Tampering, Threat, & Incident Report
Water Quality Control Division - Safe Drinking Water Program
This report form will satisfy the requirement in Reg 11 to deliver a written report documenting tampering events to the WQCD within 5 days of discovery of the event. To meet the requirement to notify the WQCD by 10am of the following day please call the 24 hour CDPHE report line and indicate that you are reporting a security tampering event to the WQCD acute team -  303-692-3308

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PWSID
PWS Name
PWS Address
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First Name
Last Name
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E-mail Address
Work Phone
Mobile Phone
Are you the Operator in Responsible Charge (ORC)?
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