| #Q001 | operational | health | recommended | Source-to-tap or water safety plan approach | drinking water | a priority focus on drinking water process management, for example, through the implementation of a source-to-tap or water safety plan approach, is the recommended strategy for water utilities to manage potential risks. | To manage potential risks from waterborne pathogens | high |
| #Q002 | reporting | reporting | recommended | Education and outreach programs | drinking water | Water utilities should also have education and outreach programs to make consumers aware of how water quality can deteriorate within residential and building plumbing systems. | | high |
| #Q003 | operational | health | recommended | Building water management plans | drinking water | Building water management plans are the recommended best practice for building owners/managers. | | high |
| #Q004 | monitoring | health | recommended | Multi-parameter risk management strategies | drinking water | water utilities and building owners/managers should have appropriate risk management strategies that utilize multiple parameters to assess the performance of drinking water treatment and/or distribution operations. | | high |
| #Q005 | monitoring | health | recommended | Source water assessments contents | drinking water | Source water assessments should include: the identification of potential sources of microbiological contamination in the watershed/aquifer; potential pathways and/or events (low to high risk) by which microorganisms of concern can make their way into the source water and affect water quality; and conditions likely to lead to peak concentrations. | | high |
| #Q006 | monitoring | health | recommended | Subsurface source assessments | drinking water | Assessments for subsurface sources should include, at a minimum, a hydrogeological assessment, an evaluation of well integrity and a survey of activities and physical features in the area | When evaluating subsurface sources | high |
| #Q007 | monitoring | health | guidance | Land-based and aerosol-generating activities risk assessment | drinking water | It is important that risks from both land-based and aerosol-generating activities (e.g., spray irrigation, pressure washers) be considered in the source water assessment. | | high |
| #Q008 | monitoring | health | recommended | Nutrient concentration characterization | drinking water | surface and subsurface sources should be characterized with regard to organic and inorganic nutrient concentrations | | high |
| #Q009 | treatment | treatment | recommended | Produce biologically stable water | drinking water | Water utilities should therefore aim to produce biologically stable water to minimize the potential for problems to occur in distribution and premise plumbing systems | | high |
| #Q010 | treatment | treatment | guidance | Optimize treatment for turbidity and NOM | drinking water | Important elements related to drinking water treatment include: optimize treatment performance for turbidity and natural organic matter removal; | | high |
| #Q011 | treatment | treatment | guidance | Apply primary disinfection properly | drinking water | Important elements related to drinking water treatment include: properly apply primary disinfection technologies to meet appropriate CT (disinfectant concentration in mg/L × time in minutes) requirements when using chemical oxidants (i.e., free chlorine, ozone, chlorine dioxide) or IT (intensity measured in mW/cm2 or W/m 2× time measured in seconds resulting in a computed fluence in mJ/cm2) requirements when using ultraviolet (UV) disinfection; | when using chemical oxidants or UV disinfection | high |
| #Q012 | treatment | treatment | guidance | Minimize nutrient concentrations in treated water | drinking water | Important elements related to drinking water treatment include: minimize nutrient concentrations in treated water and have a good understanding of their concentrations in the distribution system; | | high |
| #Q013 | treatment | treatment | guidance | Optimize treatment to minimize scaling and corrosion | drinking water | Important elements related to drinking water treatment include: optimize treatment to minimize the amount of scaling and/or corrosion in the distribution system; | | high |
| #Q014 | treatment | treatment | guidance | Apply secondary disinfection | drinking water | Important elements related to drinking water treatment include: properly apply secondary disinfection technologies (i.e., free chlorine or monochloramine) for residual maintenance in the distribution system; | | high |
| #Q015 | monitoring | health | guidance | Conduct performance testing at treatment plant | drinking water | Important elements related to drinking water treatment include: conduct performance testing using multiple parameters (e.g., disinfectant residual, microbiological indicators, pH, turbidity); | | high |
| #Q016 | operational | operational | guidance | Provide operator training | drinking water | Important elements related to drinking water treatment include: provide operator training to assure the effectiveness of the water safety plan at all times. | | high |
| #Q017 | prohibition | treatment | recommended | Monochloramine for secondary disinfection only | drinking water | It is important to note that monochloramine is recommended only for secondary disinfection and residual maintenance in the distribution system | | high |
| #Q018 | monitoring | health | recommended | Multi-parametric monitoring in distribution system | drinking water | Comprehensive, multi-parametric monitoring programs (e.g., disinfectant residual paired with temperature and biofilm formation rate) are recommended to confirm system-specific requirements | | high |
| #Q019 | design | operational | guidance | Use proper construction materials | drinking water | Key distribution system operational and maintenance practices include: use proper construction materials; | | high |
| #Q020 | corrective_action | treatment | guidance | Maintain disinfectant residual and take preventive/corrective actions | drinking water | Key distribution system operational and maintenance practices include: maintain an effective disinfectant residual and take preventive/corrective actions when low disinfectant residuals occur, particularly during warm water temperature conditions when biofilm growth accelerates; | when low disinfectant residuals occur | high |
| #Q021 | operational | operational | guidance | Manage water age and temperature | drinking water | Key distribution system operational and maintenance practices include: manage water age and the effects of temperature; | | high |
| #Q022 | operational | health | guidance | Minimize contaminant entry from external sources | drinking water | Key distribution system operational and maintenance practices include: minimize the potential for contaminant entry from external sources (e.g., maintain positive pressure, implement cross-connection/backflow control programs, practice strict hygiene during mains constructions and repairs); | | high |
| #Q023 | operational | operational | guidance | Keep distribution system clean | drinking water | Key distribution system operational and maintenance practices include: keep the distribution system clean by removing biofilm, loose deposits and sediment from watermains and storage facilities (e.g., use of appropriate flushing and cleaning techniques); | | high |
| #Q024 | monitoring | health | guidance | Conduct performance testing in distribution system | drinking water | Key distribution system operational and maintenance practices include: conduct performance testing using multiple parameters (e.g., disinfectant residual, microbiological indicators, biological stability indicators, pH, pressure, temperature, turbidity); | | high |
| #Q025 | operational | operational | guidance | Provide operator training for distribution | drinking water | Key distribution system operational and maintenance practices include: provide operator training to assure the effectiveness of the water safety plan at all times. | | high |
| #Q026 | reporting | reporting | recommended | Educate customers on premise plumbing | drinking water | Thus, water utilities should educate their customers of the potential for water quality deterioration in premise plumbing. | | high |
| #Q027 | operational | health | guidance | Building owner responsibility for water quality | drinking water | Building owners/managers are responsible for managing water quality within their buildings and therefore should be aware of practices that reduce the risk of microorganism growth. | | high |
| #Q028 | design | treatment | guidance | Limit nutrient levels in plumbing | drinking water | Important elements of control strategies for plumbing systems include: limiting nutrient levels through an emphasis on system design and materials; | | high |
| #Q029 | design | operational | guidance | Minimize areas of low flow or stagnation | drinking water | Important elements of control strategies for plumbing systems include: minimizing areas of low flow/stagnation; | | high |
| #Q030 | operational | treatment | guidance | Manage cold and hot water system temperatures | drinking water | Important elements of control strategies for plumbing systems include: keeping temperatures of cold and hot water systems outside of the ideal range for microorganism growth (e.g., cold water less than 20°C, hot water tank temperature greater than 60°C; hot water lines at distal points ideally greater than 55°C); | | high |
| #Q031 | operational | health | guidance | Reduce aerosol formation and transmission | drinking water | Important elements of control strategies for plumbing systems include: reducing the formation and transmission of contaminated aerosols from system components such as cooling towers, showers, faucets, hot tubs and humidifiers. | | high |
| #Q032 | administrative | reporting | recommended | Contact responsible authority for specific requirements | drinking water | In addition, building owners/managers should contact the responsible authority in the affected jurisdiction to confirm if specific requirements will apply to their system (e.g., cooling tower registry). | | high |
| #Q033 | reporting | reporting | guidance | Establish education and outreach programs | drinking water | Establish education and outreach programs to inform water consumers about the risks posed by water quality degradation from the source to the tap | | high |
| #Q034 | administrative | operational | recommended | Consult responsible authority for forecast scenarios | drinking water | The responsible authority should be consulted to discuss relevant forecast scenarios. | | high |
| #Q035 | operational | operational | recommended | Integrate climate change risks into management strategies | drinking water | Thus, water utilities and building owners/managers should integrate the risks associated with climate change into their management strategies to maximize the reliability, robustness and resilience of their water systems. | | high |
| #Q036 | prohibition | treatment | recommended | Prohibition of monochloramine for primary disinfection | drinking water | Monochloramine should not be used for primary disinfection due to its low oxidation potential; monochloramine is recommended only for secondary disinfection (i.e., to maintain a disinfectant residual in the distribution system) | | high |
| #Q037 | monitoring | health | guidance | Residential physical inspection and testing | drinking water | For residential-scale systems and private wells, regular physical inspection to identify deficiencies and testing of the water system (e.g., for Escherichia coli and total coliforms) to confirm the microbiological quality of the water are important. | | high |
| #Q038 | treatment | health | recommended | Use certified drinking water treatment devices | drinking water | Where treatment is necessary, Health Canada recommends that consumers use devices certified by an accredited certification body as meeting the appropriate NSF International (NSF)/American National Standards Institute (ANSI) drinking water treatment unit standards | Where treatment is necessary | high |
| #Q039 | monitoring | health | guidance | Include additional parameters when microbiological problems suspected | drinking water | Where problems with the microbiological quality of the drinking water are suspected, it may be useful to include additional parameters (e.g., HPC) in the analysis | Where problems with the microbiological quality of the drinking water are suspected | medium |
| #Q040 | administrative | operational | recommended | Obtain specific guidance from responsible authority | drinking water | Specific guidance on construction, operation, maintenance and testing should be obtained from the responsible drinking water authority in the affected jurisdiction. | | high |
| #Q041 | monitoring | health | recommended | Environmental monitoring informed by site-specific risk assessment | drinking water | Thus environmental monitoring at individual facilities should be informed by a site-specific risk assessment as part of a Water Management Plan | | high |
| #Q042 | administrative | treatment | recommended | Consult water treatment professional before supplemental disinfection | drinking water | A water treatment professional should be consulted before applying any supplemental disinfection. | before applying any supplemental disinfection | high |
| #Q043 | design | operational | recommended | Positioning of mixing valves | drinking water | Mixing valves should be positioned as close as possible to the point of use and provide access for maintenance and cleaning | | high |
| #Q044 | operational | treatment | recommended | Minimum weekly flushing of plumbing | drinking water | Guidance documents for building systems recommend minimum weekly flushing of low flow pipe runs, dead ends/dead legs and infrequently used fittings or outlets | | high |
| #Q045 | operational | health | recommended | Regular cleaning and maintenance of plumbing fittings | drinking water | Additional actions recommended as part of a water safety plan include regular cleaning and maintenance of plumbing fittings and equipment that can support biofilm growth and aerosol formation (faucets, showerheads, hot tubs/spas, cooling towers) | | high |
| #Q046 | operational | health | guidance | Cleaning and maintenance of plumbing fittings for Acanthamoeba control | drinking water | As part of a general facility water management plan, building system managers may implement regular cleaning and maintenance of plumbing fittings and equipment that can support biofilm growth and aerosol formation (e.g., faucets, showerheads, hot tubs/spas, cooling towers). | | high |
| #Q047 | operational | health | recommended | Guidance for contact lens wearers | drinking water | Individuals in the home who wear contact lenses should also follow guidance from their eye care providers on proper lens handling, cleaning and wear | For individuals who wear contact lenses | high |
| #Q048 | operational | health | recommended | Use boiled or distilled water for nasal rinses | drinking water | individuals should ensure that they conduct nasal rinses using water that has been boiled and cooled, or distilled water. | when conducting nasal rinses | high |
| #Q049 | operational | health | guidance | Opportunistic pathogen awareness for water management | drinking water | It is important that those responsible for managing drinking water quality be aware that the absence of indicator bacteria (e.g., Escherichia coli , total coliforms) does not indicate the absence of opportunistic pathogens such as Legionella and Mycobacterium. | | high |
| #Q050 | treatment | treatment | guidance | Disinfectant concentration adjustment for biofilm removal | drinking water | Water utilities that regularly remove biofilms and loose deposits from their distribution systems may require lower concentrations. | For systems that regularly remove biofilms and loose deposits | high |
| #Q051 | operational | treatment | recommended | Electric storage-type water heater temperature preset | drinking water | electric storage-type water heaters should be pre-set to a temperature of 60°C as a result of the temperature stratification that can occur with this type of heater. | | high |
| #Q052 | operational | treatment | guidance | Building flushing frequency for at-risk populations | drinking water | For buildings with larger numbers of at-risk individuals, more frequent flushing may be needed, as determined by the risk assessment | For buildings with larger numbers of at-risk individuals | high |
| #Q053 | treatment | treatment | recommended | Chlorine residual for Naegleria control | drinking water | Maintaining a minimum free chlorine residual of 0.5 mg/L throughout the distribution system is recommended for the control of N. fowleri in vulnerable drinking water systems | In vulnerable drinking water systems | high |
| #Q054 | monitoring | operational | recommended | Biofilm control disinfectant residual targets | drinking water | Studies indicate that disinfectant residual concentrations in the order of 1.0 mg/L free chlorine (for systems that chlorinate) and 1.8 mg/L total chlorine (for systems that chloraminate) are required for controlling biofilm formation | for systems aiming to control biofilm growth in the distribution system | high |
| #Q055 | operational | health | guidance | Maximum water outlet temperature (scalding prevention) | drinking water | The NPC specifies that water valves supplying showerheads and bathtubs should be capable of maintaining a water outlet temperature that does not exceed 49°C in order to reduce the risk of scalding | for plumbing valves supplying showerheads and bathtubs | high |
| #Q056 | operational | health | guidance | Plumbing flushing precaution | drinking water | Care should be taken during plumbing flushing procedures. | during plumbing flushing procedures due to potential aerosol generation | high |
| #Q057 | operational | health | guidance | Eyewash station microbiological control | drinking water | Control of Acanthamoeba spp. may be particularly important in some specialised uses of water such as emergency eye-wash stations. | for emergency eye-wash stations | high |
| #Q058 | treatment | treatment | recommended | Monochloramine residual for Naegleria control | drinking water | The suggested best practice for a chloramine residual of greater than 1.5 mg/L throughout the distribution system (Health Canada, 2020b) is sufficient for N. fowleri control | for systems using chloramination in Naegleria-vulnerable areas | high |
| #Q059 | treatment | treatment | mandatory | Protozoa control for Legionella mitigation | drinking water | Providing effective control of free-living protozoa in drinking water (e.g., Acanthamoeba , Naegleria – see Section B.2.2) is also necessary for reducing Legionella populations | within treatment plant processes to manage downstream Legionella risks | high |
| #Q060 | operational | operational | recommended | Balancing secondary disinfectant objectives | drinking water | the choice of disinfectant residual should effectively balance concomitant water quality objectives related to: 1) microbial species (e.g., Legionella , mycobacteria); 2) water chemistry; 3) disinfection by-product concentrations; and 4) the complexity of the distribution system (Donohue et al., 2019a). | When choosing a secondary disinfectant for residual maintenance | high |
| #Q061 | administrative | operational | mandatory | Tap temperature regulatory compliance | drinking water | Applications of temperature management strategies should operate in accordance with regulations in place regarding maximum allowable temperatures at the tap. | When implementing temperature management strategies in plumbing | high |
| #Q062 | operational | treatment | recommended | Legionella control co-benefits | drinking water | Ideally, selected controls for Legionella should have benefits for the control of other pathogens in water systems (NASEM, 2020). | | high |
| #Q063 | monitoring | health | guidance | Integrated Legionella monitoring programs | drinking water | In general, monitoring programs consist of routine monitoring of general microbiological quality, as an indication of system control, in conjunction with testing for Legionella at regular time intervals | as part of a Water Management Plan | high |