Form WG1

Grant Application for the provision or necessary improvement of an individual water supply to a house

Explanatory Notes:

  1. Please read the Well Grants Guide for the scheme before you complete this form. Please Note: The grant may only be applied for once in any 7 year period
  1. This form must be completed by the property holder applying for the grant and returned to the Water Services Department
  1. This form must be accompanied by –

(a)a site location map of the house concerned (Ordnance

Survey Map Scale 1:2500) and the exact location of the house must be clearly identified on this map to include the XY Coordinates.

(b)where the exact nature and extent of proposed works are known at the time of the application,

-detailed specification of the proposed works,

-a detailed & itemised estimate of cost of the proposed works

(c)Where the deficiency in the supply relates to water quality, a certificate of analysis must be provided from an accredited laboratory¹ which clearly indicates the parameter in question. Whilst a full suite of analysis is not required we would advise that a ‘check²’ analysis is conducted on a sample from your private supply to ensure that common quality deficiencies are indentified at an early stage. See appendix for further details.

Please note: ‘Hardness’ is not a parameter that causes quality deficiencies in water and therefore the installation of water softeners will not be covered by the grant. Similarly, systems installed to remove ‘sodium’ in water that has been softened will not be covered by the grant

  1. Incomplete or unsigned forms will be returned.
  1. Works carried out before a prior inspection by the local authority do not qualify for a grant
  1. Following the completion of works, Meath County Council personnel will conduct an inspection and obtain a sample of the water for analysis. Prior to the final inspection applicants must pay a contribution in the sum of €50 towards the Laboratory fees for water analysis.

1.Full name of

(a)Applicant______

(b)Spouse______

2.Personal Public Service (PPS) Number

(a)Applicant______

(b)Spouse______

(Applicants who do not have a PPS Number should obtain one from their local Social Community and Family Affairs Office)

3.Present Postal Address______

______

______

4.Phone number______

5.Email address______

6.Address of house where water supply is being provided or improved

______

______

7.Age of house ______years

8.If there is an existing supply of piped water in the house?Yes YsNo No

If so, in what respect is it seriously deficient? (Include copy of certificate of analysis with application form)

______

______

______

9.Has any grant in respect of the house been received previously from

- the Department of Environment?Yes Ys No No

- the Department of Arts, Culture & the Gaeltacht?Yes Ys No No

- a local authority?Yes No

If so please give details of such grants (the nature of the grant, Department or authority which paid, date of payment, amount of grant, reference numbers, etc.)

10.Do the proposed works involve (tick as appropriate)

–an up-grading of an existing supply?No

–the provision of a new supply?No

11.Description of the proposed works

______

______

______

12.Will the new or up-graded supply of water be used for non domestic purposes?

Yes Ys No No

13.Estimated cost of proposed works €______

14.Name and Address of Contractor(s)______

______

______

Contact Number(s) for Contractor______

15.Contractor’s income tax reference number______

Contractor’s VAT reference number______

Contractor’s Tax District______

Contractor’s C2 Certificate Number______

Tax clearance Access Number ______

Declaration by the applicant

I declare that –

(a)the information given by me for the purpose of obtaining a grant is correct,

(b)I am aware of the conditions of payment for the grant and believe that these conditions are fulfilled, and

(c)My tax affairs are in order.

I understand that the local authority may make any enquiries from official sources as it may consider necessary entitlement to the grant.

Applicant’s signature______Date______

Application Checklist

To avoid any delays in processing your application, please ensure that you have included the following information

Completed application form

Submission of Site Location Map (Ordnance Survey Map) Scale 1:2500.

(The exact position of the house must be clearly identified on this map and must include XY Coordinates and townland).

Detailed breakdown of cost for proposed works

A certificate of water analysis if applicable

Appendix

Meath County Council,

Water Services Section

Buvinda House

Dublin Rd

Navan,

Co. Meath

C15 Y291

Phone: 046 9097240

Email:

Water Quality Results

¹ Please ensure that the sampling and analysis of your well water is conducted by a laboratory which is accredited to INAB or ISO for purpose of water analysis.

² It is advised that a ‘check’ analysis in accordance with European Union (Drinking Water) Regulations 2014is conducted on your well water. The following parameters are recommended for inclusion in the list of analysis;

Ammonium,

Conductivity,

E.Coli,

pH,

Iron,

Odour,

Coliform Bacteria,

Turbidity,

Nitrate and

Manganese

In certain areas of Meath other chemicals may exist and should be included in the test analysis

  • Bellewstown – arsenic
  • Cortown – arsenic, fluoride etc (mainly effecting deep wells)
  • Kilmessan – fluoride
  • Ballinabrackey – fluoride