Consolidated Statutes and Regulations
Consolidated Statutes
Consolidated Regulations
Annual Statutes and Regulations
Annual Statutes
Annual Regulations
Additional information
Québec Official Publisher
What’s new?
Information note
Policy of the Minister of Justice
Laws: Amendments
Laws: Provisions not in force
Laws: Provisions brought into force
Annual Statutes: PDF versions since 1996
Regulations: Amendments
Annual Regulations: PDF versions since 1996
Court Decisions
Q-2, r. 21 - Regulation respecting waterworks and sewer services
Schedule
Disposition versions
FORM 6
(s. 49)
GOUVERNEMENT DU QUÉBEC
MINISTÈRE DU DÉVELOPPEMENT DURABLE, DE L’ENVIRONNEMENT ET DES PARCS
APPLICATION FOR A WATERWORKS SYSTEM OPERATING PERMIT
In accordance with section 32.1 of the Environment Quality Act (chapter Q-2), the undersigned applicant hereby applies for a waterworks system operating permit.
For such purpose, the applicant gives the following information:
1. Name and address of individual, partnership, association, legal person or company applying for the permit:
Name: ______________________________________________________________________
Address: ____________________________________________________________________
2. Nature of applicant: individual, partnership, association, legal person or company, (strike off inapplicable designations).
3. Date and place of registration or constitution (in the case of a partnership, association or legal person)
____________________________________________________________________________
4. Person responsible for administration:
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Telephone number: ____________________________________________________________
(area code)
5. Person responsible for operation:
Name: ______________________________________________________________________
Address: ____________________________________________________________________
Telephone number: ____________________________________________________________
(area code)
6. Give the following information on the table hereunder:
(a) name of the municipality (ies) where the service will be provided and their designation as city, town, village, parish, township, etc., name or number of the range(s) to be served;
(b) number of subscribers in each municipality where the service will be provided; (in the case where the system is operated by a municipality, give the total number of the entire system and, separately, the number of subscribers outside the territory of the municipality which operates the system);
(c) number of hydrants in each municipality (where applicable):
_______________________________________________________________________
| | | | |
| Name of municipality | Name or number | Number of | Number of |
| and designation | of range(s) | subscribers | hydrants |
|________________________|__________________|_____________|_____________|
|________________________|__________________|_____________|_____________|
| | | | |
|________________________|__________________|_____________|_____________|
| | | | |
|________________________|__________________|_____________|_____________|
| | | | |
|________________________|__________________|_____________|_____________|
| | | | |
|________________________|__________________|_____________|_____________|
| | | | |
|________________________|__________________|_____________|_____________|
| | | | |
|________________________|__________________|_____________|_____________|
7. Total length of the main and secondary conduits, with the exception of inlets or service pipes:
____________________________________________________________________________
8. Total length of conduits, diameter, nature and year of installation; (in the case where the system is operated by a municipality, specify which conduits are installed within and which conduits are installed outside the municipal territory):
________________________________________________________________________________
| | | | |
| Length | Diameter | Nature | Year |
|_____________________|____________________|__________________|__________________|
| | | | |
|_____________________|____________________|__________________|__________________|
| | | | |
|_____________________|____________________|__________________|__________________|
| | | | |
|_____________________|____________________|__________________|__________________|
| | | | |
|_____________________|____________________|__________________|__________________|
| | | | |
|_____________________|____________________|__________________|__________________|
| | | | |
|_____________________|____________________|__________________|__________________|
9. The detailed annual tariffs in each municipality where the service will be provided (in the case where the system is operated by a municipality, give the detailed tariffs which will be in force outside the municipal territory):
________________________________________________________________________________
|________________________________________________________________________________|
| || || || |
| Annual tariff for || Name of || Name of || Name of |
| || municipality || municipality || municipality |
|_____________________||__________________||__________________||_________________|
|_____________________||__________________||__________________||_________________|
| || || || |
| || || || |
|_____________________||__________________||__________________||_________________|
| || | || | || | |
| || Number | Tariff || Number | Tariff || Number | Tariff |
| ||_________|________||_________|________||________|________|
| || | || | || | |
| House || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| 1st faucet || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Additional faucets || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Bath || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Water-closets || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Hose || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Cooler || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Heating || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Automobile || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Hydrants || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Farmers || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Animals || | || | || | |
| or || | || | || | |
| Stables || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Presbytery and || | || | || | |
| church * || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| School * || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Convent * || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Hotel || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Store || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Commercial or || | || | || | |
| industrial || | || | || | |
| establishments || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| Miscellaneous || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| || | || | || | |
|_____________________||_________|________||_________|________||________|________|
| || | || | || | |
| || | || | || | |
|_____________________||_________|________||_________|________||________|________|
|________________________________________________________________________________|
| |
| * Immovables followed by an asterisk are not subject to rates in the case |
| where the operator of the system is a municipality. |
|________________________________________________________________________________|
N.B. If another tariff method is used, give details on a separate sheet.
10. Average depth of conduits in the ground: ______________________________________________
11. Nature of soil: ___________________________________________________________________
12. The waterworks will operate:
by gravity ______________________________________________________________________
or by pumping (details, where applicable): _____________________________________________
13. The flow and pressure of each pump in litres per minute or per hour and the power of the motor driving it:
________________________________________________________________________________
|________________________________________________________________________________|
| | | |
| Flow | Pressure | Power |
|________________________|__________________________|____________________________|
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
14. Will the water be treated? filtered ________________________________________ chlorinated ______________________________________________________ Give a description of the devices __________________________________________________________________________________
15. Supply sources of the waterworks (stream, lake, spring, well, etc.)
_______________________________________________________________________________
(indicate name of the lake or water course, where applicable)
16. If the water comes from a source already measured, indicate the minimum flow noted:
_______________________________________________________________________________
17. Year of inauguration of service:
_______________________________________________________________________________
18. Capacity, dimensions and nature (wood, concrete, steel) of reservoir(s):
________________________________________________________________________________
|________________________________________________________________________________|
| | | |
| Capacity | Dimensions | Nature |
|________________________|__________________________|____________________________|
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
| | | |
|________________________|__________________________|____________________________|
19. Will the reservoirs rest on the ground or on a metal or wooden structure?
______________________________________________________________________________
20. On what date are the subscriptions collected? ________________________________________
21. Will the subscription be payable in advance? ________________________________________
22. Cost of system with its accessories: _______________________________________________
23. If water is purchased from another waterworks, give name and address of vendor and purchase price:
Name _______________________________________________________________________
Address _____________________________________________________________________
Purchase price: _______________________________________________________________
24. Annex the following documents:
(a) A plan or sketch of the waterworks system (in the case of a waterworks system operated by a municipality, indicate which conduits are outside the municipal territory);
(b) A copy of the contract forms used for the various services;
(c) A copy of the by-laws (where applicable);
(d) A copy of the financial report covering the last year of operations. In the absence of such report, it will be necessary to submit a detailed statement of the assets and liabilities together with the receipts and expenditures for the past year;
(e) recent certificate of the water analysis of the supply source(s).
25. Give all additional information on the sheet attached hereto.
_______________________________________
Applicant
Date: this_____________________ 20_____
ADDITIONAL INFORMATION TO BE PROVIDED WHERE NECESSARY
