R.053.00 (9/12), incorporated by reference in
paragraph 40D-2.091(2)(o),
F.A.C.
Notes
Rulemaking Authority 373.044, 373.113, 373.149, 373.171, 373.337 FS. Law Implemented 373.083, 373.116, 373.206, 373.207, 373.209, 373.216, 373.219, 373.229, 373.239, 373.306, 373.308, 373.309, 373.313, 373.323, 373.324, 373.413, 373.414, 373.416, 373.419, 373.421, 373.705, 373.707, 668.50 FS.
New 12-31-74, Amended 10-24-76, Formerly 16J-0.40, 40D-1.901, 40D-1.1901, Amended 12-22-94, 5-10-95, 10-19-95, 5-26-96, 7-23-96, 2-16-99, 7-12-99, 7-15-99, 12-2-99, 5-31-00, 9-3-00, 10-26-00, 6-26-01, 11-4-01, 6-12-02, 8-25-02, 2-26-03, 9-14-03, 9-30-04, 2-1-05, 6-5-05, 10-19-05(1), (2), 10-19-05(5), 10-19-05(20), 2-6-07, 9-27-07, 11-11-07, 11-25-07, 1-8-08, 4-7-08, 5-12-08, 5-20-08, 8-19-08, 12-30-08, 3-26-09, 7-1-09, 8-30-09, 9-1-09, 10-26-09, 1-27-10, 4-12-10, 4-27-10, 9-5-10, 9-12-10, 12-7-10, 1-16-11, 6-16-11, 12-12-11, 12-29-11, 2-9-12, 10-14-12, 2-13-13, 5-19-14, 6-29-14, 2-18-15, 11-22-15.
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