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Dam Safety Forms

Dam Safety Annual Certification Form (PDF) 
Dam Safety Annual Certification Form (Word)

Dam Safety Regulations (Part 673.8) require dam owners of Class C - High Hazard or Class B - Intermediate Hazard dams to submit an annual certification to DEC by January 31 of each year. This form provides a means to transmit the required information to DEC.

EAP-C Instructions and Template - High Hazard Dams (PDF)
EAP-C Instructions and Template - High Hazard Dams (Word)

Dam Safety Regulations (Part 673.7(d)) require dam owners of Class C - High Hazard dams to submit an Emergency Action Plan (EAP) to DEC and local emergency responders. This form provides a template that can be used in the development of an EAP for High Hazard dams.

EAP-B Instructions and Template - Intermediate Hazard Dams (PDF)
EAP-B Instructions and Template - Intermediate Hazard Dams (Word)

Dam Safety Regulations (Part 673.7(e)) require dam owners of Class B - Intermediate Hazard dams to submit an Emergency Action Plan (EAP) to DEC and local emergency responders. This form provides a template that can be used in the development of an EAP for Intermediate Hazard dams.

Sample Promulgation and Concurrance Form (PDF)
Sample Promulgation and Concurrance Form (Word)

A Promulgation and Concurrence Form must be submitted for all EAP's to indicate that consultation with local emergency managers has been completed.

Dam Safety Emergency Action Plan (EAP) Requirement of Services of a Professional Engineer - Waiver Application Form (PDF)
Dam Safety Emergency Action Plan (EAP) Requirement of Services of a Professional Engineer - Waiver Application Form (Word)

Dam Safety regulations (Part 673.7(d)) require that owners of Class C - High Hazard dams have a Professional Engineer (P.E.) licensed in NYS prepare their EAP. The dam owner is allowed to make a written request for DEC to waive this P.E. requirement with respect to some or all components of an EAP. This form serves as the  application form for such a waiver.

Dam Safety Property Transfer Form (PDF)
Dam Safety Property Transfer Form (Word)

Dam Safety Regulations (Part 673.11) require that when a dam is sold, or otherwise transferred, both the seller (or transferor) and the buyer (or transferee) must submit one or more "Property Transfer Notices." This form may be used for such notices.

Inspection & Maintenance Plan for Dams - Template (PDF)
Inspection & Maintenance Plan for Dams - Template (Word)

Dam Safety Regulations (Part 673.6) require that dam owners develop and implement an Inspection & Maintenance Plan (I&M Plan) for their dam. This document may be used to assist the dam owner in developing an I&M Plan. The I&M Plan should be tailored for each specific dam and its unique characteristics. The I&M Plan must be implemented by the dam owner and kept on file, but does not need to be submitted to DEC, unless requested.

Dam Post Incident Report Form (PDF)
Dam Post Incident Report Form (Word)

Dam Safety Regulations require dam owners of Class C - High Hazard or Class B - Intermediate Hazard dams to submit a written Incident Report to DEC within 5 days of either of the following:

  • Activation of the Emergency Action Plan (Part 673.7(h))
  • Flow through an erodible auxiliary spillway (Part 673.9)

This form provides a means to submit the incident information to DEC if either situation occurs.

 
 
 
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  • NYSDEC, Division of Water
    Bureau of Flood Protection and Dam Safety
    625 Broadway 4th Floor
    Albany, NY 12233-3504
    518-402-8185
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