Florida Administrative Code
40 - WATER MANAGEMENT DISTRICTS
40D - Southwest Florida Water Management District
Chapter 40D-1 - PROCEDURAL
Part VI - PERMITTING
Section 40D-1.659 - Forms and Instructions

Universal Citation: FL Admin Code R 40D-1.659

Current through Reg. 50, No. 187; September 24, 2024

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.

http://www.flrules.org/Gateway/reference.asp?No=Ref-02270.

(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.

http://www.flrules.org/Gateway/reference.asp?No=Ref-02271.

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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