Managed aquifer recharge (MAR) with reclaimed water is an important water reuse application. As an intentional way of recharging water into aquifers, MAR can be used to address water shortages and contribute to sustainable water resources management practices. The establishment of a MAR system depends on the source of recharge water, the selection of a recharge method and site, the type of water treatment system, and the ultimate purpose of recovered water, and these components are closely related and integrated. However, at present, detailed regulations or guidelines that specifically guide MAR with reclaimed water are unavailable in most countries. The complexity of MAR systems and the lack of a sophisticated regulatory framework increase the difficulties of MAR implementation. This review provides an introduction to MAR with reclaimed water and a comparison of current worldwide water reuse regulations or guidelines, including a proposed approach for MAR implementation. An analysis of selected MAR with reclaimed water case studies was also done within the context of this proposed approach. This paper recommends the development of specific regulatory or design criteria, including a complete quantitative risk assessment framework for the evaluation and operation of MAR systems.

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