Government of Ontario: Ministry of the Environment

Registration and Laboratory Services Notification

Schools, Private Schools and Day Nurseries (O. Reg. 243/07)

Instructions for ALL FACILITIES

School/Private School/Day Nursery Operators must complete and submit this form to the Ministry prior to submitting drinking water samples to your contracted licensed laboratory for testing. This form must be re-submitted within 10 days of any change to the information provided on the form as per subsection 5(6) of O. Reg. 243/07.

Please complete this form and fax/email directly to:

Ministry of the Environment
Drinking Water Programs Branch
Fax: 416 314-8716
Email: reg170_formsubmission.moe@ontario.ca

If you require assistance in completing the form, please call 1 866 793-2588 (toll free).

The most current version of this form is posted on the Ministry of the Environment’s Drinking Water Ontario website at www.ontario.ca/drinkingwater

Form Submission Information
(please check all that apply)




Section 1: Schools, Private Schools and Day Nurseries Information

Type

   
   
   

Interested Authority

     

Location of School/Day Nursery










Contact Information








Section 2: School/Day Nursery Operator Information (if different than Section 1)














Section 3: Co-location Information (if applicable)

“Co-located Facilities”:
Facilities are “co-located” if more than one school, private school, or day nursery is served by the same plumbing. The facilities may be either located in one building (structure) or located in different buildings within one property.

My School/ Private School/ Day Nursery is co-located with another O. Reg. 243/07 facility, as listed below.



Check below if applicable



Check below if applicable



Check below if applicable

If more facilities are co-located with your School /Day Nursery, please fill out as many Section 3 of the form as needed and attach additional sheets.

Section 4: Identification of Licensed Laboratory and Lead Testing

Subsection 5 (5) of O. Reg. 243/07 requires the identification of any contracted licensed laboratory(s) hired to perform lead testing.

The listing of licensed laboratories can be found on: http://www.ontario.ca/drinkingwater/271380.pdf

Please check one of the following:



Failure to notify the parties in accordance with the Regulation and/or submission of false information constitutes an offence.

Name/Contact Information of Licensed
Laboratory Performing Lead Testing

(Your licensed laboratory can assist with completing this section of the form)










I declare that the information provided on this form is accurate.

Prepared by







Collection of information on this form by staff of the Drinking Water Management Division on behalf of the Ministry of the Environment is in accordance with the Safe Drinking Water Act, 2002 (SDWA) and its regulations. The collection, use and dissemination of this information are governed by the Freedom of Information and Protection of Privacy Act (FOIPPA). The information gathered herein will be used for the purpose of registration and compliance and may be used for secondary purposes including reporting, investigating and law enforcement under the SDWA and its regulations. Information on this form, including personal information, may be disclosed to other government agencies including municipalities, public health unit employees and the Ministry of Health and Long Term Care pursuant to section 42 of FOIPPA for the consistent purpose of administering programs related to drinking water safety. For questions and concerns, please contact the Ministry of the Environment at 1 866 793-2588.