Public Notification

&EPA	Handbook for

United States
Agency

mental Protection	Transient

Noncommunity Water
Systems

3rd Revision of Document: EPA816-R-23-001, March 2023

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(Original Public Notification Handbook Document: EPA 816-R-00-010, June 2000)

(Document updated and prepared for Transient Noncommunity Water Systems: EPA 816-R-07-004, March 2007)
(2nd Revision of Document: EPA 816-R-09-009, March 2010)

(3rd Revision of Document: EPA 816-R-23-001, March 2023)

Office of Water (4606)
816-R-23-001
March 2023

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This handbook provides guidance to states, public water systems, and the general public concerning how the
Environmental Protection Agency (EPA) interprets its public notification regulations. This document does not,
however, substitute for the public notification regulations, nor is it a regulation itself. Thus, it cannot impose
legally-binding requirements on EPA, states, or water suppliers and may not apply to a particular situation. This
document is not intended, nor can it be relied upon, to create any rights enforceable by any party in litigation
with the United States. EPA may decide to follow the guidance provided in this document, or to act at variance
with the guidance based on its analysis of the specific facts present. This guidance may be revised without public
notice to reflect changes in EPA's approach to implementing public notice, or to clarify and update text.

You should read the regulations thoroughly to ensure that you are in compliance. The public notification (PN)
Rule is in the Code of Federal Regulations under Chapter 40, Part 40 CFR 141, Subpart Q. beginning at section 40
CFR 141.201. The most recent version of the Rule can be found at the U.S. Government Publishing Office's
(GPO'si Web site.

This document includes public notification requirements and information for all applicable regulations through
December 2020.

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Public Notification Handbook for

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Contents

Contents	iii

Acronyms	iv

1.	Introduction	1

2.	How to Use This Handbook	3

3.	Summary of Requirements	5

What kinds of violations and situations require public notice?	5

What information do I need to include in each notice for a violation or situation?	7

What standard language do I have to include in my public notices?	8

What information do I need to include for special public notices if my state has allowed my NCWS to exceed
the nitrate standard up to 20 mg/L?	8

What information do I need to include for special notice for repeated failure to conduct required
Cryptosporidium monitoring?	9

What information do I need to include for special notice for failure to determine my bin classification or my
mean Cryptosporidium level?	9

Deadlines for issuing public notice	10

Required methods of delivery	11

Are there formatting requirements for public notices?	11

4.	Suggestions for Layout of the Notice	13

How should the notice be formatted to get people's attention?	13

How can I make a notice easier to read?	13

How should I tailor the notice to my situation?	14

5.	Suggestions for Effective Public Notice Delivery	15

How can I make posting effective?	15

What other methods are available to reach all consumers?	15

After providing the notice, what information must I provide my state?	16

Procedures for Returning to Compliance	16

Appendix A: Templates for TNCWSs	21

Tier 1 Templates	21

Tier 2 Templates	47

Tier 3 Templates	89

Appendix B: NPDWR Violations and Other Situations Requiring Public Notice1	103

Appendix B—Endnotes	107

Appendix C: Standard Health Effects Language for Public Notification	110

Appendix C—Endnotes	121

Appendix D: Translated Phrases	124

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Acronyms

CFE

Combined Filter Effluent

CFR

Code of Federal Regulations

DBP

Disinfection Byproducts

EPA

United States (US) Environmental Protection Agency

FBRR

Filter Backwash Recycling Rule

FDA

United States Food and Drug Administration

GWR

Ground Water Rule

HPC

Heterotrophic Plate Count

IESWTR

Interim Enhanced Surface Water Treatment Rule

LT1ESWTR

Long Term 1 Enhanced Surface Water Treatment Rule

LT2ESWTR

Long Term 2 Enhanced Surface Water Treatment Rule

MCL

Maximum Contaminant Level

mg/L

Milligrams per Liter

MRDL

Maximum Residual Disinfectant Level

MRDLG

Maximum Residual Disinfectant Level Goal

NPDWR

National Primary Drinking Water Regulation

NTU

Nephelometric Turbidity Unit

PN

Public Notification

PWS

Public Water System

RTCR

Revised Total Coliform Rule

Stage 1 DBPR

Stage 1 Disinfectants and Disinfection Byproducts Rule

SWTR

Surface Water Treatment Rule

TCR

Total Coliform Rule

TT

Treatment Technique

UV

Ultraviolet Light

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1. Introduction

The purpose of this handbook is to explain the U.S. Environmental Protection Agency's (EPA's) Public
Notification (PN) Rule and provide specific examples of public notices. This version of the handbook updates the
March 2010 version (EPA 816-R-09-013). It reflects necessary changes in light of recent EPA regulations,
including the Revised Total Coliform Rule (RTCR) and other rule-related updates. New templates for some
violations and situations of these rules are included.

This version of the handbook updates the March 2010 version (EPA 816-R-09-013). It reflects necessary changes
in light of new EPA regulations, including the Revised Total Coliform Rule (RTCR) and other rule-related updates.

This handbook is geared to the specific needs of transient noncommunity water systems (TNCWSs) that must
issue a notice when faced with a violation or situation affecting their water supply. TNCWSs provide drinking
water to a population that changes day to day. They include, among others, campgrounds, hotels, rest areas,
and restaurants with their own water supplies. The majority of these systems are very small, serving 500 people
or less.

Public notification is designed to protect public health. As a public water supplier, you are required by law to
prepare and distribute public notification to consumers. One of the best ways water systems can contribute to
community health is to make sure people within a service area know about water quality issues and how to
protect themselves from potential risks.

All water system operators share an obligation to protect the health of their consumers. Regardless of the
system type, all consumers have the same general health risk concerns. It is important to note that PN is the
responsibility of the PWS, the time allotted for public notice begins when you find out about the violation.

Throughout this document, tips and suggestions are provided to help you create an effective communication
strategy for meeting the public notification requirements under the PN Rule. The suggestions contained in this
document are based on the guiding principles for good risk communication and public education1, including:

•	Accept and involve the public as a legitimate partner.

•	Listen carefully to the public's concerns.

•	Be honest, frank, and open.

•	Coordinate and collaborate with other credible sources.

•	Meet the needs of the media.

•	Speak clearly and with compassion.

•	Plan carefully and evaluate your efforts.

The communication strategy outlined in this document will help water systems plan for effective public
notification by analyzing the population they serve, determining the best ways to reach consumers, and creating
effective channels for distributing public notices.

This handbook complements EPA's Revised Public Notification Handbook (EPA 816 -R-23-002, March 2023),
which was written for community water systems (CWSs) and nontransient noncommunity water systems
(NTNCWSs). The Revised Public Notification Handbook provides more detail on risk communication and public

1 From: Covello, V.T. and Sandman, P.M. 2001. "Risk Communication: Evolution and Revolution." In: Wolbarst, A, ed. Solutions to and
Environment in Peril. Baltimore, MD: Johns Hopkins Univ. Press, pp 164-178.

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education strategies, with a focus on reaching large, diverse populations via a wide variety of communication
methods, including radio and television. TNCWS operators may benefit from reading that version as well.

In addition to increasing the effectiveness of public notices, this handbook should make TNCWS owners' and
operators' jobs easier and help them comply with federal and state PN Rule requirements. This handbook
contains templates designed for posted notices for several violations and situations that are relevant to
TNCWSs. The templates are located in Appendix A.

Throughout this document, the terms "state" and "states" are used to refer to all types of primacy agencies
including states, U.S. territories, Native American tribes, and EPA Regions that maintain state primacy. Note that
the PN Rule requirements described in this handbook are based on federal regulations. Citations provided within
the document refer to specific sections found in Title 40 of the Code of Federal Regulations (e.g., 40 CFR
141.201). States or tribes may have alternate public notice requirements or more stringent drinking water
standards. You should check with your state to make sure you meet its specific requirements.

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2. How to Use This Handbook

This handbook contains information to help you prepare and issue a public notice. Before you are faced with a
violation or situation requiring public notification, you should read this handbook. You should also check with
your state to determine if there are additional public notification requirements or if more stringent public
notification requirements apply. The steps to take to respond to a drinking water violation or other situation
requiring notice are listed below:

1.	Determine what tier your violation or situation falls into. Use Table 1 in Chapter 3 for a summary of
violations and situations requiring notice and your deadline for providing public notice. You can also
refer to Appendix A for a listing by contaminant [40 CFR 141.201(a)!.

2.	Consult your state if required.

a.	For violations and situations requiring Tier 1 public notification, consult with your state as
soon as practical, but no later than 24 hours after you learn of the violation or situation [40

CFR 141.202(b)1. You must issue the notice within 24 hours, even if you are unable to contact
the state.

b.	If you treat surface water or ground water under the direct influence of surface water, and
have a single exceedance of turbidity limits or a two-day turbidity maximum contaminant
level (MCL) violation, immediately consult with your state when you learn of the violation.

Your state will determine whether the violation needs to be elevated to Tier 1 public
notification [40 CFR 141.203(b)!.

3.	Review the requirements for public notices. Read Chapter 3 in this guidance, which describes content,
mandatory language, formatting, and the distribution requirements that are applicable to all notices.
Chapter 4 provides guidance on effective public communication.

4.	Determine the appropriate method(s) of delivery. For TNCWSs, this is generally posting or hand
delivery, plus another method. Table 2 in Chapter 3 summarizes requirements for issuing a public
notice. See Chapter 5 on "Suggestions for Effective Public Notice Delivery" for other ideas on
appropriate delivery methods for different situations.

5.	Develop a notice. You can use the templates that fit your situation or write your own. Templates for
violations or situations are provided in Appendix A of this handbook, along with specific instructions
for modifying each template. The instructions for each template are on the front of the page; the
corresponding template is on the back. Public Notification Templates for Community and Non-
transient Non-community Water Systems are available at https://www.epa.gov/dwreginfo/public-
notification-templates-communitv-and-non-transient-non-community-water-systems. . If there is no
template for your specific violation or situation, write your own notice using the list of required
elements or other applicable requirements provided in Chapter 3. Chapter 4 provides tips for
formatting an effective notice. Most violations and situations have required language regarding health
effects [40 CFR 141.205(d)!. This language is discussed in Chapter 3. found in Appendix C. and included
in the templates provided in this document.

6.	Provide information for non-English speakers. If a large proportion of the population you serve does
not speak English, the public notice must contain information in the appropriate language regarding
the importance of the notice, and provide contact information at the water system for additional
assistance [40 CFR 141.205(c)!. See Chapter 3 for more information on how to determine if you need

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to include translations and how to get help translating notices. See Appendix D of this document for
information on some important and relevant phrases translated into various languages.

7.	Provide your notice to persons served as soon as practical, but within the required time frame. Use
the method of delivery chosen in step 4 above.

8.	Send a copy of each notice issued (including repeat notices) to your state. The copy is due to your
state within 10 days of distribution, along with a statement certifying that all public notification
requirements have been met [40 CFR 141.31(d)!. See the sample certification statement in Chapter 5.

Plan in advance for Public Notification

Any advance work that you can do to prepare for a public notification effort will really pay off if you are faced
with a violation or situation.

•	Create a list of emergency contacts, including staff at the state, people who can help copy or distribute a
notice on short order, or people who can translate your notice.

•	Know in advance what languages are spoken by your customers. In many areas of the country operators
should plan on providing notices in English and Spanish, at a minimum. See the discussion of translations in

Chapter 3.

•	Think about methods of delivery that would most effectively reach your consumers. Posting in a central
location will reach transient populations in many situations, but other methods are also required. See
Chapter 5 for ideas.

•	If your water system is "prone" to certain types of violations (e.g., nitrate exceedances in agricultural areas)
be prepared to deal with these, especially during the growing season, when fertilizers are applied.

•	Prepare to have bottled water or an alternative water supply available if needed.

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3. Summary of Requirements

You should read this handbook before a violation or other situation occurs to familiarize yourself with the
public notification process and requirements. This chapter summarizes the federal PN Rule requirements. This
chapter discusses the types of violations or situations that require public notice, the required elements of a public
notice, and the timing and method of delivery of the notice based on the severity of the potential health risk.
Except where noted, all requirements in this chapter can be found in the Code of Federal Regulations (CFR) at 40
CFR 141, Subpart Q. beginning at section 40 CFR 141.201. See the U.S. Government Publishing Office's (GPO's)
Web site for the current version of the federal PN Rule. Check with your state to see if more stringent
requirements apply.

What kinds of violations and situations require public notice?

In general, public notice is required for any of the following:

•	Violations of MCLs or maximum residual disinfectant levels (MRDLs).

•	Violation of treatment techniques (TT).

•	Monitoring, testing procedure, and reporting violations.

•	Failure to comply with the schedule of a variance or exemption.

Other situations (not violations) which require public notice include:

•	Occurrence of a waterborne disease outbreak or other waterborne emergency.

•	Fecal indicator-positive ground water source sample.

•	Special public notice for exceedance of the nitrate MCL in noncommunity water systems (NCWSs) that
have been granted permission by the state to continue to exceed the nitrate MCL of 10 milligrams per
liter (mg/l) (although they may not exceed 20 mg/l).

•	Special public notice for exceedance of the fluoride secondary MCL (SMCL) - community water system
(CWS) only.

•	Special public notice for availability of unregulated contaminant monitoring results.

•	Operation under a variance or exemption.

•	Special public notice for failure to 3 or more Cryptosporidium samples.

•	Special public notice for failure to determine bin classification or mean Cryptosporidium level.

States may also require notice for other violations or situations.

EPA has assigned each violation and situation requiring public notice to one of three categories, or public
notification tiers, based on the risk of adverse health effects (see Appendix C).

•	Violations and situations with significant potential to have serious adverse health effects on human
health as a result of short-term exposure require Tier 1 public notification.

•	Violations and situations with potential to have serious adverse health effects on human health require
Tier 2 public notification.

•	All other violations and identified situations not included in the list in Appendix A as requiring Tier 1 or
Tier 2 public notification require Tier 3 public notification.

Table 1 on the next page shows the organization of violations and situations into tiers based on the seriousness
of potential adverse health effects. For a complete list of contaminants and their appropriate tiers, refer to

Appendix B.

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Table 1. Violations and Situations Requiring Public Notice by PN Rule Tier

Tier 1 - Violations and Other Situations Requiring Notice Within 24 Hours*

•	Violation of the MCLfor E. coli if the system: [141.63(c) and 141.S60(a)1

o Has an E. coli-positive REPEAT sample following a total coliform-positive ROUTINE sample,
o Has a total coliform-positive REPEAT sample following an E. co/i-positive ROUTINE sample,
o Fails to take all required REPEAT samples following an E. coli-positive ROUTINE sample,
o Fails to test for E. coli when any REPEAT sample tests positive for total coliform.

•	Violation of the MCL for nitrate, nitrite, or Total Nitrate + Nitrite.

•	When a nitrate or nitrite confirmation sample is not taken within 24 hours of the system's receipt of the first
sample showing exceedance of the nitrate or nitrite MCL.

•	Special public notice for exceedance of the nitrate MCL (10 mg/l) by NCWSs, where permitted to exceed the MCL
(up to 20 mg/l) by the state.

•	Violation of the alternate nitrate MCL of 20 mg/L by a NCWS allowed to go up to 20 mg/L [40 CFR 141,23(o)1

•	Violation of the MRDL for chlorine dioxide when one or more of the samples taken in the distribution system on
the day after exceeding the MRDL at the entrance of the distribution system, or when required samples are not
taken in the distribution system.

•	Violation of the turbidity MCL of 5 NTU, where the state determines after consultation that a Tier 1 notice is
required or where consultation does not occur in 24 hours after the system learns of violation.

•	Violation of the treatment technique requirement resulting from a single exceedance of the maximum allowable
turbidity limit, where the state determines after consultation that a Tier 1 notice is required or where consultation
does not take place in 24 hours after the system learns of violation.

•	Occurrence of a waterborne disease outbreak, as defined in 40 CFR 141.2.. or other waterborne emergency.

•	Detection off. coli, enterococci, or coliphage in a ground water source sample.

•	Other violations or situations with significant potential to have serious adverse effects on human health as a result
of short-term exposure, as determined by the state either in its regulations or on a case-by-case basis.

* If the system experiences any of these violations or situations, in addition to issuing public notice, it must initiate
consultation with the state as soon as practical but within 24 hours after learning of the violation or situation. Note:
Initiate consultation means that at a minimum, the system has taken steps to contact the state. EPA and most states
now have voicemail or an emergency hotline, so systems should be able to leave a message. If the system is not able to
reach anyone within the 24-hour period, the system must still issue public notice within that timeframe. When
consultation does occur, the state or EPA will inform the system of any additional steps they must take as a follow-up to
the initial notice.

Tier 2 - Violations and Other Situations Requiring Notice Within 30 Days**

•	All violations of MCL, MRDL and TT requirements except where Tier 1 public notice is required.

•	Violations of monitoring requirements where the state determines that a Tier 2 public notice is required, taking
into account potential health impacts and persistence of the violation.

•	Failure to comply with the terms and conditions of any variance or exemption in place.

•	For ground water systems providing 4-log treatment for viruses, failure to maintain required treatment for more
than 4 hours.

•	Failure to take corrective action within the required timeframe or be in compliance with a state-approved
corrective action plan and schedule for a fecal indicator-positive source sample under the Ground Water Rule
(GWR).

•	Failure to take corrective action within the required timeframe or be in compliance with a state-approved
corrective action plan and schedule for a significant deficiency under the GWR.

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Tier 2 - Violations and Other Situations Requiring Notice Within 30 Days**

•	Special public notice for repeated failure to conduct monitoring for Cryptosporidium (40 CFR 141.211).

•	Special public notice for failure to determine bin classification or mean Cryptosporidium level (40 CFR 141.211).

** If the system exceeds the maximum allowable turbidity level, as identified in Appendix A to Subpart Q, it must consult
with the state as soon as practical but no later than 24 hours after learning of the violation. Note: Consult with the state
means that the system contacts and has a discussion with the state about the violation. If the system does not have a
consultation with the state within the 24-hour period, a Tier 1 public notice requirement is automatically triggered, and
the system must issue a public notice within the next 24-hour period. This is in contrast to the term "initiate
consultation" for violations or situations requiring Tier 1 public notification, here EPA intends that the system actually
have a discussion about the violation or situation.

Tier 3 - Violations and Other Situations Requiring Notice Within 1 Year

•	Monitoring violations, except where a Tier 1 notice is required or the state determines that the violation requires a
Tier 2 notice.

•	Failure to comply with an established testing procedure, except where a Tier 1 notice is required or the state
determines that the violation requires a Tier 2 notice.

•	Operation under variance granted under § 1415 or exemption granted under § 1416 of the Safe Drinking Water Act.

•	Failure to submit a completed assessment form after a system properly conducts an assessment in a timely
manner. ri41.860(d)(l)1

•	Failure to notify the state following an E. coli-positive ROUTINE OR REPEAT sample in a timely manner.

ri41.860(d)(2)1

•	Failure by a seasonal NCWS to submit certification of completion of state-approved start-up procedures.

ri41.860(d)(3)1

What information do I need to include in each notice for a violation or situation?

Your public notice must include specific information listed in the following text box order to be considered
complete. For each violation and situation requiring notice (except for operation under a variance or
exemption), you must provide a clear and easy-to-understand explanation of the following 10 elements [40 CFR
141.205(a)!:

1.	Description of the violation or situation, including the contaminant(s) of concern, and (as applicable) the
contaminant level(s).

2.	When the violation or situation occurred (e.g., date the sample was collected or was supposed to be
collected).

3.	Any potential adverse health effects from the violation or situation, using standard language for health
effects provided in Appendix B to 40 CFF	ibpart Q or for monitoring or testing procedure
violations provided in 40 CFR 141.205(d)(2) or later in this chapter.

4.	The population at risk, including subpopulations that may be particularly vulnerable if exposed to the
contaminant in their drinking water.

5.	Whether alternate water supplies should be used.

6.	Actions consumers should take, including when they should seek medical help, if known.

7.	What you are doing to correct the violation or situation.

8.	When you expect to return to compliance or resolve the situation.

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9.	Your name, business address, and phone number, or those of a designee of the PWS as a source of
additional information concerning the notice.

10.	A statement encouraging notice recipients to distribute the notice to others, where applicable, using the
standard language given in this chapter.

What standard language do I have to include in my public notices?

Health effects language for MCL and MRDL violations, treatment technique violations, and violations of the
conditions of a variance or exemption. You must include the health effects language specified in Appendix C for
such violations. You must also describe potential health effects for other situations, even if there is no
mandatory language. Contact your local health department or primary agency for suggestions.

Lanauaae to encourage the widest possible distribution of the notice to all persons served. You must include the
following language in all notices where applicable. There are situations where this may not apply—for example,
this language would probably not be necessary on a posted notice, since posting makes the notice available to
everyone who passes by.

"Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or
mail."

Use of this language does not relieve you of your obligation to notify persons served.

Lanauaae for monitoring violations (including testing procedure violations). You must include the following
language for all monitoring and testing procedure violations:

"We are required to monitor your drinking water for specific contaminants on a regular basis. Results of
regular monitoring are an indicator of whether or not your drinking water meets health standards.
During [compliance period], we ['did not monitor or test' or 'did not complete all monitoring or testing']
for [contaminant(s)], and therefore cannot be sure of the quality of your drinking water during that
time."

What information do I need to include for special public notices if my state has allowed my
NCWS to exceed the nitrate standard up to 20 mg/L?

When a NCWS has been given permission by the state to provide water in excess of the nitrate MCL (although
no higher than 20 mg/L), the NCWS is required to issue a special public notice in a form and manner similar to
public notice meeting Tier 1 requirements. The notice must be continuously posted and must include the
mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) as written. The notice must
contain the 10 required elements. See Template NC1-5 for an example.

In addition, if the NCWS incurs a nitrate violation (i.e., the average of two sample results > 20mg/L), then the
system must issue a Tier 1 public notice for the violation in addition to continuously posting the special public
notice f40 CFR 141.23(o)l.

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What information do I need to include for special notice for repeated failure to conduct
required Cryptosporidium monitoring?

Surface water systems that incur a violation for failure to sample for Cryptosporidium in the source water for any
three months as required under the Long Term 2 Enhanced Surface Water Treatment Rule (LT2ESWTR) are
required to issue special public notice in a form and manner similar to public notice meeting Tier 2
requirements. The notice must include the following text as written (with information in brackets filled in).

"We are required to monitor the source of your drinking water for Cryptosporidium. Results of the
monitoring are to be used to determine whether water treatment at the [treatment plant name] is
sufficient to adequately remove Cryptosporidium from your drinking water. We are required to
complete this monitoring and make this determination by [required bin determination date]. We ["did
not monitor or test" or "did not complete all monitoring or testing"] on schedule and, therefore, we may
not be able to determine by the required date what treatment modifications, if any, must be made to
ensure adequate Cryptosporidium removal. Missing this deadline may, in turn, jeopardize our ability to
have the required treatment modifications, if any, completed by the deadline required, [date].

For more information, please call [name of water system contact] of [water system name] at [phone
number]."

The notice must contain the 10 required elements, including a description of what you are doing to correct the
violation and when you expect to return to compliance or resolve the situation. See Template NC2-16 for an
example.

What information do I need to include for special notice for failure to determine my bin
classification or my mean Cryptosporidium level?

Surface water systems that fail to determine their bin classification or mean Cryptosporidium level after
completing source water monitoring required under LT2ESWTR are required to issue special public notice in a
form and manner similar to public notice meeting Tier 2 requirements. The notice must include the following
text as written (with information in brackets filled in).

"We are required to monitor the source of your drinking water for Cryptosporidium in order to
determine by [date] whether water treatment at the [treatment plant name] is sufficient to adequately
remove Cryptosporidium from your drinking water. We have not made this determination by the
required date. Our failure to do this may jeopardize our ability to have the required treatment
modifications, if any, completed by the required deadline of [date]. For more information, please call
[name of water system contact] of [water system name] at [phone number]."

The notice must contain the 10 required elements, including a description of what you are doing to correct the
violation and when you expect to return to compliance or resolve the situation. See Template NC2-17 for an
example of failure to determine bin classification or Template NC2-18 for an example of failure to determine
mean Cryptosporidium level.

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SPECIAL NOTICE FOR GROUND WATER RULE (GWR) UNCORRECTED SIGNIFICANT DEFICIENCIES

Under the GWR, if the state identifies a significant deficiency and it is uncorrected (after a specified amount of
time), special notice is required.

This GWR special notice is required if the significant deficiency has not been completely corrected within 12
months of notification of the deficiency. This notice is required regardless of whether a violation has occurred.
This special notice is not a public notification requirement and, therefore, the content, form, and manner
requirements do not apply. However, the special notice must include:

•	The nature of the significant deficiency.

•	The date it was identified by the state.

•	The state-approved plan and schedule for correction (including interim measures, progress to date, and any
interim measures completed) [40 CI	03(a)(7)(ii)1.

The following text illustrates an example of special notice for this violation:

On September 14, 2013, we were informed by the State Department of Public Health that a significant deficiency,
two leaking septic tanks near our source water supply, had been identified during a September 1, 2013 sanitary
survey.

As required, we contacted the State Department of Public Health and were directed to make arrangements with
the owner of the property on which the septic tanks are located to have the tanks replaced. We did not do so
within the established deadline. Since being informed of the deficiency, we have been conducting regular testing
of our source water and we are implementing the corrective action plan established by the Department of Public
Health. Under this plan, the leaking tanks will be replaced by October 20, 2018.

Deadlines for issuing public notice

The deadline for issuing a public notice varies by tier.

•	For Tier 1 public notification, you must provide the notice as soon as practical but no later than 24
hours after you learn of the violation or situation. In addition, you must contact the state within 24
hours to determine additional public notice requirements such as the length of time the notice must be
posted and if repeat notices are needed.

•	For Tier 2 public notification, you must provide the notice as soon as practical but no later than 30 days
after you learn of the violation or situation. If you post the notice, you must keep it posted for as long as
the violation or situation lasts, but in no case for less than seven days (even if you resolve the violation
or situation before seven days). You must repeat the notice every three months as long as the violation
or situation lasts.

•	For Tier 3 public notification, you must provide the notice no later than one year after you learn of the
violation or situation. If you post the notice, you must keep it posted for as long as the violation or
situation lasts, but in no case for less than seven days (even if you resolve the violation or situation
before seven days). You must repeat the notice annually for as long as the violation or situation lasts.

Generally, a violation or situation is considered resolved when the water system has returned to compliance as
defined by the regulation in question; however, you may wish to contact your state to determine whether a
violation or situation is considered resolved.

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Required methods of delivery

The delivery methods vary by tier as follows:

•	For violations and situations requiring Tier 1 public notification, you must use one of the following
methods to distribute required notices: posting in a conspicuous place throughout the system, hand
delivery, or radio and/or television. You may need to use another method such as publication in a
community newspaper or posting at a community center to reach other persons served [40 CFR
141.202(c)!.

•	For violations and situations requiring Tier 2 or 3 public notification, you must use posting in a
conspicuous place throughout the system, by mail or direct delivery, plus another method such as
publication in a newspaper or posting at a community center to reach others if they would not normally
be reached by the first method.

Posting will probably be the most effective delivery method for the vast majority of TNCWSs. Your state may
allow you, in writing, to use a different method of delivery for any tier. See Chapter 5 on "Suggestions for
Effective Public Notice Delivery" for additional ideas on how various types of businesses can meet notice
delivery requirements.

You must also post every notice for as long as the violation or situation exists to let visitors or new employees
know of the situation. If the violation or situation has already been resolved, Tier 2 and 3 notices must still be
posted for at least seven days [40 CFR 141.2.03(b): 40 CFR 141.2.04(b)!.

Are there formatting requirements for public notices?

All public notices must meet certain formatting standards. These requirements will help highlight your notice in
the newspaper or other printed or posted format and ensure that consumers can easily read and understand the
notice.

Notices must: [40 CFR 141.205(c)(1)!

•	Be displayed in a conspicuous way (where printed or posted).

•	Not contain overly technical language or very small print.

•	Not be formatted in a way that defeats the purpose of the notice.

•	Not contain language which nullifies the purpose of the notice.

Your state may have special formatting requirements. Check to be sure that you meet all of its requirements.

Remember that your goal is to inform and protect the public and the best way to do that is to make it easy for
them to understand your message. Messages are easiest to understand when they are presented in the
audience's first language. When it comes to communicating risks, it is important to make it as easy as possible
for your audience to understand your message. Clarity and simplicity help people understand risks and put them
in perspective.

If a large proportion of the population you serve does not speak English, the PN Rule requires that your notice
must, at a minimum, contain information in the appropriate language(s) regarding the importance of the notice,
or it must provide a phone number or address where a translated notice or information or assistance in the
appropriate language is available. Your state may have established criteria for what constitutes a large
proportion of the people you serve; check with the state to be sure.

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To facilitate translations, especially for violations or situations requiring Tier 1 public notification, establish
contacts with institutions and people who can translate notices into other languages for you. Community
centers and universities can help provide translations. If your system is in an area where a language other than
English is predominant (for example in the Southwest, where Spanish is commonly spoken), there is a good
chance that some of your employees may also speak that language. These employees can be valuable assets if
you need to translate a notice or respond to questions. Spanish-language templates for nitrate and E. coli
notices are provided in Appendix A of this handbook.

EPA has resources available for any language barriers and translations in multiple languages. Information can be
found on the EPA's website www.epa.gov. specifically Information for Individuals with Limited English
Proficiency https://www.epa.gov/lep and Processes for Assisting People with Limited English Proficiency

https://www.epa.gov/ogc/assisting-people-limited-english-proficiency. can be found by clicking the links
provided. Specific questions can be asked by using the EPA's Contact Page and more information will be
provided to you.

Appendix D provides translations of several useful phrases that convey the importance of the message and the
need to have it translated.

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4. Suggestions for Layout of the Notice

In addition to meeting the formatting requirements discussed in Chapter 3, notices for TNCWSs should be
appropriate to the consumers' situation. For example, visitors at a rest stop just need to be aware they should
not drink the water, rather than being told to boil it. See Appera of this handbook for examples of postings.

Formatting Hints

•	Limit the notice to one page.

•	Display important elements in bold and/or large type and/or all upper-case letters.

•	List each of the most important elements on a separate line and center the text, leaving a blank line
between each element.

•	Other required elements, such as health effects and your corrective actions, can be provided in paragraph
format, with a title for each paragraph if space permits.

How should the notice be formatted to get people's attention?

A person walking by a posted notice is unlikely to read the entire notice. Therefore, you should format the
notice so that consumers will see and read the most important information first. Posters should include a title
designed to catch people's attention. For example, "WARNING" is better than "Public Notice." It should
highlight the population at risk (if applicable), provide actions consumers should take, state a very short
description of the violation or situation, and tell where to obtain alternative sources of water if alternative water
supplies should be used.

How can I make a notice easier to read?

Most readers only read the top half of a notice (or what can be read in 10 seconds) and focus on large text such
as headings and bolded text. The most important information, especially instructions to protect consumers'
health, should be placed on the top half of the notice in large print. Smaller type is appropriate for the less
critical elements, such as what the system is doing, an explanation of the cause of the violation or situation, etc.
You must still include all the required elements in the notice.

Remember that some of your consumers may have limited reading abilities. It is important that notices do not
contain overly technical or confusing language. Whoever on your staff is responsible for responding to questions
about the notice should keep in mind that it may be necessary to read or explain the entire notice. If many of
the visitors to your system are young children, remember that they do not read at an adult level, and their
parents may not see a posted notice (for example, at a rest stop, children may use the bathrooms while their
parents wait outside).

If your system serves a large proportion of non-English speaking people, include the appropriate translated
phrases provided in Appendix D. Appendix D also includes simple pictures that convey the concept of "do not
drink the water," that would be understood by someone who cannot read. These pictures would also grab the
attention of people passing by.

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How should I tailor the notice to my situation?

If you are providing bottled or other sources of water:

•	List the location from which you are distributing it.

•	If you use water for cooking or ice making (e.g., at a restaurant), be sure to let customers know that you
are using bottled water for this purpose.

•	Confirm ahead of time and periodically reconfirm that available bottled water supplies meet the U.S.
Food and Drug Administration (FDA) and/or state bottled water safety standards.

If your system supplies water to people for cooking (such as a campground), your notice should provide
instructions on how to use the water to cook. The following are examples for nitrate, E. coli, or arsenic
violations:

•	For a nitrate violation, instruct consumers that boiling the water will not make the water safe for infants
as boiling only makes nitrates more concentrated. In this scenario, the water should not be provided to
infants.

•	For a E. coli violation, instruct consumers to use boiled water for brushing teeth, washing dishes and
food preparation.

•	For an arsenic violation, instruct consumers to not boil the water as that will concentrate the
contaminant.

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5. Suggestions for Effective Public Notice Delivery

Most TNCWSs can probably use some combination of posting and hand delivery. For instance, a campground
should post notices in bathrooms or at water pumps and hand out flyers to campers as they register. A resort or
hotel should hand deliver notices to guests' rooms or cottages, as well as post notices in common areas.

How can I make posting effective?

Post notices at all water fountains, kitchen and bathroom sinks, ice machines, soda machines, coffee makers, on
bulletin boards, outside administrative offices, and at any other appropriate central locations. Posted notices
must remain posted for as long as the violation or situation lasts, in all cases no less than seven days, even if the
violation or situation is resolved [40 CFR 141.203(b) and 40 CFR 141.204(b)!. This is especially important for
TNCWSs, where consumers are continuously entering and leaving the area served.

Be sure that the notice is durable. It should not blow away if posted outdoors. Consider laminating notices that
will be placed over sinks or outside, especially if they are likely to remain there for an extended time. You can
make door hangers for hand delivery. Knot a rubber band through a hole punched in the notice and put the
rubber band around door knobs. This method will be useful at a hotel or a campground with cabins.

What other methods are available to reach all consumers?

You may also want to use some of these ideas, in addition to one of the required methods listed above:

•	Spoken word — If you are hand delivering notices and time permits, take the time to explain the
situation as you deliver the notice, or have a meeting to explain the situation to your employees,
students, etc. For notifications at a hotel or campground, speak to guests as they register.

•	Sound trucks — Sound trucks (or police cars with speakers) might be useful as a supplement to hand
delivery for violations or situations that have potential for serious adverse health effects as a result of
short-term exposure. They are most appropriate for distribution at a time of day when most people are
expected to be in a concentrated area such as a beach or campground.

•	Answering machines — Consider including public notice information on the greeting of your answering
machine or voicemail. The greeting can be updated as you make progress in resolving the violation or
situation. It also enables you to at least partially answer your customers' questions and address the
violation at the same time.

•	Community organizations — You might distribute multiple copies to nearby social service agencies or
clinics. This way doctors or case workers will be informed if their patients or clients ask them about the
implications of the violation or situation.

•	Automatic dialers — Some phone systems can be programmed to send voicemail to every extension.
This might be useful to notify guests at a hotel or resort.

•	In-house/Cable television — Some hotels have in-house cable television systems in which you can put
information about the violation on the "hotel information" station. For potentially serious adverse
health effects as a result of short-term exposure, ask a local television station or cable company to put
"scrollers" across the screen similar to National Weather Service announcements for extreme weather.

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•	E-mail — If you have e-mail addresses for people registering at your facility you could also e-mail the
public notice.

•	Website and Social Media Platforms - Your facility may post the public notice to your website or various
social media forums, if available.

After providing the notice, what information must I provide my state?

After you provide the notice to your consumers, you must, within 10 days, send your state a copy of each type
of notice you distribute (e.g., newspaper article, press release to television/radio, mail notices) and a
certification that you have met all the public notification requirements [40 CFR 141.31(d)!. You must send
certifications for both initial and any repeat notices.

A sample certification "box" with appropriate language is provided below. Although a certification is mandatory,
this example is only one suggested format. Contact your state; they may have a certification form they require
to be submitted to them. If your state does not have a required certification form for you to use, you may wish
to copy this certification (with appropriate blanks filled in) onto the bottom or reverse of the copy of the public
notice you send to the state.

Sample Certification "Box"

PWS Name: [water system namel	

PWS ID #: [PWS ID numberl	

For Violation: [describe violation or situation]	

Occurring on: [datel	

The public water system indicated above hereby affirms that public notice has been provided to consumers in
accordance with the delivery, content, and format requirements and deadlines in [regulatory citation].

Consultation with state (if required) on: [datel	.

Notice distributed by: [methodl	on: [datel	.

Notice distributed by: [methodl	on: [datel	.

Content - required elements.

Signature of owner or operator	Date

Procedures for Returning to Compliance

If your system has not adequately provided public notification to the consumer or intended audience, the water
system will remain out of compliance. It is important to take steps to achieve compliance, so the public is
properly aware of the potential issues or hazards with their drinking water.

Water systems can achieve compliance once the system issues proper public notification in the form, manner,
and frequency required.

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Water systems that fail to submit a certification documenting PN distribution can achieve compliance when the
system submits certification to the state that it has fully complied with the public notification requirements.

Water systems that are required to consult with the state, must initiate a consultation with the state to achieve
compliance. This includes water systems that were required to provide Tier 1 public notice and failed to initiate
the consultation with the state. The water system is returned to compliance once they consult with the primacy
agency. [40 CFR 141.202(b)(2)!

Systems that have a failure to send adequate, timely, and repeat public notice for failure to comply with any
schedule prescribed pursuant to a variance or exemption can achieve compliance by sending adequate, timely,
and repeat public notice for failure to comply with any schedule prescribed pursuant to a variance or exemption,
or timely and adequate notice after the granting of a variance or exemption. [40 CFR 141.6(c). 40 CFR 141.201.
40 CFR141.204(a)-(b). 40 CFR 141.205(b), 40 CFR 141.206. and Appendix A to Subpart Q of Part 1411

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Appendices

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Appendix A: Templates for TNCWSs

The pages that follow contain templates recommended for use by TNCWSs. They are generally designed for
posting, and are tailored to water systems where consumers will not be able to boil or otherwise treat their
water. You should modify the templates, if necessary, to meet the needs of your system (e.g., if you operate a
campground and have an E. coli violation, you should provide information on boiling the water), but remember
to include all 10 required elements of a public notice. Along with each template are instructions on how to
complete the template, and suggestions for methods of delivery and modifying individual sections of the notice.
These suggestions are designed to supplement the handbook, so you may see much of the information repeated
here.

Each template also includes the mandatory health effects language from Appendix B to 40 CFR 141 Subpart Q
(presented in italics in each notice, with an asterisk on either end). This information must be included as
written; with additional violation or situation specific information added in the brackets.

You must also include the following italicized language in all notices, where applicable [40 CFR 141.205(d)!. This
language will encourage word-of-mouth communication of the problem. Use of this language does not relieve
you of your obligation to take steps reasonably calculated to notify all persons served:

Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example¦, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail.

Tier 1 Templates

•	RTCR E. coli MCL Violation Notice - Template NCl-l

•	RTCR E. coli MCL Violation Notice in Spanish - Template NC1-1A

•	Nitrate MCL Violation -Template NC1-2

•	Nitrate MCL Violation Notice in Spanish - Template NC1-2A

•	Nitrate Failure to Take a Confirmation Sample - Template NC1-3

•	Special Notice: NCWS Allowed Up to 20 mg/L Nitrate - Template NC1-4

•	NCWS Allowed > 20 mg/L Nitrate that Exceed 20 mg/L - Template NC1-5

•	Chlorine Dioxide MRDL- Template NC1-6

•	Combined Filter Effluent (CFE) Maximum Turbidity Exceedance, or Turbidity Single Exceedance -
Template NC1-7

•	Waterborne Disease Outbreak - Template NC1-8

•	Fecal Indicator-Positive Source Sample - Template NC1-9

•	Problem Corrected - Template NC1-10

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Instructions for E. coli MCL Violation Notice - Template NC1-1

Template below

Description of Violation or Situation

An E. coli maximum contaminant level (MCL) violation requires Tier 1 public notification. This violation occurs when any
public water system has:

A total coliform-positive routine sample result followed by an E. coli-positive repeat sample result;

An E. coli-positive routine sample result followed by a total coliform-positive repeat sample result;

An E. coli-positive routine sample result and fails to take all required repeat samples; or
A total coliform-positive repeat sample result and fails to test for E. coli.

You must provide public notice to persons served as soon as practical but no more than 24 hours after learning of the MCL
violation [40 CFR 141.2.02(b}1. During this time, you must also contact your state. You should also coordinate with your local
health department. You must use one or more of the following methods to deliver the notice to consumers [40 CFR

32(c)!:

Radio
Television

Hand or direct delivery

Posting in conspicuous locations

Another method approved in writing by the state

You may need to use additional methods (e.g., newspaper or delivery of multiple copies to hospitals, clinics, or apartment
buildings) since notice must be provided in a manner reasonably calculated to reach all persons served. If you post or hand
deliver, EPA recommends printing your notice on your system's letterhead, if you have it.

The notice on the reverse is appropriate for hand delivery or for publication in a newspaper. However, you may wish to
modify it before using it for a radio or television broadcast. If you do modify the notice on the reverse, you must still include
all required public notice elements from 40 CFR 141.205(a) and leave the mandatory language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q.) must be included as written and is
presented in this notice in italics with an asterisk on each end. You will need to update the information presented in
brackets with the appropriate information.

You must also include standard language to encourage the distribution of the public notice to all persons served, where
applicable [40 CFR 141,205(d)1. This language is also presented in this notice in italics with an asterisk on each end.

Alternative Sources of Water

If you are providing bottled water, your notice should say where it can be obtained. If you are providing bottled water,
make sure it meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

Corrective Action

In your notice, you must describe corrective actions you are taking [40 CFR 141,205(a)(7)! and when you expect to return to
compliance or resolve the situation [40 CFR 141,205(a)(8)1. Listed below are some steps commonly taken by water systems
with the presence off. coli. Depending on the corrective action you are taking, you can use one or more of the following
statements, if appropriate, or develop your own text:

We are completing a comprehensive assessment of our water system and of our monitoring and operational practices
to identify and correct any causes of the contamination.

We are chlorinating and flushing the water system.

We are switching to an alternate drinking water source.

We are increasing sampling for coliform bacteria to determine the source of the contamination.

We are repairing the wellhead seal.

We are repairing, cleaning, and disinfecting the storage tank.

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We are restricting water intake from the river/lake/reservoir to prevent additional bacteria from entering the water
system and restricting water use to emergencies.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification
requirements to your state within 10 days after the original or any repeat notice(s) [40 CFR 141,31(d)1.

It is recommended that you notify health professionals in the area of the violation. People may call their doctors with
questions about how the violation may affect their health, and the doctors should have the information they need to
respond appropriately. In addition, health professionals, including dentists, use tap water during their procedures and need
to know about the potential contamination so they can use bottled water.

It is a good idea to inform your consumers when the violation has been resolved. See Template 1-6 of the Revised Public
Notification Handbook (2nd Revision of Document: EPA 816-R-09-013, March 2010) for a "problem corrected" notice
template and Template NCI-10 of the Public Notification Handbook for Transient Non-community Water Systems, EPA
816-R-09-009, March 2010.

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E. coli MCL Violation Notice - Template NC1-1

DRINKING WATER WARNING
E. coli is present in [Water System Name]'s water
BOIL YOUR WATER BEFORE USING

[Briefly describe the situation, such as: "E. coli bacteria were found in the water supply on [give date]" or "We did not
perform required testing of the water system and must assume that E. coli bacteria are in the water as of [give date]]. These
bacteria can make you sick, and are especially a concern for people with weakened immune systems.

Bacterial contamination can occur when increased run-off enters the drinking water source (for example, following heavy
rains). It can also happen due to a break in the distribution system (pipes) or a failure in the water treatment process.

What should I do? What does this mean?

• DO NOT DRINK THE WATER WITHOUT BOILING IT FIRST. Bring all water to a boil, let it boil for one minute and let
it cool before using, or use bottled water. Boiled or bottled water should be used for drinking, making ice, brushing
teeth, washing dishes, and food preparation until further notice. Boiling kills bacteria and other organisms in the
water.

*E. coli are bacteria whose presence indicates that the water may be contaminated with human or animal wastes.
Human pathogens in these wastes can cause short-term effects, such as diarrhea, cramps, nausea, headaches, or
other symptoms. They may pose a greater health risk for infants, young children, the elderly, and people with
severely compromised immune systems. *

The symptoms above are not caused only by organisms in drinking water. If you experience any of these symptoms
and they persist, you may want to seek medical advice. People at increased risk should seek advice from their
healthcare providers about drinking this water.

What is being done?

[Describe corrective action]. We will inform you when tests show no bacteria are present and you no longer need to boil
your water. We anticipate resolving the problem within [estimated timeframe].

For more information, please contact [name of contact] at [phone number] or [mailing address]. General guidelines on
ways to lessen the risk of infection by bacteria and other disease-causing organisms are available from the EPA Ground
Water and Drinking Water Website at httpsi//www,epa,gov/ground~water-and~drinking-water.

* Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for E. coli MCL Violation Notice in Spanish - Template NC1-1A

Template on Reverse

The template on reverse is a Spanish translation of Template NC1-1 for an E. coli maximum contaminant level (MCL)
violation. All the instructions of Template NC1-1 apply. This template is an exact translation of the English template, so if
you need to modify the English templates, you should modify this template accordingly. Schools or universities may be able
to provide low-cost translations. See the discussion on translations in Chapter 3 for suggestions on multilingual notices.

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E. coli MCL Violation Notice in Spanish - Template NC1-1A

AVISO SOBRE SU AGUA POTABLE
[E. coli esta] presente en el agua del Sistema [Water System Name]
HIERVAN EL AGUA ANTES DE USARLA

[Briefly describe the situation in Spanish, such as: "E. coli fue encontrada en su servicio de agua el dia [given date]" or "No
hicimos las pruebas necesarias del servicio de agua y debemos suponer que la bacteria E. coli esta en la agua a partir de
[given date]]. Estas bacterias pueden enfermarle, y son especialmente peligrosas para personas con los sistemas
inmunologicos debiles.

Contaminacion bacteriana puede ocurrir cuando un exceso de aguas rebasa sus cauces y entran en las fuentes de agua
potable (por ejemplo, despues de una lluvia fuerte). Tambien, puede ocurrir cuando se rompe un sistema de recoleccion de
aguas negras (por ejemplo una tuberia), o cuando hay una falla en el tratamiento de agua.

dQue debo hacer? dQue es la significa de este?

NO BEBA EL AGUA SIN HERVIRLA ANTES. Hierva toda el agua, dejela hervir por un minuto, y dejela reposar antes
de usarla, o utilice agua embotellada. Agua hervida o embotellada debe ser usada para beber, hacer hielo, lavarse
los dientes, lavar los platos y para preparar la comida hasta proximo aviso. El proceso de hervir mata a bacteria y
otros organismos en el agua.

*E. coli son bacterias cuya presencia indican que el agua esta contaminada con desechos humanos o de animales.
Los agentes patogenos humanos en estos desechos pueden causar consecuencias a corto plazo, como diarrea,
colicos, nausea, dolores de cabeza u otros sintomas. Pueden representor un peligro mas grave para la salud de
bebes, ninos y ninas de corta edad, los ancianos y personas con sistemas inmunologicos en alto riesgo. *

Los sintomas descritos arriba no ocurren solamente debido a los microbios; pueden ser resultados de otros
factores. Sin embargo, si usted siente estos sintomas y los persisten, usted puede optar por hacer una consulta con
su medico. Personas en situaciones de alto riesgo deben consultar con sus proveedores de servicios medicos.

dQue se esta haciendo al respecto?

[Describe corrective action in Spanish], Le informaremos cuando las pruebas demuestren que no hay bacterias y cuando
usted ya no necesita hervir su agua. Anticipamos que resolveremos el problema el [date of expected resolution in Spanish
day-month-year].

Para obtener mas informacion, contacte a [name of contact] al [phone number] o [mailing address], Reglas generales sobre
las maneras de reducir el riesgo de infeccion por bacterias y otros organismos causantes de enfermedades estan
disponibles en el sitio web de Office of Ground Water and Drinking Water de la EPA en httpsi//www,epa,gov/ground-

water-and-drinking-water.

*Por favor, comparta esta informacion con otros que toman de estafuente de agua, especialmente con
aquellos que no hayan recibido el aviso directamente, por ejemplo: personas en apartamentos, hospitales,
hogares de infantes, escuelas o comunidades de negocios. Usted puede compartirlo en un lugar publico o
distribuyendo unas copias a mano o por correo. *

Este aviso ha sido enviado a usted por [water system name], Numero de Identificacion:	.

Fecha de distribucion:	.

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Instructions for Nitrate MCL Violation Notice - Template NC1-2

Template on Reverse

Violating the nitrate maximum contaminant level (MCL) of 10 milligrams per liter (mg/L) requires Tier 1 public notification and you must
provide public notice to persons served as soon as practical but no more than 24 hours from learning of the violation [40 CFR 141.202(b)!.
During this time, you must also contact your state. You should also coordinate with your local health department. This template is also
applicable to nitrite and total nitrate and nitrite violations. You must use one or more of the following methods to deliver the notice to
consumers [40 CFR 141.202(c)!:

Posting in conspicuous locations
Hand or direct delivery
Radio
Television

Another method approved in writing by the state

You may need to use additional methods if needed to reach all persons served. If you post or hand deliver, print your notice on your
system's letterhead, if you have it.

If you do modify the notice on the reverse, you must still include all required public notice elements from 40 CFR 141.205(a) and leave
the mandatory language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Alternative Sources of Water

If you are providing bottled water, your notice should say where it can be obtained. If you are providing bottled water, make sure it
meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

Repeat Notices

If this is a repeat notice (as required by your state), or if your water system's nitrate levels fluctuate around the MCL, you may wish to
include an explanation similar to the following:

On [give date], you were also notified of high nitrate levels that occurred during the [give quarter e.g., first, second, third or
fourth] of the year. Since that time the water system has been monitoring the nitrate concentration every three months. Seasonal
fluctuations in nitrate concentrations have been observed due to nitrates contained in fertilizer. It appears the high nitrates occur
during the later summer and fall. Note that previous tests prior to [give year] show that we were meeting drinking water
standards for nitrate.

Corrective Action

In your notice, describe corrective actions you are taking. The bullet below describes one action commonly taken by water systems with
nitrate/nitrite violations. You can use the following language, if appropriate, or develop your own:

We are investigating water treatment and other options. These may include drilling a new well or buying water from another
water system.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

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Nitrate MCL Violation Notice - Template NC1-2

DRINKING WATER WARNING

[Water System Name] water has high levels of nitrate -

DO NOT GIVE THE WATER TO INFANTS UNDER 6 MONTHS OLD OR USE IT

TO MAKE INFANT FORMULA

On [give date], we received notice that the sample collected on [give date] showed nitrate levels of [level and units]. This is
above the nitrate standard, or maximum contaminant level (MCL), of [state/federal MCL], Nitrate in drinking water is a
serious health concern for infants less than six months old.

Nitrate in drinking water can come from natural, industrial, or agricultural sources (including septic systems and run-off).
Levels of nitrate in drinking water can vary throughout the year.

What should I do? What does this mean?

DO NOT GIVE THE WATER TO INFANTS. * Infants below the age of six months who drink water containing nitrate
in excess of the MCL could become seriously ill and, if untreated, may die. Symptoms include shortness of breath
and blue baby syndrome. * Blue baby syndrome is indicated by blueness of the skin. Symptoms in infants can
develop rapidly, with health deteriorating over a period of days. If symptoms occur, seek medical attention
immediately.

Ice, juice, and formula for children under six months of age should not be prepared with tap water. Bottled water
or other water low in nitrates should be used for infants until further notice.

DO NOT BOIL THE WATER. Boiling, freezing, filtering, or letting water stand does not reduce the nitrate level.
Boiling can make the nitrates more concentrated, because nitrates remain behind when the water evaporates.

Adults and children older than six months can drink the tap water (nitrate is a concern for infants because they
can't process nitrates in the same way adults can). However, if you are pregnant or have specific health concerns,
you may wish to consult your doctor.

What is being done?

[Describe all corrective actions being taken and when your water system expects to return to compliance.]

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for Nitrate MCL Violation Notice in Spanish - Template NC1-2A

Template on Reverse

The template on reverse is a Spanish translation of Template NC1-2 for a nitrate maximum contaminant level (MCL) violation. All the
instructions of Template NC1-2 apply. This template is an exact translation of the English template, so if you need to modify the English
templates, you should modify this template accordingly. Schools or universities may be able to provide low-cost translations. See the
discussion on translations in Chapter 3 for suggestions on multilingual notices.

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Nitrate MCL Violation Notice in Spanish - Template NC1-2A

AVISO SOBRE SU AGUA POTABLE

Agua del sistema [Water System Name] tiene altos niveles de nitratos -

NO DAR DE BEBER ESTA AGUA A BEBES MENORES DE 6 MESES DE EDAD Nl
USARLA PARA HACER LECHE DE FORMULA

Recibimos un aviso el [give date of when notice was received] que la muestra tomada el [give date of when sample was
taken] demuestra una concentracion de nitrato de [level found and units in Spanish], Este nivel esta por encima de la
norma, o nivel maximo de contaminacion (NMC) de [state/federal MCL with units in Spanish], Nitratos en agua potable
puede generar serios problemas de salud para bebes menores de 6 meses de edad.

Nitratos en el agua pueden provenir de fuentes naturales, industrials, o de la agricultura (incluyendo descargas de tanques
septicos y lluvias). Las concentraciones de nitratos en el agua potable varian a lo largo del ano.

dQue debo hacer?£Que es la significa de este?

NO LE DE ESTA AGUA A BEBES. *Bebes menores de seis (6) meses que ingieran agua con nitratos en exceso del
nivel maximo de contaminacion (NMC) se pueden enfermar seriamente y, de no ser tratados, pueden morir. Los
sintomas incluyen dificultad en respirar y sindrome de bebe azul. * El sindrome de bebe azul se refiere al color
azulado que toma la piel del bebe. Los sintomas en los bebes pueden desarrollarse con rapidez, con el deterioro de
su salud en los dias subsiguientes. Si los sintomas ocurren en infantes menores de seis (6) meses de edad, busque
atencion medica inmediatamente.

Hielo, jugo o leche en polvo para bebes menores de seis (6) meses de edad no debe prepararse con agua del grifo.
Debe emplear agua embotellada u otra agua baja en nitratos hasta proximo aviso.

No hierva el agua. Hervir, congelar, filtrar, o dejar el agua en reposo no reduce el nivel de nitratos. De hecho, al
hervir el agua puede aumentar aun mas la concentracion de nitratos, debido a que los nitratos permanecen
cuando parte del agua se evapora.

Adultos e infantes mayores de seis (6) meses de edad pueden tomar el agua del grifo. (Los nitratos son peligrosos
para los bebes debido a que ellos no pueden procesar los nitratos de la misma manera que los adultos). Sin
embargo, si usted esta embarazada o tiene algun problema de salud en particular, puede optar por hacer una
consulta con su medico.

dQue se esta haciendo al respecto?

[Describe all corrective actions being taken and when your water system expects to return to compliance in Spanish.]

Para mayor informacion, favor contactar a [name of contact] al [phone number] o [mailing address],

*Por favor comparta esta informacion con otros que pueden tomar de esta agua, colocando este aviso en
lugares visibles, o remitiendolo por correo, o entregandolo manualmente. Es de particular interes distribuir
este aviso ampliamente si usted lo recibe representando un negocio, un hospital u hogar de infantes u
hogar de ancianos o comunidad residencial. *

Este aviso ha sido enviado a usted por [water system name], Numero de Identificacion :	.

Fecha de distribucion:	.

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Instructions for Nitrate Failure to Take a Confirmation Sample - Template NC1-3

Template on Reverse

Since failure to take a confirmation sample for nitrate within 24 hours after learning that an initial sample exceeded the maximum
contaminant level (MCL) requires Tier 1 public notification, you must provide public notice to persons served as soon as practical but no
more than 24 hours from learning of the violation [40 CFR 141.202(b)!. During this time period you must also contact your state. You
should also coordinate with your local health department. This template is also applicable to missed confirmation samples for nitrite. You
must use one or more of the following methods to deliver the notice to consumers [40 CFR 141.202(c)!:

Posting in conspicuous locations
Hand or direct delivery
Radio
Television

Another method approved in writing by the state

You may need to use additional methods if needed to reach all persons served. If you post or hand deliver, print your notice on your
system's letterhead, if you have it.

If you do modify the notice on the reverse, you must still include all required public notice elements from 40 CFR 141.205(a) and leave
the mandatory language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Alternative Sources of Water

If you are providing bottled water, your notice should say where it can be obtained. If you are providing bottled water, make sure it
meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

Repeat Notices

If this is a repeat notice (as required by your state), you may wish to include an explanation similar to the following:

•	You were initially notified of our water system's failure to take a confirmation sample following high nitrate level on [give date].
Since that time, we have taken a confirmation sample on [give date] that also resulted in a high nitrate level. We are currently
monitoring the nitrate concentration [give sampling timeframe e.g., every three months]. Seasonal fluctuations in nitrate
concentrations have been observed, due to nitrates contained in fertilizer. It appears that high nitrates occur during the later
summer and fall. Note that prior to [give year] we were meeting drinking water standards for nitrate.

Corrective Action

In your notice, describe corrective actions you are taking. The bullet below describes one action commonly taken by water systems with
nitrate/nitrite violations. You can use the following language, if appropriate, or develop your own text:

•	We are in the process of collecting a confirmation sample to determine if we have high nitrate levels. If the sample shows we
are meeting our drinking water standards, you will not receive another notice. However, if the sample shows that we do have
high nitrate levels in our water, another notification will be issued within 24 hours after we receive the results.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

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Nitrate Failure to Take a Confirmation Sample Notice - Template NC1-3

DRINKING WATER WARNING

[Water System Name] did not take a confirmation sample to determine if

the water has high levels of nitrate -

DO NOT GIVE THE WATER TO INFANTS UNDER 6 MONTHS OLD OR USE IT

TO MAKE INFANT FORMULA

*We are required to monitor your drinking water for nitrate on a regular basis. Results of regular monitoring are an
indicator of whether or not our drinking water meets health standards. During [compliance period] we ['did not monitor or
test' or 'did not complete all monitoring or testing'] for nitrate and therefore cannot be sure of the quality of your drinking
water during that time. *

On [give date], we received notice that the sample collected on [give date] showed nitrate levels above the nitrate
standard, or maximum contaminant level (MCL), of [give state/federal MCL], We were required to take a confirmation
sample within 24 hours. We did not complete the required confirmation sample monitoring. Nitrate in drinking water is a
serious health concern for infants less than six months old.

Nitrate in drinking water can come from natural, industrial, or agricultural sources (including septic systems and run-off).
Levels of nitrate in drinking water can vary throughout the year.

What should I do? What does this mean?

DO NOT GIVE THE WATER TO INFANTS. *lnfants below the age of six months who drink water containing nitrate in
excess of the MCL could become seriously ill and, if untreated, may die. Symptoms include shortness of breath and
blue baby syndrome. * Blue baby syndrome is indicated by blueness of the skin. Symptoms in infants can develop
rapidly, with health deteriorating over a period of days. If symptoms occur, seek medical attention immediately.

Ice, juice, and formula for children under six months of age should not be prepared with tap water. Bottled water
or other water low in nitrates should be used for infants until further notice.

DO NOT BOIL THE WATER. Boiling, freezing, filtering, or letting water stand does not reduce the nitrate level.
Boiling can make the nitrates more concentrated, because nitrates remain behind when the water evaporates.

Adults and children older than six months can drink the tap water (nitrate is a concern for infants because they
can't process nitrates in the same way adults can). However if you are pregnant or have specific health concerns,
you may wish to consult your doctor.

What is being done?

[Describe all corrective actions being taken and when your water system expects to return to compliance.] After receiving
the results of our first sample, we failed to collect a second sample within 24 hours to confirm the results of the first
sample. We have since collected the second sample and are waiting for the results.

For more information, please contact [name of contact] at [phone number] or [mailing address],

* Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed: 	.

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Special Notice: Instructions for NCWSs Allowed Up to 20 mg/L Nitrate Notice -

Template NC1-4

Template on Reverse

NCWSs that have received approval by their state to exceed the nitrate maximum contaminant level of 10 milligrams per liter (mg/L) but
no more than 20 mg/L are required to provide Tier 1 public notification. You do not incur a violation but are still required to provide
public notice to persons served as soon as practical but no more than 24 hours from learning of the situation [40 CFR 141.202(b)!. You
must use one or more of the following methods to deliver the notice to consumers [40 CFR 141.202(c)!:

Posting in conspicuous locations
Hand or direct delivery
Radio
Television

Another method approved in writing by the state

You may need to use additional methods if needed to reach all persons served. If you post or hand deliver, print your notice on your
system's letterhead, if you have it.

If you do modify the notice on the reverse, you must still include all required public notice elements from 40 CFR 141.205(a) and leave
the mandatory language unchanged (see below).

Continuous Notices

If you are granted permission by the state to exceed the nitrate MCL, you must provide continuous posting that the nitrate levels
exceeded 10 mg/L and of the potential health effects of exposure [40 CFR 141.209(b)!.

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Alternative Sources of Water

If you are or providing bottled water, your notice should say where it can be obtained. If you are providing bottled water, make sure it
meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

Public Notification Handbook for
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Special Notice: NCWSs Allowed Up to 20 mg/L Nitrate Notice - Template NC1-4

DRINKING WATER WARNING

[Water System Name] water has high levels of nitrate -

DO NOT GIVE THE WATER TO INFANTS UNDER 6 MONTHS OLD OR USE IT

TO MAKE INFANT FORMULA

Water sample results show nitrate levels of [level and units]. This is above the nitrate standard or maximum contaminant
level (MCL), of 10 milligrams per liter (mg/L). Nitrate in drinking water is a serious health concern for infants less than six
months old.

We have been given permission by [state] to provide water in excess of the standard as long as:

Nitrate levels do not exceed 20 mg/L.

The water is not made available to children under 6 months of age.

We continuously post this notice meeting all public notice requirements.

Local and state health officers are notified annually.

No adverse health effects result.

What should I do? What does this mean?

DO NOT GIVE THE WATER TO INFANTS. *lnfants below the age of six months who drink water containing nitrate in
excess of the MCL could become seriously ill and, if untreated, may die. Symptoms include shortness of breath and
blue baby syndrome. * Blue baby syndrome is indicated by blueness of the skin. Symptoms in infants can develop
rapidly, with health deteriorating over a period of days. If symptoms occur, seek medical attention immediately.

Ice, juice, and formula for children under six months of age should not be prepared with tap water. Bottled water
or other water low in nitrates should be used for infants until further notice.

DO NOT BOIL THE WATER. Boiling, freezing, filtering, or letting water stand does not reduce the nitrate level.
Boiling can make the nitrates more concentrated, because nitrates remain behind when the water evaporates.

Adults and children older than six months can drink the tap water (nitrate is a concern for infants because they
can't process nitrates in the same way adults can). However, if you are pregnant or have specific health concerns,
you may wish to consult your doctor.

For more information, please contact [name of contact] at [phone number] or [mailing address],

* Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Transient Noncommunity Water Systems

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Instructions for NCWSs Allowed > 20 mg/L Nitrate that Exceed 20 mg/L -

Template NC1-5

Template on Reverse

Since exceeding the maximum contaminant level (MCL) of 20 milligrams per liter (mg/L) for NCWSs that have received approval by their
state to exceed the nitrate (MCL) of 10 mg/L but no more than 20 mg/L requires Tier 1 public notification, you must provide public notice
to persons served as soon as practical but no more than 24 hours from learning of the violation [40 CFR 141.202(b)!. During this time
period you must also contact your state. You should also coordinate with your local health department. This template is also applicable to
nitrite and total nitrate and nitrite violations. You must use one or more of the following methods to deliver the notice to consumers [40
CFR 141.202(c)!:

Posting in conspicuous locations
Hand or direct delivery
Radio
Television

Another method approved in writing by the state

You may need to use additional methods if needed to reach all persons served. If you post or hand deliver, print your notice on your
system's letterhead, if you have it.

If you do modify the notice on the reverse, you must still include all required public notice elements from 40 CFR 141.205(a) and leave
the mandatory language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Alternative Sources of Water

If you are providing bottled water, your notice should say where it can be obtained. If you are providing bottled water, make sure it
meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

Repeat Notices

If this is a repeat notice (as required by your state), or if your system's nitrate levels fluctuate around the MCL, you may wish to include
an explanation similar to the following:

You were initially notified of high nitrate levels on [give date]. Since that time, we have been monitoring the nitrate concentration
every three months. Seasonal fluctuations in nitrate concentrations have been observed, due to nitrates contained in fertilizer. It
appears that high nitrates occur during the later summer and fall. Note that prior to [give year] we were meeting drinking water
standards for nitrate.

Corrective Action

In your notice, describe corrective actions you are taking. The bullet below describes one action commonly taken by water systems with
nitrate/nitrite violations. You can use the following language, if appropriate, or develop your own:

We are investigating water treatment and other options. These may include drilling a new well, mixing the water with low-nitrate
water from another source, or buying water from another water system.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

Public Notification Handbook for
Transient Noncommunity Water Systems

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NCWS Allowed > 20 mg/L Nitrate that Exceed 20 mg/L Notice - Template NC1-5

DRINKING WATER WARNING

[Water System Name] water has high levels of nitrate -

DO NOT GIVE THE WATER TO INFANTS UNDER 6 MONTHS OLD OR USE IT

TO MAKE INFANT FORMULA

Water sample results show nitrate levels of [level and units]. This is above the nitrate standard or maximum contaminant
level (MCL), of 10 milligrams per liter (mg/L). Nitrate in drinking water is a serious health concern for infants less than six
months old. We have been given permission by [state] to provide water in excess of the standard as long as:

Nitrate levels do not exceed 20 mg/L.

The water is not made available to children under 6 months of age.

We continuously post this notice meeting all public notice requirements.

Local and state health officers are notified annually.

No adverse health effects result.

On [give date], we received notice that the sample collected on [give date] showed nitrate levels of [level and units]. This is
above the 20 mg/L level allowed by [state]. Nitrate in drinking water is a serious health concern for infants less than six
months old.

Nitrate in drinking water can come from natural, industrial, or agricultural sources (including septic systems and run-off).
Levels of nitrate in drinking water can vary throughout the year.

What should I do? What does this mean?

DO NOT GIVE THE WATER TO INFANTS. * Infants below the age of six months who drink water containing nitrate
in excess of the MCL could become seriously ill and, if untreated, may die. Symptoms include shortness of breath
and blue baby syndrome. * Blue baby syndrome is indicated by blueness of the skin. Symptoms in infants can
develop rapidly, with health deteriorating over a period of days. If symptoms occur, seek medical attention
immediately.

Ice, juice, and formula for children under six months of age should not be prepared with tap water. Bottled water
or other water low in nitrates should be used for infants until further notice.

DO NOT BOIL THE WATER. Boiling, freezing, filtering, or letting water stand does not reduce the nitrate level.
Boiling can make the nitrates more concentrated, because nitrates remain behind when the water evaporates.

Adults and children older than six months can drink the tap water (nitrate is a concern for infants because they
can't process nitrates in the same way adults can). However, if you are pregnant or have specific health concerns,
you may wish to consult your doctor.

What is being done?

[Describe corrective action and when system expects to return to compliance.]

For more information, please contact [name of contact] at [phone number] or [mailing address],

* Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Transient Noncommunity Water Systems

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Instructions for Chlorine Dioxide MRDL - Template NC1-6

Template on Reverse

If a system exceeds the chlorine dioxide maximum residual disinfectant level (MRDL) when one or more of the samples taken in the
distribution system on the day after exceeding the MRDL at the entrance to the distribution system or if a system does not take required
samples in the distribution system, Tier 1 public notification is required. You must provide public notice to persons served as soon as
practical but no more than 24 hours from learning of the violation [40 CFR 141.202(b)!. During this time, you must also contact your
state. You should also coordinate with your local health department. You must use one or more of the following methods to deliver the
notice to consumers [40 CFR 141.202(c)!:

Posting in conspicuous locations
Hand or direct delivery
Radio
Television

Another method approved in writing by the state

You may need to use additional methods if needed to reach all persons served. If you post or hand deliver, print your notice on your
system's letterhead, if you have it.

If you do modify the notice on the reverse, you must still include all required public notice elements from 40 CFR 141.205(a) and leave
the mandatory language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Alternative Sources of Water

If you are providing bottled water, your notice should say where it can be obtained. If you are providing bottled water, make sure it
meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

Population at Risk

The language on the reverse lists "young children" as one of the groups at increased risk. Because the potential health effects of chlorine
dioxide are based on tests on laboratory animals, there is no way to determine at exactly what age the water is safe to drink. If your
consumers have questions, encourage them to err on the side of caution.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with chlorine
dioxide violations. You can use one or more of the following statements, if appropriate, or develop your own text:

We are resetting the chlorine dioxide generator to generate the correct amount of chlorine dioxide.

We are repairing the chlorine dioxide generator.

We have already fixed the problem, but it will take additional time for the extra chlorine dioxide to be flushed from the
distribution system (pipes).

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

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Chlorine Dioxide MRDL Notice-Template NC1-6

DRINKING WATER WARNING
PREGNANT WOMEN AND YOUNG CHILDREN
SHOULD NOT DRINK THE WATER

On [give date], we received notice that the sample collected on [give date] showed chlorine dioxide levels of [level and
units]. This is above the standard, or maximum residual disinfectant level (MRDL) of 0.8 milligrams per liter (mg/L). Chlorine
dioxide is used for disinfection, but too much of it over a short period of time may harm the development of children,
infants, and fetuses.

Chlorine dioxide is used in small amounts every day to kill bacteria and other organisms that may be in your drinking water.
A problem occurred with our chlorine dioxide generator, and too much chlorine dioxide was released.

What should I do? What does this mean?

• DO NOT USE THIS WATER IF YOU ARE PREGNANT OR GIVE IT TO YOUNG CHILDREN. Bottled water should be used
until further notice. *Some infants and young children who drink water containing chlorine dioxide in excess of the
MRDL could experience nervous system effects. Similar effects may occur in fetuses of pregnant mothers who drink
water containing chlorine dioxide in excess of the MRDL. Some people may experience anemia.

The chlorine dioxide violations reported today include exceedances of the EPA standard within the distribution
system which delivers water to consumers. Violations of the chlorine dioxide standard within the distribution
system may harm human health based on short-term exposures. Certain groups, including fetuses, infants, and
young children, may be especially susceptible to nervous system effects from excessive chlorine dioxide exposure. *
There are no obvious symptoms, but chlorine dioxide can affect development of the nervous system.

Ice, juice, and formula for young children and for pregnant women should not be prepared with tap water.

Adults who are not pregnant and older children can drink the tap water because their nervous systems are already
developed. However, if you have specific health concerns, you may wish to consult your doctor.

What is being done?

[Describe corrective action and when you expect to return to compliance.]

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for CFE Maximum Turbidity Exceedance, or Turbidity Single

Exceedance - Template NC1-7

Template on Reverse

This template is intended for water systems where consumers will not be able to boil water. If your state has designated this turbidity
single exceedance as a Tier 1 violation [40 CFR 141.202(a)!. you must provide public notice to persons served within 24hours after it has
been designated Tier 1 [40 CFR 141.202(b)!. Turbidity violations are Tier 2 by default, but may frequently be elevated to Tier 1 by your
state. In addition, violations are automatically elevated if you are unable to consult with your state within 24 hours. In such cases, you
must issue a notice within the next 24 hours. You may elevate the violation to Tier 1 yourself as well. You should also coordinate with
your local health department. You must use one or more of the following methods to deliver the notice to consumers [40 CFR
141.202(c)!:

Posting in conspicuous locations
Hand or direct delivery
Radio
Television

Another method approved in writing by the state

You may need to use additional methods if needed to reach all persons served. If you post or hand deliver, print your notice on your
system's letterhead, if you have it.

If you do modify the notice on the reverse, you must still include all required public notice elements from 40 CFR 141.205(a) and leave
the mandatory language unchanged (see below).

Instructions to Consumers

You may need to modify the instructions in the public notice based on your water system type. For instance, at a campground, you might
tell consumers to boil the water before drinking or using for food preparation. If you do modify the notice, you must still include all
required Public Notification (PN) Rule elements from 40 CFR 141.205(a) and leave the mandatory language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information. This template also includes mandatory language encouraging further distribution to persons who may not have received the
notice, where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end.
However, if you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Alternative Sources of Water

If you are providing bottled water, your notice should say where it can be obtained. If you are providing bottled water, make sure it
meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with a single
turbidity exceedance. You can use one or more of the following statements, if appropriate, or develop your own text:

We are adding chemicals that reduce turbidity.

We are sampling both untreated and treated water for the presence of coliform bacteria.

We are inspecting and repairing the filters.

Source of the Problem

If you know why the turbidity is high, explain it in your notice. For instance, unusual conditions such as heavy rains and flooding can
overburden the water plant and treated water may therefore not meet the standards. In addition, run-off from parts of the watershed
could contain increased concentrations of sediment and animal waste.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

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CFE Maximum Turbidity Exceedance, or Turbidity Single Exceedance as Tier 1

Notice - Template NC1-7

DRINKING WATER WARNING
[Water System Name] has high turbidity levels
Bottled water is available from [provide location]

We routinely monitor your water for turbidity (cloudiness). This tells us whether we are effectively filtering the water
supply. A water sample taken [give date] showed turbidity levels of [number] turbidity units. This is above the standard of
[standard] turbidity units. Because of these high levels of turbidity, there is an increased chance that the water may contain
disease-causing organisms.

What should I do? What does this mean?

*Turbidity has no health effects. However, turbidity can interfere with disinfection and provide a medium for
microbial growth. Turbidity may indicate the presence of disease causing organisms. These organisms include
bacteria, viruses, and parasites, which can cause symptoms such as nausea, cramps, diarrhea, and associated
headaches. *

The symptoms above are not caused only by organisms in drinking water. If you experience any of these symptoms
and they persist, you may want to seek medical advice. People at increased risk should seek advice from their
healthcare providers about drinking this water.

What is being done?

[Describe corrective action and when the system expects to return to compliance.]

We will inform you when turbidity returns to appropriate levels and when you no longer need to boil your water. We
anticipate resolving the problem within [estimated timeframe].

For more information, please contact [name of contact] at [phone number] or [mailing address]. General guidelines on
ways to lessen the risk of infection by microbes are available from the EPA Ground Water and Drinking Water Website at

httpsi//www,epa,gov/ground~water-and~drinking-water.

* Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

Public Notification Handbook for
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Instructions for Waterborne Disease Outbreak - Template NC1-8

Template on Reverse

Since a waterborne disease outbreak is a situation requiring Tier 1 public notification and you must provide public notice to persons
served as soon as practical but no more than 24 hours from learning of the situation [40 CFR 141.202(b)!. During this time, you must also
contact your state. You should also coordinate with your local health department. You must also issue a public notice if you are
experiencing a waterborne emergency other than a waterborne disease outbreak, such as one caused by flooding or treatment failure.
In such cases, you may be able to modify this template to apply to your situation. Check with your state for more direction. More
information on waterborne disease outbreaks and emergencies is available from the Centers for Disease Control and Prevention
(http://www.cdc.gov/healthywater/diseases.html. 1-800-232-4636). You must use one or more of the following methods to deliver the
notice to consumers [40 CFR 141.202(c)!:

Posting in conspicuous locations
Hand or direct delivery
Radio
Television

Another method approved in writing by the state

You may need to use additional methods if needed to reach all persons served. If you post or hand deliver, print your notice on your
system's letterhead, if you have it. If you do modify the notice on the reverse, you must still include all required public notice elements
from 40 CFR 141.205(a) and leave the mandatory language unchanged (see below).

Instructions to Consumers

This template is intended for water systems where consumers will not be able to boil water. You may need to modify the instructions in
the public notice based on your water system type. For instance, at a campground, you might tell consumers to boil the water before
drinking or using for food preparation. Instructions should also depend on whether your system has elevated nitrate or arsenic levels;
boiling water concentrates nitrates and arsenic and makes levels higher.

Describing the Outbreak

If known, list any organisms detected, the number of affected people, any water treatment problems contributing to the waterborne
disease outbreak, and any sources of contamination, such as flooding.

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information. This template also includes mandatory language encouraging further distribution to persons who may not have received the
notice, where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end.
However, if you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.
No federal mandatory health effects language exists for waterborne disease outbreaks. You may wish to use the sentence below, if
appropriate, or contact your state or health department for other language.

These symptoms are common to many diseases caused by microscopic organisms: Symptoms may include nausea, cramps,
diarrhea, jaundice, and associated headaches and fatigue.

Alternative Sources of Water

If you are providing bottled water, your notice should say where it can be obtained. If you are providing bottled water, make sure it
meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

Corrective Action

In your notice, describe the corrective actions you are taking. Listed below are some steps commonly taken by water systems with
waterborne disease outbreaks. You can use one or more of the following statements, if appropriate, or develop your own text:

We are repairing our filtration system.

We are increasing sampling for disease-causing organisms.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!. It is a good idea to inform your consumers when the
violation has been resolved, especially if you have regular customers. See Template NC1-10 for a "problem corrected" notice template.

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Waterborne Disease Outbreak Notice - Template NC1-8

DRINKING WATER WARNING

Disease-causing organisms have entered [Water System Name]'s water supply.
Bottled water is available from [provide location].

These organisms are causing illness in people served by [water system name]. We learned of a waterborne disease
outbreak from [agency] on [give date].

What should I do? What does this mean?

[Describe symptoms of the waterborne disease.] If you experience one or more of these symptoms and they
persist, contact your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about this drinking water.

What is being done?

[Describe the corrective action and when the outbreak might end.]

We will inform you when you can use the water.

For more information, please contact [name of contact] at [phone number] or [mailing address]. General guidelines on
ways to lessen the risk of infection by microbes are available from the EPA Ground Water and Drinking Water Website at

httpsi//www. epa.gov/ground-water-and-drinking-water.

* Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for Fecal Indicator-Positive Source Sample - Template NC1-9

Template on Reverse

Since detection of a fecal indicator (E coli, enterococci or coliphage) in a ground water source sample is a situation requiring Tier 1 public
notification, you must provide public notice to persons served as soon as practical but no more than 24 hours from learning of the
violation [40 CFR 141.202(b)!. During this time, you must also contact your state. You should also coordinate with your local health
department. You must use one or more of the following methods to deliver the notice to consumers [40 CFR 141.202(c)!:

Posting in conspicuous locations
Hand or direct delivery
Radio
Television

Another method approved in writing by the state

You may need to use additional methods if needed to reach all persons served. If you post or hand deliver, print your notice on your
system's letterhead, if you have it.

If you do modify the notice on the reverse, you must still include all required public notice elements from 40 CFR 141.205(a) and leave
the mandatory language unchanged (see below).

Instructions to Consumers

This template is intended for water systems where consumers will not be able to boil water. You may need to modify the instructions in
the public notice based on your water system type. For instance, at a campground, you might tell consumers to boil the water before
drinking or using for food preparation.

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Alternative Sources of Water

If you are providing bottled water, your notice should say where it can be obtained. If you are providing bottled water, make sure it
meets U.S. Food and Drug Administration (FDA) and/or state bottled water safety standards.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems that have
detected a fecal indicator in their ground water source. You can use one or more of the following statements, if appropriate, or develop
your own text:

We are increasing sampling at our sources to determine the source of the contamination.

We are working with state officials to implement corrective actions to ensure water supplies are protected against contamination.

We are providing water from an alternative source until the problem is resolved.

We have discontinued use of the contaminated well and will rely on our other sources to meet demand.

We are abandoning the contaminated well and will replace it with a well constructed to standards.

We are pursuing treatment options for disinfection of the water from this source.

We have installed temporary disinfection while we pursue long-term treatment or other options to eliminate contamination from
this source.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

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GWR Fecal Indicator-Positive Source Sample Notice-Template NC1-9

DRINKING WATER WARNING
[Water System Name]'s [Source] Tested Positive for Fecal Indicator
Bottled water is available from [provide location].

Our water system recently detected a fecal indicator [give contaminant, e.g., E. coli, enterococci, coliphage] (see definition
below) in [source]. As our customers, you have a right to know what happened and what we are doing to correct this
situation. On [give date], we collected a sample from [source]. The sample tested positive for [give contaminant, e.g., E. coli,
enterococci, coliphage].

What should I do? What does this mean?

*Fecal indicators are microbes whose presence indicates that the water may be contaminated with human or
animal wastes. Microbes in these wastes can cause short-term health effects, such as diarrhea, cramps, nausea,
headaches, or other symptoms. They may pose a special health risk for infants, young children, some of the elderly,
and people with severely compromised immune systems. *

The symptoms above are not caused only by organisms in drinking water. If you experience any of these symptoms
and they persist, you may want to seek medical advice. People at increased risk should seek advice from their
healthcare providers about drinking this water.

What is being done?

[Describe corrective action.] We will inform you when tests show no [give contaminant, e.g., E. coli, enterococci, coliphage]
and you can drink the water. We anticipate resolving the problem within [estimated timeframe].

For more information, please contact [name of contact] at [phone number] or [mailing address]. General guidelines on
ways to lessen the risk of infection by microbes are available from the EPA Ground Water and Drinking Water Website at

httpsi//www,epa,gov/ground~water-and~drinking-water.

* Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Transient Noncommunity Water Systems

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Instructions for "Problem Corrected" Notice - Template NC1-10

Template on Reverse

It is a good idea to issue a notice when a serious violation or situation has been resolved. Although EPA regulations do not
require such notices, your state may require you to issue one. You should coordinate with your local health department as
well. Below are some recommended methods for a "problem corrected" notice. You should use the same delivery methods
you used for the original notice.

The notice on the reverse is very general and can be used for any violation or situation. However, to help restore
consumers' confidence in the water system, you should modify the notice to fit your situation. Although the public should
have seen your initial notice, there may be additional information you learned after the notice was issued. Therefore, you
should describe the violation or situation again and discuss how the problem was solved.

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"Problem Corrected" Notice - Template NC1-10

DRINKING WATER PROBLEM CORRECTED

Customers of [water system name] were notified on [give date] of a problem with our drinking water and were advised to
[describe recommended action]. We are pleased to report that the problem has been corrected and that it is no longer
necessary to [describe recommended action]. We apologize for any inconvenience and thank you for your patience.

[Add further details here when appropriate.]

As always, you may contact [contact name] at [phone number] or [mailing address] with any comments or questions.

Please share this information with all the other people who drink this water, especially those who may not
have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail.

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Tier

2 Templates

•	SWTR Failure to Filter-Template NC2-1

•	SWTRsTurbidity Exceedance-Template NC2-2

•	SWTR Disinfection Treatment - Template NC2-3

•	LT2ESWTR Uncovered Finished Water Reservoir Treatment Technique Violation - Template NC2-4

•	LT2ESWTR Failure to Provide or Install an Additional Level of Treatment-Template NC2-5

•	LT2ESWTR Unfiltered System Failure to Achieve Required Inactivation Level -Template NC2-6

•	LT2ESWTR Filtered System Failure to Achieve Required Treatment Credit-Template NC2-7

•	LT2ESWTR Unfiltered System Failure to Maintain Required Inactivation Level -Template NC2-8

•	LT2ESWTR Unfiltered System Failure to Install Second Disinfectant-Template NC2-9

•	Filter Backwash Recycling Rule Treatment Technique Violation -Template NC2-10

•	RTCR Failure of a Seasonal System to Complete Start-Up Procedures - Template NC2-11

•	RTCR Failure to Perform any Level 1 Assessment or a Level 2 Assessment that is Not Triggered by E. coli
MCL violations or the Related Corrective - Template NC2-12

•	RTCR Failure to Perform a Level 2 Assessment Triggered by an E. coli MCL violation or the Related
Corrective Actions - Template NC2-13

•	GWR Failure to Take Corrective Action within Required Time Frame - Template NC2-14

•	GWR Failure to Maintain 4-log Treatment of Viruses - Template NC2-15

•	Special Notice: LT2ESWTR Failure to Conduct Required Cryptosporidium Monitoring for Any Three
Months-Template NC2-16

•	Special Notice: LT2ESWTR Filtered System Failure to Determine and Report Bin Classification -Template
N

•	Special Notice: LT2ESWTR Unfiltered System Failure to Calculate and Report Mean Cryptosporidium
Level - Template NC2-18

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Instructions for SWTR Failure to Filter - Template NC2-1

Template on Reverse

Since surface water treatment technique violations require Tier 2 public notification, you must provide public notice to persons served as
soon as practical but within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your state may have more stringent
requirements for treatment technique violations (e.g., it may require you to provide water from an alternate source). Check with your
state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with surface
water treatment technique violations. Depending on the corrective action you are taking, you can use one or more of the following
statements, if appropriate, or develop your own text:

Our treatment plant needs upgrades to meet the requirements.

We are installing filtration. We expect that the filtration system will be operational by [month, year].

We are monitoring for turbidity (cloudiness), disinfectant levels, and the presence of bacteria.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

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SWTR Failure to Filter Notice - Template NC2-1

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Does Not Meet Treatment Requirements

Our water system recently violated a drinking water requirement. Although this situation does not require that you take
immediate action, as our customers, you have a right to know what happened, what you should do, and what we did (are
doing) to correct this situation.

On [give date], the [state] ordered us to filter the water in addition to disinfecting. We are required to install this filtration
because we no longer meet the requirements that allowed us to not provide filtration. However, we have not yet installed a
filtration system.

What should I do?

You do not need to boil your water. However, if you have specific health concerns, consult your doctor. A home
filter will not necessarily solve the problem, because not all home filters protect against parasites. Call NSF
International at 1(800) NSF-8010 or the Water Quality Association at 1(800) 749-0234 for information on
appropriate filters.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by microbes are available at the EPA Ground Water and Drinking Water
Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours. We do not know of any cases of
contamination. However, until improvements are made, there is an increased chance that disease-causing organisms could
contaminate the water supply, inadequately treated water may contain disease-causing organisms. These organisms
include bacteria, viruses, and parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated
headaches.* These symptoms, however, are not caused only by organisms in drinking water. If you experience any of these
symptoms and they persist, you may want to seek medical advice.

What is being done?

Filtration is the best method for removing these organisms. [Describe corrective action.]

We anticipate resolving the problem within [estimated timeframe]. Until filtration is installed, you will receive a notice
similar to this every three months.

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for SWTRs Turbidity Exceedance - Template NC2-2

Template on Reverse

Since surface water treatment filtration treatment technique violations require Tier 2 public notification, you must provide public notice
to persons served as soon as practical but within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your state may have more
stringent requirements for treatment technique violations (e.g., it may require you to provide water from an alternate source). Check
with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

For Exceedances of Single Turbidity Limits

For Exceedances of Monthly Turbidity Limits

You must consult with your state as soon as practical but within 24 hours of
learning of the violation. During the consultation, the agency may choose to
elevate your turbidity exceedance to Tier 1. If consultation does not occur, the
violation is automatically elevated to Tier 1 For a Tier 2 notice, describe your
violation as follows in the second paragraph of the notice:

"Normal turbidity levels at our plant are [number] turbidity units. A water
sample taken [date] showed levels of [number] turbidity units. This was above
the standard of [standard] units. Because of these high levels of turbidity, there
is an increased chance that the water may contain disease-causing organisms."

Use the following language to describe your violation
and insert into the second paragraph of the template:
"Water samples for [month] showed that [percentage]
percent of turbidity measurements were over
[standard] turbidity units - the standard is that no
more than 5 percent of samples may exceed [standard]
turbidity units per month. The turbidity levels are
relatively low. However, their persistence is a concern.
Normal turbidity levels at our plant are [number]
units."

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with filtration
treatment technique violations. You can use one or more of the following statements, if appropriate, or develop your own text:

We added chemicals that reduce turbidity.

We sampled both untreated and treated water for the presence of coliform bacteria.

We monitored chlorine levels and adjusted them as needed to compensate for the filtration problems.

We inspected and cleaned the filters.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

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SWTRs Turbidity Exceedance Notice - Template NC2-2

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Does Not Meet Treatment Requirements

Our water system recently violated a drinking water requirement. Although this was not an emergency, as our customers,
you have a right to know what happened, what you should do, and what we did (are doing) to correct this situation.

We routinely monitor your water for turbidity (cloudiness). This tells us whether we are effectively filtering the water
supply. [Insert appropriate description of the violation from instructions on the previous page.]

What should I do?

There is nothing you need to do. You do not need to boil your water or take other actions. We do not know of any
contamination, and none of our testing has shown disease-causing organisms in the drinking water.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by microbes are available at the EPA Ground Water and Drinking Water
Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

* Turbidity has no health effects. However, turbidity can interfere with disinfection and provide a medium for microbial
growth. Turbidity may indicate the presence of disease causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms are not caused only by organisms in drinking water. If you experience any of these symptoms and they
persist, you may want to seek medical advice.

What is being done?

[Describe the corrective actions and when the system returned or expects to return to compliance.]

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Transient Noncommunity Water Systems

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Instructions for SWTR Disinfection Treatment - Template NC2-3

Template on Reverse

Since surface water treatment disinfection treatment technique violations require Tier 2 public notification, you must provide public
notice to persons served as soon as practical but within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your state may have
more stringent requirements for treatment technique violations (e.g., it may require you to provide water from an alternate source).
Check with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Description of the Violation

Include one of the following descriptions of violations, and modify to fit your situation.

Not Enough Disinfection Purine Treatment - In order to ensure proper disinfection, water in the treatment plant must be in
contact with enough chlorine or a similar disinfectant for a minimum amount of time. On [give date], this did not occur. Although
chlorine quickly kills most bacteria, it is less effective against organisms such as viruses and parasites. For this reason, water needs
to mix with chlorine for a longer time period to kill such organisms. The amount of time necessary, or the "contact time," depends
on the amount of disinfectant in the water and the temperature of the water.

Disinfectant Residual - We routinely monitor for disinfectant residual in the distribution system. This measurement tells us
whether we are effectively disinfecting the water supply. Disinfectant residual is the amount of chlorine or related disinfectant
present in the pipes of the distribution system. If the amount of disinfectant is too low, organisms could grow in the pipes.
Monthly exceedance - During the months of [give dates], disinfectant residual was undetectable in more than 5% of samples. The
standard is that disinfectant may be undetectable in no more than 5% of samples each month for two months in a row.

Single exceedance - On [give date], disinfectant levels dropped below 0.2 milligrams per liter (mg/L) for [give number of hours]
hours. The standard is that levels may not drop below 0.2 mg/L for more than four hours.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with
disinfection treatment technique violations. You can use one or more of the following statements, if appropriate, or develop your own
text:

We are sampling/we sampled both untreated and treated water for the presence of coliform bacteria.

We are sampling/we sampled disinfectant levels and will adjust/adjusted the amount of disinfectant added as necessary to

maintain adequate levels.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!. It is a good idea to inform your consumers when the
violation has been resolved, especially if you have regular customers. See Template NC1-10 for a "problem corrected" notice template.

Public Notification Handbook for
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SWTR Disinfection Treatment Notice - Template NC2-3

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Does/Did Not Meet Treatment Requirements

Our water system recently violated a drinking water requirement. Although this situation does not require that you take
immediate action, as our customers, you have a right to know what happened, what you should do, and what we did (are
doing) to correct this situation.

[Describe the violation - use descriptions from instructions on reverse.]

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by microbes are available at the EPA Ground Water and Drinking Water
Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours. Tests taken during this same time
period did not indicate the presence of bacteria in the water.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action.]

[Disinfectant residual levels/contact times] so far this month have met all requirements.

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for LT2ESWTR Uncovered Finished Water Reservoir Treatment -

Template NC2-4

Template on Reverse

A system's failure to cover an uncovered finished water reservoir, provide treatment of the reservoir's discharge, or be in compliance
with a state-approved schedule to cover the reservoir(s) or treat the reservoir(s) discharge by April 1, 2009, is a treatment technique
violation and requires Tier 2 public notification. You must provide public notice to persons served as soon as practical but within 30 days
after you learn of the violation [40 CFR 141.203(b)!. Your state may have more stringent requirements for treatment technique violations
(e.g., it may require you to provide water from an alternate source). Check with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with this type
of Long Term 2 Enhanced Surface Water Treatment Rule (LT2ESWTR) treatment technique violation. You can use one or more of the
following statements, if appropriate, or develop your own text:

We are currently working with state officials to revise our schedule for covering our uncovered finished water storage reservoir.
We expect to have the state-approved schedule in place by [give date] and the reservoir covered by [give date]. Until our schedule
receives state approval, you will receive a notice similar to this every three months.

We are currently working with state officials to revise our schedule for treating the discharge from our uncovered finished water
storage reservoir. We expect to have the state-approved schedule in place by [give date] and treatment in place by [give date].
Until the schedule receives state approval, you will receive a notice similar to this every three months.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

Public Notification Handbook for
Transient Noncommunity Water Systems

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LT2ESWTR Uncovered Finished Water Reservoir Treatment Notice - Template

NC2-4

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

Uncovered Finished Water Reservoir Violation at [Water System Name]

Our water system recently violated a drinking water requirement. Although this situation is not an emergency, as our
customers, you have a right to know what happened and what we did (are doing) to correct this situation.

Water systems with uncovered finished water reservoirs are required to cover these reservoirs, treat the water from these
reservoirs, or be in compliance with a state-approved schedule to cover the reservoir(s) or provide treatment. We have
failed to meet this requirement.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by microbes are available at the EPA Ground Water and Drinking Water
Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

Uncovered finished water reservoirs are a pathway for contaminants to enter the drinking water supply. Therefore, it is
necessary to cover the reservoirs or treat the discharge. *lnadequately treated water may contain disease-causing
organisms. These organisms include bacteria, viruses, and parasites which can cause symptoms such as nausea, cramps,
diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action.] We anticipate resolving the problem within [estimated timeframe].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Transient Noncommunity Water Systems

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Instructions for LT2ESWTR Filtered System Failure to Provide or Install an
Additional Level of Treatment-Template NC2-5

Template on Reverse

A filtered system's failure to provide or install an additional level of treatment appropriate for its LT2ESWTR bin classification by the
required date, is a treatment technique (TT) violation and requires Tier 2 public notification. You must provide public notice to persons
served as soon as practical but within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your state may have more stringent
requirements for treatment technique violations (e.g., it may require you to provide water from an alternate source). Check with your
state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with LT2ESWTR
treatment technique violations. You can use one or more of the following statements, if appropriate, or develop your own text:

We are currently working to [install treatment/adjust our treatment processes] to achieve the required level of additional
treatment.

We are currently working with state officials to finalize plans for water treatment that will satisfy this requirement once it is
installed.

We have [installed treatment/made adjustments to our treatment processes] and are now achieving the required level of
additional treatment.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

Public Notification Handbook for
Transient Noncommunity Water Systems

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LT2ESWTR Filtered System Failure to Provide or Install an Additional Level of

Treatment-Template NC2-5

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Provide the Appropriate Level of Treatment Within

Required Time Frame

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our customers, you
have a right to know what happened, what you should do, and what we did (are doing) to correct this situation.

Cryptosporidium is a disease-causing microorganism that has been found in our raw water source. Our water system [give
system name] was required to provide an additional level of treatment to address Cryptosporidium by [provide date]. We
failed to do this by the required date.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by Cryptosporidium and other microbial contaminants are available at the
EPA Ground Water and Drinking Water Website at https://www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action.] We expect to achieve this additional level of treatment by [give date].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

Public Notification Handbook for
Transient Noncommunity Water Systems

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Instructions for LT2ESWTR Unfiltered System Failure to Achieve Required

Inactivation Level - Template NC2-6

Template on Reverse

Based on Cryptosporidium monitoring results, an unfiltered system must meet inactivation requirements for Cryptosporidium by a
required date. Failure to do this is a treatment technique violation and requires Tier 2 public notification. You must provide public notice
to persons served as soon as practical but within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your state may have more
stringent requirements for treatment technique violations (e.g., it may require you to provide water from an alternate source). Check
with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with Long Term
2 Enhanced Surface Water Treatment Rule (LT2ESWTR) treatment technique violations. You can use one or more of the following
statements, if appropriate, or develop your own text:

We are currently working to adjust our treatment processes to achieve the required level of treatment.

We are currently working with state officials and our engineers to finalize plans for water treatment that will satisfy this

requirement once it is installed.

We have made adjustments to our treatment processes and are now achieving the required level of treatment.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

Public Notification Handbook for
Transient Noncommunity Water Systems

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LT2ESWTR Unfiltered System Failure to Achieve Required Inactivation Level

Notice - Template NC2-6

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Provide the Appropriate Level of Treatment Within

Required Time Frame

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our customers, you
have a right to know what happened, what you should do, and what we did (are doing) to correct this situation.

Cryptosporidium is a disease-causing microorganism that may be in our raw water source. Our water system [give system
name] was required to provide a specified level of treatment to address Cryptosporidium by [provide date]. We failed to do
this by the required date.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by Cryptosporidium and other microbial contaminants are available at the
EPA Ground Water and Drinking Water Website at https://www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action.] We expect to achieve this specified level of treatment by [give date].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

Public Notification Handbook for
Transient Noncommunity Water Systems

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Instructions for LT2ESWTR Filtered System Failure to Achieve Required

Treatment-Template NC2-7

Template on Reverse

Based on Cryptosporidium monitoring results, some filtered systems are required to achieve additional treatment using a microbial
toolbox option. A filtered system's failure to achieve required treatment credit to meet the bin classification requirements, is a treatment
technique violation and requires Tier 2 public notification. You must provide public notice to persons served as soon as practical but
within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your state may have more stringent requirements for treatment
technique violations (e.g., it may require you to provide water from an alternate source). Check with your state to make sure you meet all
its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with Long Term
2 Enhanced Surface Water Treatment Rule (LT2ESWTR) treatment technique violations. You can use one or more of the following
statements, if appropriate, or develop your own text:

We are taking steps to ensure the required level of treatment can be maintained at all times.

The reason for the lapse in treatment has been identified and addressed.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

Public Notification Handbook for
Transient Noncommunity Water Systems

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LT2ESWTR Filtered System Failure to Achieve Required Treatment Notice -

Template NC2-7

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Maintain the Required Level of Treatment

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our customers, you
have a right to know what happened, what you should do, and what we did (are doing) to correct this situation.

Cryptosporidium is a disease-causing microorganism that has been found in our raw water source. Our water system [give
system name] was required to maintain a specified level of additional treatment to address Cryptosporidium. During
[provide date range], our system fell below this level.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by Cryptosporidium and other microbial contaminants are available at the
EPA Ground Water and Drinking Water Website at https://www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action and when the system returned or expects to return to compliance.]

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

Public Notification Handbook for
Transient Noncommunity Water Systems

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Instructions for LT2ESWTR Unfiltered System Failure to Maintain Required

Inactivation Level - Template NC2-8

Template on Reverse

Based on Cryptosporidium monitoring results, an unfiltered system must maintain specified inactivation levels to ensure adequate
treatment for Cryptosporidium. Failure to do this is a treatment technique violation and requires Tier 2 public notification. You must
provide public notice to persons served as soon as practical but within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your
state may have more stringent requirements for treatment technique violations (e.g., it may require you to provide water from an
alternate source). Check with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with (Long
Term 2 Enhanced Surface Water Treatment Rule) LT2ESWTR treatment technique violations. You can use one or more of the following
statements, if appropriate, or develop your own text:

We are taking steps to ensure the required level of treatment can be maintained at all times.

The reason for the lapse in treatment has been identified and addressed.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

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LT2ESWTR Unfiltered System Failure to Maintain Required Inactivation Level

Notice - Template NC2-8

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Maintain the Required Level of Treatment

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our customers, you
have a right to know what happened, what you should do, and what we did (are doing) to correct this situation.

Cryptosporidium is a disease-causing microorganism that may be in our raw water source. Our water system [give system
name] was required to maintain a specified level of treatment to address Cryptosporidium. During [provide date range], our
system fell below this level.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by Cryptosporidium and other microbial contaminants are available at the
EPA Ground Water and Drinking Water Website at https://www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action and when the system returned or expects to return to compliance.]

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for LT2ESWTR Unfiltered System Failure to Install Second

Disinfectant - Template NC2-9

Template on Reverse

An unfiltered system's failure to install a second disinfectant to treat for Cryptosporidium by the required date, is a treatment technique
violation and requires Tier 2 public notification. You must provide public notice to persons served as soon as practical but within 30 days
after you learn of the violation [40 CFR 141.203(b)!. Your state may have more stringent requirements for treatment technique violations
(e.g., it may require you to provide water from an alternate source). Check with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by unfiltered water systems with
Long Term 2 Enhanced Surface Water Treatment Rule (LT2ESWTR) treatment technique violations. You can use one or more of the
following statements, if appropriate, or develop your own text:

We will install a second disinfectant by [provide date] to satisfy this requirement.

We are currently working with state officials and our engineers to finalize plans for water treatment that will satisfy this
requirement once it is installed.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

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LT2ESWTR Unfiltered System Failure to Install Second Disinfectant Notice -

Template NC2-9

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Provide the Appropriate Level of Treatment Within

Required Time Frame

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our
customers, you have a right to know what happened, what you should do, and what we did (are doing) to
correct this situation.

Our unfiltered water system [give system name] was required to use a minimum of two disinfectants to meet our
treatment requirement by [give date]. We failed to have the new [ultraviolet light (U.V.)/ chlorine dioxide/ozone]
disinfection system installed by the required date.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by microbes are available f at the EPA Ground Water and Drinking Water
Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

We expect to have the [U.V./chlorine dioxide/ozone] disinfection system installed by [give date]. We continue to disinfect
the water with chlorine as we have in the past.

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for Filter Backwash Recycling Rule Treatment Technique Violation -

Template NC2-10

Template on Reverse

Since failure to recycle spent filter backwash, thickener supernatant, and liquids from dewatering processes before all processes of the
direct filtration treatment train; failure to obtain state approval for the use of an alternative recycle location; or failure to pursue capital
improvements are violations that require Tier 2 public notification, you must provide public notice to persons served as soon as practical
but within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your state may have more stringent requirements for treatment
technique violations (e.g., it may require you to provide water from an alternate source). Check with your state to make sure you meet all
its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Do not use overly technical terminology when describing treatment methods.
You can use one or more of the following statements, if appropriate, or develop your own text:

On [give date], we will no longer recycle our filter backwash and will not be in violation of this requirement.

On [give date], the filter backwash will be piped to the beginning of our water treatment process, and we will no longer be in

violation of this requirement.

On [give date], the filter backwash and all other current recycle flows will be discharged to waste as approved by the state.
Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

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Filter Backwash Recycling Rule Treatment Technique Violation Notice -

Template NC2-10

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Meet Treatment Requirements

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our
customers, you have a right to know what happened, what you should do, and what we did (are doing) to
correct this situation.

The Filter Backwash Recycling Rule requires water systems that recycle liquids used for water treatment to recycle these
liquids through the system's existing filtration system or to an alternate location approved by the state. Our system did not
return its water treatment recycle flows to the required location or a state-approved location by the required date of [give
date].

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by microbes are available at the EPA Ground Water and Drinking Water
Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action.] We anticipate resolving the problem within [estimated timeframe].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for RTCR Failure of a Seasonal System to Complete Start-Up

Procedures-Template NC2-11

Template below

Description of Violation or Situation

A seasonal NCWS that fails to follow state-approved start-up procedures prior to serving water to the public after the
system had been out of service has incurred a treatment technique (TT) violation. This violation requires Tier 2 public
notification. Start-up procedures are approved by the state and may include, but are not limited to, activities such as:

Inspecting all water system components, including source(s), treatment components, distribution lines, and storage
tanks and addressing any issues.

Activating the source and thoroughly flushing water through all pipes in the water system.

Draining and re-filling storage tanks.

Chlorinating the water in the system and leaving the chlorinated water in the system for at least 24 hours before
flushing the water to waste.

Collecting water samples at key locations within the system and ensuring the water system is not contaminated by
bacteria.

You must provide public notice to persons served as soon as practical but no later than 30 days after you learn of the
violation [40 CFR 141.2.03(b)1. Your state may have more stringent requirements for treatment technique violations (e.g., it
may require you to provide water from an alternate source). Check with your state to make sure you meet all its
requirements.

NCWSs must use one of the following methods to deliver the notice to consumers [40 CFR 141,203(c)!:

Posting in conspicuous locations

Hand delivery

Mail

Another method approved in writing by the state

In addition, NCWSs must use another method reasonably calculated to reach others if they would not be reached by the
first method [40 CFR 141.2.03(c)1. Such methods could include newspapers, e-mail, or delivery to community organizations.
If you mail, post, or hand deliver, EPA recommends printing your notice on your system's letterhead, if available.

The notice on the reverse is appropriate for mailing, posting, or hand delivery. If you modify this notice, you must still
include all required public notice elements from 40 CFR 141.2.05(a) and leave the mandatory language unchanged (see
below). All posted notices must remain in place for as long as the violation or situation persists but in no case for less than
seven days, even if the violation or situation is resolved.

Mandatory Language

Mandatory language on health effects (from 40 CFR 141.205(d)(2)) must be included as written if the required start-up
procedure includes collecting coliform bacteria samples. The mandatory language is provided below and is presented in this
notice in italics with an asterisk on each end. You will need to update the information presented in brackets with the
appropriate information. If monitoring is not required as part of the start-up procedures the italicized mandatory language
should be omitted and language must be used to appropriately describe the violation.

*We are required to monitor your drinking water for specific contaminants on a regular basis. Results of
regular monitoring are an indicator of whether or not your drinking water meets health standards. During
[compliance period], we "did not complete all monitoring or testing" for [contaminant(s)], and therefore
cannot be sure of the quality of your drinking water during that time. *

You must also include standard language to encourage the distribution of the public notice to all persons served, where
applicable [40 CFR 141,205(d)1. This language is also presented in this notice in italics with an asterisk on each end.

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Corrective Action

In your notice, you must describe corrective actions you are taking [40 CFR 141.205(a}(7}1 and when you expect to return to
compliance or resolve the situation [40 CFR 141.205(a}(8)1. Do not use overly technical terminology when describing
treatment methods. Listed below are some steps commonly taken by water systems with TT violations relating to
incomplete start-up procedures. Depending on the corrective action you are taking, you can use the following statement, if
appropriate, or develop your own text:

We have completed the required start-up procedures and provided the appropriate certification to the state. The
procedures included [describe what you did, for example, flushed the system, disinfected the system, collected total
coliform bacteria samples, etc.].

We have collected [number] coliform bacteria samples as required and [number] sample results were negative for total
coliform bacteria.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out
any previous notices.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

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RTCR Failure of a Seasonal System to Complete Start-Up Procedures - Template

NC2-11

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Complete Seasonal Start-Up Procedures

Before we open each year and serve water to the public we are required to complete certain start-up procedures to make
sure the water we provide is safe to drink. This year we failed to [describe what you failed to do, for example, disinfect the
water system or collect the required number of coliform bacteria samples] before providing water. As our customers, you
have a right to know what happened and what we are doing to correct this situation.

Inadequately treated or inadequately protected water may contain disease-causing organisms. These organisms can cause
symptoms such as diarrhea, nausea, cramps, and associated headaches.

*We are required to monitor your drinking water for specific contaminants on a regular basis. Results of regular monitoring
are an indicator of whether or not your drinking water meets health standards. During [compliance period], we "did not
complete all monitoring or testing" for [contaminant(s)], and therefore cannot be sure of the quality of your drinking water
during that time. *

What should I do?

If you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, are pregnant, or are elderly, you may be at increased risk and
should seek advice from your healthcare provider about drinking this water. You should also seek advice from your
healthcare provider about using the water if you have an infant. General guidelines on ways to lessen the risk of
infection by bacteria and other disease-causing organisms are available at the EPA Ground Water and Drinking
Water Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency, as we have completed the start-up procedures. If it had been, you would have been notified
within 24 hours.

Failure to perform the required start-up procedures prior to serving water to the public has the potential to distribute
contaminated water. When our system shuts down operation, the lack of pressure in our pipes can allow the entry of
bacteria and other disease-causing microorganisms into the drinking water. By performing start-up procedures such as
flushing the pipes, disinfecting the water, and collecting a coliform bacteria sample before we open, we can be sure that we
are providing you with safe water.

What is being done?

[Describe corrective action including when you returned to compliance or resolved the situation].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for RTCR Failure to Perform any Level 1 Assessment or a Level 2
Assessment that is Not Triggered by E. coli MCL Violations or the Related

Corrective Actions - Template NC2-12

Template below

Description of Violation or Situation

A water system triggers a Level 1 assessment when:

For systems taking 40 or more samples (including routine and repeat samples) per month, the water system exceeds
5.0 percent total coliform-positive samples for the month;

For systems taking fewer than 40 samples (including routine and repeat samples) per month, the water system has two
or more total coliform-positive samples in the same month; or

The water system fails to take every required repeat sample after any single routine total coliform-positive sample.

A water system triggers a Level 2 assessment when:

The water system has a second Level 1 assessment treatment technique (TT) trigger within a rolling 12-month period
unless the state has determined a likely reason for the total coliform-positive samples that caused the initial Level 1
assessment TT trigger, and the state establishes that the system has fully corrected the problem; or,

For water systems with approved reduced annual monitoring, the system has a Level 1 assessment TT trigger in two
consecutive years.

TT violations related to triggered assessments occur when any public water system has:

Failed to conduct the triggered Level 1 or Level 2 assessment within 30 days after learning that it has exceeded the
trigger; or

Failed to correct any sanitary defect found through a Level 1 or Level 2 assessment within 30 days or in accordance
with a schedule acceptable to the state.

TT violations related to any Level 1 assessment or to a Level 2 assessment that is not triggered by an E. coli MCL violation
require similar Tier 2 public notice. TT violations for Level 2 assessments that are triggered by E. coli MCL violations require
different mandatory health effects language and are addressed in Template NC2-15.

You must provide public notice to persons served as soon as practical but no later than 30 days after you learn of the
violation [40 CFR 141.2.03(b)1. You must issue a repeat notice every three months for as long as the violation persists. Check
with your state to make sure you meet all its requirements.

NCWSs must use one of the following methods to deliver the notice to consumers [40 CFR 141,203(c)!:

Posting in conspicuous locations

Hand delivery

Mail

Another method approved in writing by the state

In addition, NCWSs must use another method reasonably calculated to reach others if they would not be reached by the
first method [40 CFR 141.2.03(c)1. Such methods could include newspapers, e-mail, or delivery to community organizations.
If you mail, post, or hand deliver, EPA recommends printing your notice on your system's letterhead, if available.

The notice on the reverse is appropriate for mailing, posting, or hand delivery. If you modify this notice, you must still
include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory language unchanged (see
below). All posted notices must remain in place for as long as the violation or situation persists but in no case for less than
seven days, even if the violation or situation is resolved.

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q.) must be included as written and is
presented in this notice in italics with an asterisk on each end.

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*Coliforms are bacteria that are naturally present in the environment and are used as an indicator that
other, potentially harmful, waterborne pathogens may be present or that a potential pathway exists
through which contamination may enter the drinking water distribution system. We found coliforms
indicating the need to look for potential problems in water treatment or distribution. When this occurs, we
are required to conduct assessments to identify problems and to correct any problems that are found. *

You are also required to include one or both of the following statements, also presented in this notice in italics with an
asterisk on each end, as appropriate for the violation:

*We failed to conduct the required assessment. *

*We failed to correct all identified sanitary defects that were found during the assessment that we
conducted. *

You must also include standard language to encourage the distribution of the public notice to all persons served, where
applicable [40 CFR 141.205(d)]. This language is also provided below and presented in this notice in italics with an asterisk
on each end.

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

Corrective Action

The specific cause(s) of total coliforms in the distribution system that triggered the assessment will likely differ from system
to system. Your notice must describe the corrective action(s) you are taking [40 CFR 141,205(a)(7)1 to address the TT
violation and when you expect to return to compliance or resolve the situation [40 CFR 141,205(a)(3)]. You can use one or
more of the following statements, if appropriate, or develop your own text.

We have begun to correct the sanitary defect(s) identified during an assessment of our water system by taking the
following corrective actions: [Describe corrective actions].

To ensure that our water system is protected against contamination, we are working with the state to implement the
following corrective actions: [Describe corrective actions].

We completed the required assessment and identified the cause of the sanitary defect to be addressed [describe the
issue or problem found, for example, damage to the storage tank, a missing vent screen, etc.] We are currently
correcting the problem on a schedule approved by [State Department of Public Health],

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification
requirements to your state within 10 days after the original or any repeat notice(s) [40 CFR 141,31(d)].

It is a good idea to inform your consumers when the violation has been resolved. See Template NCI-10 for a "problem
corrected" notice template.

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RTCR Failure to Perform any Level 1 Assessment or a Level 2 Assessment that is
Not Triggered by E. coli MCL Violations or the Related Corrective Actions -

Template NC2-12

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Perform Activities Required to Address Coliform
Bacteria Contamination of the Water System

During recent routine monitoring, our water system tested positive for total coliforms. *Coliforms are bacteria that are
naturally present in the environment and are used as an indicator that other, potentially harmful, waterborne pathogens
may be present or that a potential pathway exists through which contamination may enter the drinking water distribution
system. We found coliforms indicating the need to look for potential problems in water treatment or distribution.

When this occurs, we are required to conduct assessments to identify problems and to correct any problems that are found. *
[Describe the TT violation, using the mandatory language of *We failed to conduct the required assessment* by [Enter date
the assessment was due] and/or *We failed to correct all identified sanitary defects that were found during the
assessment(s)* by [Enter date correction was due].]

As our customers, you have a right to know what happened and what we are doing to correct this situation.

What should I do?

You do not need to boil your water or take other corrective actions. However, if you have specific health concerns,
consult your doctor.

If you have a severely compromised immune system, are pregnant, or are elderly, you may be at increased risk and
should seek advice from your healthcare provider about drinking this water. You should also seek advice from your
healthcare provider about using the water if you have an infant. General guidelines on ways to lessen the risk of
infection by bacteria and other disease-causing organisms are available at the EPA Ground Water and Drinking
Water Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

Since total coliform bacteria are generally not harmful themselves, this is not an emergency. If it had been you would have
been notified within 24 hours.

Failure to identify and correct the defects has the potential to cause continued distribution system contamination.
Inadequately treated or inadequately protected water may contain disease-causing organisms. These organisms can cause
symptoms such as diarrhea, nausea, cramps, and associated headaches.

What is being done?

[Describe corrective action including when your water system expects to return to compliance or resolve the violation].

For more information, please contact [name of contact] at [phone number] or [mailing address],

* Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for RTCR Failure to Perform a Level 2 Assessment Triggered by an E.
coli MCL Violation or the Related Corrective Actions - Template NC2-13

Template below

Description of Violation or Situation

A water system triggers a Level 2 assessment when:

The water system has an E. coli maximum contaminant level (MCL) violation;

A TT violation related to a Level 2 assessment that was triggered by an E. coli MCL violation requires Tier 2 public notice
with mandatory health effects language stating E. coli was detected in the water system. Violations of Level 2 assessments
related to E. coli require Tier 2 public notice and occur when any public water system has:

Failed to conduct the triggered Level 2 assessment within 30 days after learning that it has exceeded the trigger; or
Failed to correct any sanitary defect found through a Level 2 assessment within 30 days or in accordance with a
schedule acceptable to the state.

TT violations for Level 2 assessments that are triggered by more than one Level 1 assessment require different mandatory
health effects language and are addressed in Template N

You must provide public notice to persons served as soon as practical but no later than 30 days after you learn of the
violation [40 CFR 141.2.03(b)1. You must issue a repeat notice every three months for as long as the violation persists. Check
with your state to make sure you meet all its requirements.

NCWSs must use one of the following methods to deliver the notice to consumers [40 CFR 141,203(c)!:

Posting in conspicuous locations

Hand delivery

Mail

Another method approved in writing by the state

In addition, NCWSs must use another method reasonably calculated to reach others if they would not be reached by the
first method [40 CFR 141.2.03(c)1. Such methods could include newspapers, e-mail, or delivery to community organizations.
If you mail, post, or hand deliver, EPA recommends printing your notice on your system's letterhead, if available.

The notice on the reverse is appropriate for mailing, posting, or hand delivery. If you modify this notice, you must still
include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory language unchanged (see
below). All posted notices must remain in place for as long as the violation or situation persists but in no case for less than
seven days, even if the violation or situation is resolved.

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q.) must be included as written and is
presented in this notice in italics with an asterisk on each end.

*E. coli are bacteria whose presence indicates that the water may be contaminated with human or animal
wastes. Human pathogens in these wastes can cause short-term effects, such as diarrhea, cramps, nausea,
headaches, or other symptoms. They may pose a greater health risk for infants, young children, the
elderly, and people with severely compromised immune systems. We violated the standard for E. coli,
indicating the need to look for potential problems in water treatment or distribution. When this occurs, we
are required to conduct a detailed assessment to identify problems and to correct any problems that are
found. *

You are also required to include one or both of the following statements, also presented in this notice in italics with an
asterisk on each end, as appropriate for the violation:

*We failed to conduct the required assessment. *

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* We failed to correct all identified sanitary defects that were found during the assessment that we
conducted. *

You must also include standard language to encourage the distribution of the public notice to all persons served, where
applicable [40 CFR 141,205(d)!. This language is also provided below and presented in this notice in italics with an asterisk
on each end.

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

Corrective Action

The specific cause(s) of E. coli in the distribution system will likely differ from system to system. Your notice must describe
the corrective action(s) you are taking [40 CFR 141.2.05(a)(7)1 and when you expect to return to compliance or resolve the
situation [40 CFR 141.2.05(a)(8)1. You can use one or more of the following statements, if appropriate, or develop your own
text.

We have begun to correct the sanitary defect(s) identified during an assessment of our water system by taking the
following corrective actions. [Describe corrective actions].

To ensure that our water supplies are protected against contamination, we are working with the state to implement
the following corrective actions. [Describe corrective actions].

We completed the required assessment and identified the cause of the sanitary defect to be addressed [describe the
issue or problem found, for example, damage to the storage tank, a missing vent screen, etc.] We are currently
correcting the problem on a schedule approved by [State Department of Public Health],

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification
requirements to your state within 10 days after the original or any repeat notice(s) [40 CFR 141,31(d)].

It is a good idea to inform your consumers when the violation has been resolved. See Template NCI-10 for a "problem
corrected" notice template.

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RTCR Failure to Perform a Level 2 Assessment Triggered by an E. coli MCL
Violation or the Related Corrective Actions - Template NC2-13

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Correct a Problem Discovered During an Assessment
of the Water System after Testing Positive for E. coli

During recent monitoring, our water system tested positive for E. coli. *E. coli are bacteria whose presence indicates that
the water may be contaminated with human or animal wastes. Human pathogens in these wastes can cause short-term
effects, such as diarrhea, cramps, nausea, headaches, or other symptoms. They may pose a greater health risk for infants,
young children, the elderly, and people with severely compromised immune systems. We violated the standard for E. coli,
indicating the need to look for potential problems in water treatment or distribution.

When this occurs, we are required to conduct a detailed assessment to identify problems and to correct any problems that
are found.* [Describe the TT violation, using the mandatory language of *We failed to conduct the required assessment* by
[Enter date the assessment was due] and/or *We failed to correct all identified sanitary defects that were found during the
assessment(s)* by [Enter date correction was due]]

As our customers, you have a right to know what happened and what we are doing to correct this situation. You were
notified of the E. coli in our water on [enter date when Tier 1 public notice of the MCL violation that triggered the
assessment was provided] and on [enter date] that no additional contamination has been identified and that you do not
need to boil your water or take other corrective actions. Although our recent sampling has indicated coliform bacteria are
absent, we are still required to assess the system and correct any defects found.

What should I do?

You still do not need to boil your water or take corrective actions. However, if you have specific health concerns,
consult your doctor.

If you have a severely compromised immune system, are pregnant, or are elderly, you may be at increased risk and
should seek advice from your healthcare provider about drinking this water. You should also seek advice from your
healthcare provider about using the water if you have an infant. General guidelines on ways to lessen the risk of
infection by bacteria and other disease-causing organisms are available from at the EPA Ground Water and
Drinking Water Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been you would have been notified within 24 hours.

Failure to identify and correct system defects has the potential to cause distribution system contamination. Inadequately
treated or inadequately protected water may contain disease-causing organisms. These organisms can cause symptoms
such as diarrhea, nausea, cramps, and associated headaches.

What is being done?

[Describe corrective action including when you expect to return to compliance or resolve the situation].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for GWR Failure to Maintain 4-log Treatment of Viruses - Template

NC2-14

Template on Reverse

A ground water system's failure to maintain required 4-log treatment of viruses for a period greater than four hours is a treatment
technique violation that requires Tier 2 public notification. You must provide public notice to persons served as soon as practical but
within 30 days after you learn of the violation [40 CFR 141.203(b)!. Your state may have more stringent requirements for treatment
technique violations (e.g., it may require you to provide water from an alternate source). Check with your state to make sure you meet all
its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with Ground
Water Rule treatment technique violations. You can use one or more of the following statements, if appropriate, or develop your own
text:

We are increasing disinfection to maintain our proper residual levels.

We are pursuing improvements to our treatment system so that we can maintain required treatment at all times.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

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GWR Failure to Maintain 4-log Treatment of Viruses Notice - Template NC2-14

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failure to Meet Treatment Requirements

Our water system recently violated a drinking water requirement. Although this incident was not an emergency, as our
customers, you have a right to know what happened and what we did (are doing) to correct this situation.

We are required to [treat/disinfect] our drinking water source [name source]. From [give date] to [give date] we did not
meet one or more of our treatment requirements [provide sufficient levels of disinfectant/provide adequate contact
time/meet alternative treatment criteria] due to [describe issue, e.g., malfunctioning equipment].

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by microbes are available from at the EPA Ground Water and Drinking Water
Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

While we have not detected any evidence of contamination in, or other health threats to, our source water, we are still
committed to restoring the required level of treatment to the water from [source] to eliminate the threat of contamination.

What is being done?

[Describe corrective action.] We anticipate resolving the problem within [estimated timeframe], OR The problem was
resolved on [give date].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Instructions for GWR Failure to Take Corrective Action Within Required Time

Frame - Template NC2-15

Template on Reverse

A system's failure to take corrective action within the required timeframe or be in compliance with a state-approved corrective action
plan and schedule for a fecal indicator-positive ground water source sample or significant deficiency under GWR is a treatment technique
violation and requires Tier 2 public notification. You must provide public notice to persons served as soon as practical but within 30 days
after you learn of the violation [40 CFR 141.203(b)!. Your state may have more stringent requirements for treatment technique violations
(e.g., it may require you to provide water from an alternate source). Check with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with Ground
Water Rule treatment technique violations. You can use one or more of the following statements, if appropriate, or develop your own
text:

Although we did not meet our deadline, we are now in consultation with the state to develop a corrective action plan.

The [source of contamination/significant deficiency] has been identified and addressed.

We have implemented a short-term plan to address the immediate issue while we pursue the long-term solution.

Repeat Notices

For repeat notices, you should state how long the violation has been ongoing and remind consumers of when you sent out any previous
notices. If you are making progress, describe it. Alternatively, if funding or other issues are delaying progress, let consumers know.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NCI-10 for a "problem corrected" notice template.

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GWR Failure to Take Corrective Action Within Required Time Frame Notice -

Template NC2-15

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to [Correct a Significant Deficiency/Address a Fecal
Indicator-Positive Source Sample] Within Required Time Frame.

Our water system recently violated a drinking water requirement. Although this incident was not an emergency, as our
customers, you have a right to know what happened and what we did (are doing) to correct this situation.

[A routine inspection conducted on [give date] by the [insert state] found [describe significant deficiency in our water
system]] OR

[Sampling conducted at our ground water source on [given date(s)] found indication of fecal contamination of our
source(s)].

As required by Environmental Protection Agency's (EPA's) Ground Water Rule (GWR), we were required to take action to
[correct this deficiency/address the fecal-indicator positive source sample]. However, we failed to take this action by the
deadline established by [insert state name].

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by microbes are available from at the EPA Ground Water and Drinking Water
Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action.] We anticipate resolving the problem within [estimated timeframe] (or the problem was
resolved on [give date]).

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Special Notice: Instructions for LT2ESWTR Failure to Conduct Required
Cryptosporidium Monitoring For Any Three Months - Template NC2-16

Template on Reverse

A system's failure to conduct required Cryptosporidium monitoring of its source water for any three months is a monitoring violation that
requires Tier 2 public notification and special notice. You must provide public notice to persons served as soon as practical but within 30
days after you learn of the violation [40 CFR 141.203(b)!. You must issue a repeat notice every three months for as long as the violation
persists. Your state may have more stringent requirements for this monitoring violation (e.g., it may require you to provide water from an
alternate source). Check with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with LT2ESWTR
monitoring violations. Depending on the corrective action you are taking, you can use one or more of the following statements, if
appropriate, or develop your own text:

We will begin collecting the required source water monitoring samples on [give date].

We have since taken the required samples for source water monitoring.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

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Special Notice: LT2ESWTR Failure to Conduct Required Cryptosporidium
Monitoring for Any Three Months Notice - Template NC2-16

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

Monitoring Requirements Not Met for [Water System Name]

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our customers, you
have a right to know what happened, what you should do, and what we did (are doing) to correct this situation.

*We are required to monitor the source of your drinking water for Cryptosporidium. Results of the monitoring are to be used
to determine whether water treatment at the [treatment plant name] is sufficient to adequately remove Cryptosporidium
from your drinking water. We are required to complete this monitoring and make this determination by [required bin
determination date]. We ["did not monitor or test" or "did not complete all monitoring or testing"] on schedule and,
therefore, we may not be able to determine by the required date what treatment modifications, if any, must be made to
ensure adequate Cryptosporidium removal. Missing this deadline may, in turn, jeopardize our ability to have the required
treatment modifications, if any, completed by the deadline required, [give date], *

Cryptosporidium is a disease-causing microorganism that may be present in our raw water source.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by Cryptosporidium and other microbial contaminants are available at the
EPA Ground Water and Drinking Water Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

What is being done?

[Describe corrective action.] We will collect all required samples by [give date],

* For more information, please call [name of water system contact] of [water system name] at [phone number].*

Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail.

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Special Notice: Instructions for LT2ESWTR Filtered System Failure to Determine
and Report Bin Classification - Template NC2-17

Template on Reverse

A filtered system's failure to determine its bin classification by the required date requires a Tier 2 public notification and special notice,
and a system's failure to report its bin classification by the required date is a treatment technique violation. The template on the reverse
meets both of these requirements. You must provide public notice to persons served as soon as practical but within 30 days after you
learn of the violation [40 CFR 141.203(b)!. You must issue a repeat notice every three months for as long as the violation persists. Your
state may have more stringent requirements for this monitoring violation (e.g., it may require you to provide water from an alternate
source). Check with your state to make sure you meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with Long Term
2 Enhanced Surface Water Treatment Rule (LT2ESWTR) treatment technique violations. You can use the following language, if
appropriate, or develop your own text:

We determined our bin classification on [give date], and have notified the state.

We are in the process of determining our bin classification and will notify the state upon completion.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-10 for a "problem corrected" notice template.

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Special Notice: LT2ESWTR Filtered System Failure to Determine and Report Bin

Classification Notice-Template NC2-17

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Determine Required Treatment Based on

Cryptosporidium Level

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our customers, you
have a right to know what happened, what you should do, and what we did (are doing) to correct this situation.

*	We are required to monitor the source of your drinking water for Cryptosporidium in order to determine by [give date]
whether water treatment at the [provide treatment plant name] is sufficient to adequately remove Cryptosporidium from
your drinking water. We have not made this determination by the required date. Our failure to do this may jeopardize our
ability to have the required treatment modifications, if any, completed by the required deadline of [give date].*

Cryptosporidium is a disease-causing microorganism that may be present in our raw water source.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by Cryptosporidium and other microbial contaminants are available at the
EPA Ground Water and Drinking Water Website at httpsi//www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action.] We anticipate resolving the problem within [estimated timeframe] (or the problem was
resolved on [give date]).

*	For more information, please call [name of water system contact] of [water system name] at [phone number].*

*Please share this information with all the other people who drink this water, especially those who
may not have received this notice directly (for example, people in apartments, nursing homes,
schools, and businesses). You can do this by posting this notice in a public place or distributing copies
by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	.

Date distributed:	.

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Special Notice: Instructions for LT2ESWTR Unfiltered System Failure to Calculate
and Report Mean Cryptosporidium Level Notice - Template NC2-18

Template on Reverse

An unfiltered system's failure to calculate and report its mean Cryptosporidium level by the required date is a treatment technique (TT)
violation that requires Tier 2 public notification and special notice. The template on the reverse meets both of these requirements. You
must provide public notice to persons served as soon as practical but within 30 days after you learn of the violation [40 CFR 141.203(b)!.
You must issue a repeat notice every three months for as long as the violation persists. Your state may have more stringent requirements
for this monitoring violation (e.g., it may require you to provide water from an alternate source). Check with your state to make sure you
meet all its requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR
141.203(c)!. If you post or hand deliver, print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Action

In your notice, describe corrective actions you are taking. Listed below are some steps commonly taken by water systems with Long Term
2 Enhanced Surface Water Treatment Rule (LT2ESWTR) treatment technique violations. You can use the following language, if
appropriate, or develop your own text:

We determined our mean Cryptosporidium level on [give date], and have notified the state.

We are in the process of determining our mean Cryptosporidium level and will notify the state upon completion.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

It is a good idea to inform your consumers when the violation has been resolved, especially if you have regular customers. See Template
NC1-1 for a "problem corrected" notice template.

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Special Notice: LT2ESWTR Unfiltered System Failure to Calculate and Report
Mean Cryptosporidium Level Notice-Template NC2-18

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

[Water System Name] Failed to Determine Cryptosporidium Level

Our water system recently violated a drinking water requirement. Although this is not an emergency, as our customers, you
have a right to know what happened, what you should do, and what we did (are doing) to correct this situation.

*	We are required to monitor the source of your drinking water for Cryptosporidium in order to determine by [give date]
whether water treatment at the [provide treatment plant name] is sufficient to adequately remove Cryptosporidium from
your drinking water. We have not made this determination by the required date. Our failure to do this may jeopardize our
ability to have the required treatment modifications, if any, completed by the required deadline of [give date].*

Cryptosporidium is a disease-causing microorganism that may be present in our raw water source.

What should I do?

There is nothing you need to do. You do not need to boil your water or take other corrective actions. However, if
you have specific health concerns, consult your doctor.

If you have a severely compromised immune system, have an infant, are pregnant, or are elderly, you may be at
increased risk and should seek advice from your healthcare providers about drinking this water. General guidelines
on ways to lessen the risk of infection by Cryptosporidium and other microbial contaminants are available at the
EPA Ground Water and Drinking Water Website at https://www.epa.gov/ground-water-and-drinking-water.

What does this mean?

This is not an emergency. If it had been, you would have been notified within 24 hours.

*lnadequately treated water may contain disease-causing organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps, diarrhea, and associated headaches. *

These symptoms, however, are not caused only by organisms in drinking water, but also by other factors. If you experience
any of these symptoms and they persist, you may want to seek medical advice.

What is being done?

[Describe corrective action.] We anticipate resolving the problem within [estimated timeframe] (or the problem was
resolved on [give date]).

*	For more information, please call [name of water system contact] of [water system name] at [phone number].*

*Please share this information with all the other people who drink this water, especially those who
may not have received this notice directly (for example, people in apartments, nursing homes,
schools, and businesses). You can do this by posting this notice in a public place or distributing copies
by hand or mail. *

This notice is being sent to you by [system name]. State Water System ID#	.

Date distributed:	

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Tier 3 Templates

•	LT2ESWTR Monitoring Violation (Tier 3) Notice -Template NC3-1

•	Failure to Develop a Profile and/or Calculate a Benchmark Notice - Template NC3-2

•	RTCR Failure to Report E. coli-positive Sampling Events to the State - Template NC3-3

•	RTCR Failure to Report Monitoring Events to the State that are Not Related to E. coli-positive Sample
Results - Template NC3-4

•	RCTR Failure to Provide the State a Certificate that Confirms Seasonal System Start-up Procedures have
been Completed - Template NC3-5

•	RCTR Failure to do Recordkeeping - Template NC3-6

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Instructions for LT2ESWTR Monitoring Violation - Template NC3-1

Template on Reverse

If you are required to provide Tier 3 notification, you must provide public notice to persons served within one year after you learn of the
violation [40 CFR 141.204(b)!. Multiple monitoring violations can be serious, and your state may have more stringent requirements. The
example in this template is for Cryptosporidium monitoring under LT2ESWTR. If a system fails to conduct Cryptosporidium monitoring of
its source water for one or two months, they are required to issue Tier 3 public notification. (Note: failure to conduct required
Cryptosporidium monitoring for any three months requires Tier 2 notification and special notice. See Template NC2-16 for an example.)
Check with your state to make sure you meet its requirements.

You must use one of the following methods [40 CFR 141.204(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR

141.203(c)!.

You must post the notice until the violation is resolved. If the violation has already been resolved, you must post the notice for at least
seven days [40 CFR 141.204(b)!. If you mail, post, or hand deliver, you should print your notice on your system's letterhead, if available.

The notice on the reverse is appropriate for insertion in an annual notice, as long as public notification timing and delivery requirements
are met [40 CFR 141.204(d)!. You may need to modify the template for a notice for individual monitoring violations. This example
presents violations in a table; however, you may write out an explanation for each violation if you wish.

You may need to modify the notice if you had any monitoring violations for which monitoring later showed a maximum contaminant level
(MCL) or other violation. In such cases, you should refer to the public notice you issued at that time. If you do modify the notice, you
must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Actions

In your notice describe corrective actions you took or are taking. Listed below are some steps commonly taken by water systems with
monitoring violations. Choose the appropriate language, or develop your own text:

We have since taken the required samples, as described in the last column of the table above. The samples showed we are
meeting drinking water standards.

We have since taken the required samples, as described in the last column of the table above. The sample for [contaminant]
exceeded the limit. [Describe corrective action; use information from public notice prepared for violating the limit.]

We plan to take the required samples soon, as described in the last column of the table above.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

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LT2ESWTR Monitoring Violation Notice-Template NC3-1

DRINKING WATER NOTICE
Monitoring Requirements Not Met for [Water System Name]

*We are required to monitor your drinking water for specific contaminants on a regular basis. Results of regular monitoring
are an indicator of whether or not our drinking water meets health standards. During [compliance period] we ['did not
monitor or test' or 'did not complete all monitoring or testing'] for Cryptosporidium and therefore cannot be sure of the
quality of your drinking water during that time. *

Cryptosporidium is a disease-causing microorganism that may be present in our raw water source.

What This Means

This is not an emergency. There is nothing you need to do at this time.

The table below lists the contaminant(s) we did not properly test for during the last year, how often we are supposed to
sample for [this contaminant/these contaminants], how many samples we are supposed to take, how many samples we
took, when samples should have been taken, and the date on which follow-up samples were (or will be) taken.

Contaminant

Required sampling
frequency

Number of samples
taken

When samples should
have been taken

When samples were
taken

Cryptosporidium
(example)

Monthly

0

November 2016

December 2016





















Steps We Are Taking

[Describe corrective action.] We began collecting our monthly samples for Cryptosporidium on [give date] and will continue
to follow our required monitoring schedule.

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#:	

Date distributed:	

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Instructions for Failure to Develop a Profile and/or Calculate a Benchmark -

Template NC3-2

Template on Reverse

Failure to develop a disinfection profile for Giardia lamblia and viruses (a profile for viruses may be applicable under LT1ESWTR and is
required under LT2ESWTR) or calculate a benchmark prior to making a significant change to your disinfection practice, requires Tier 3
notification. You must provide public notice to persons served within 12 months after you learn of the violation [40 CFR 141.204(b)!.
Failure to develop a profile or calculate a benchmark can be serious and your state may have more stringent requirements. Check with
your state to make sure you meet all requirements.

You must use one of the following methods [40 CFR 141.203(c)!:

Posting in conspicuous locations
Hand delivery
• Mail

Another method approved in writing by the state

You must also use another method reasonably calculated to reach others if they would not be reached by the first method [40 CFR

141.203(c)!.

You must post the notice until the violation is resolved. If the violation has already been resolved, you must post the notice for at least
seven days [40 CFR 141.204(b)!. If you mail, post, or hand deliver, you should print your notice on your system's letterhead, if available.

If you modify this notice, you must still include all required public notice elements from 40 CFR 141.205(a) and leave the mandatory
language unchanged (see below).

Mandatory Language

Mandatory language on health effects (from Appendix B to 40 CFR 141 Subpart Q) must be included as written and is presented in this
notice in italics with an asterisk on either end. You will need to update the information presented in brackets with the appropriate
information.

This template also includes mandatory language encouraging further distribution to persons who may not have received the notice,
where applicable [40 CFR 141.205(d)!. This language is also presented in this notice in italics with an asterisk on either end. However, if
you post the notice such that all possible users have access to the notice, this language is not applicable and can be omitted.

Corrective Actions

In your notice, describe corrective actions you took, or are taking. Listed below is a step commonly taken by water systems with a
profiling and benchmarking violation. You can use the following language, if appropriate, or develop your own text:

We are in the process of developing our disinfection profile and will calculate a benchmark as soon as the profile is complete.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification requirements to your
state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

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Failure to Develop a Profile and/or Calculate a Benchmark Notice - Template

NC3-2

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

Monitoring Requirements Not Met for [Water System Name]

We violated a drinking water requirement. [Prior to making any change to our disinfection practices, we are required to
develop a year-long profile of our disinfection system to determine our inactivation levels for certain pathogenic organisms.
Development of a profile requires monitoring disinfection parameters. We did not meet this requirement.] AND/OR

[Since we [are making/made] a change to our disinfection practice, we [are/were] required to calculate a benchmark to
determine our lowest monthly inactivation level over the year. We did not calculate a benchmark.]

*We are required to monitor your drinking water for specific contaminants on a regular basis. Results of regular monitoring
are an indicator of whether or not our drinking water meets health standards. During [compliance period] we did not
complete all monitoring or testing for the profile parameters and therefore cannot be sure of the quality of our drinking
water during that time. *

What should I do?

There is nothing you need to do at this time. You may continue to drink the water. If a situation arises where the water is no
longer safe to drink, you will be notified within 24 hours.

What is being done?

We [collected /will collect] all required samples on [give date], [Describe corrective action.]

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [system name]. State Water System ID#	.

Date distributed:	

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Instructions for RTCR Failure to Report E. coli-positive Sampling Events to the

State - Template NC3-3

Template on Reverse

Description of Violation or Situation

Failure to notify the state of events that are related to E. coli-positive sample results are reporting violations that require
Tier 3 public notification. The reporting violations addressed by this Tier 3 template require similar public notification
content and include:

Failure to notify the state within 24 hours of an E. coli MCL violation.

Failure to notify the state within 24 hours of an E. coli-positive sample result.

You must provide public notice to persons served within one year after you learn of the violation [40 CFR 141,204(b)!.

Check with your state to make sure you meet all requirements.

NCWSs must use all of the following methods to deliver the notice to consumers [40 CFR 141.2.04(c}1:

Posting in a conspicuous place throughout the system, or by hand delivery or mail, and

Another method as needed to reach consumers not likely to receive a notice from methods noted above and approved
in writing by the state. Such methods could include newspapers, e-mail, or delivery to community organizations.

If you:

Post the notice, it must remain posted until the violation is resolved.

Post the notice and the violation has already been resolved, you must still post the notice for at least seven days [40

CFR 141.2.04(b)1.

Mail, post, or hand deliver, EPA recommends printing your notice on your system's letterhead, if available.

Repeat notice(s) are required annually if the violation or situation persists, unless otherwise directed by the state.
Mandatory Language

You must also include standard language to encourage the distribution of the public notice to all persons served, where
applicable [40 CFR 141,20S(d)1. This language is also presented in this notice in italics with an asterisk on each end.

Corrective Actions

In your notice, you must describe corrective actions you took, or are taking [40 CFR 141.205(a)(7)1 and when you expect to
return to compliance or resolve the situation [40 CFR 141.205(a)(8)1. You can use the following language, if appropriate, or
develop your own:

We have provided the missing reports to the state and have revised our procedures to ensure we comply with
reporting requirements in the future. We are no longer in violation.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification
requirements to your state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

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RTCR Failure to Report E. co//-positive Sampling Events to the State - Template

NC3-3

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

Reporting Requirement(s) Not Met for [Water System Name]

Our system failed to notify the state drinking water program that we [enter either "detected E. coli bacteria in a water
sample" or "have incurred an MCL violation for E. coli bacteria"]. We are required to notify the state of this information
within 24 hours of when we learned of the situation but we failed to do so.

[If applicable, enter, "We notified you of the E. coli MCL violation on [enter date] and resolved the contamination problem
on [enter date]"].

Although this situation does not create a risk to public health, as our customers you have a right to know what happened
and what we did to correct the situation.

What should I do?

There is nothing you need to do at this time. If a situation arises where the water is no longer safe to drink, you will be
notified within 24 hours. We will announce any emergencies on [media source].

What is being done?

[Describe your corrective actions including when your water system expects to return to compliance or resolve the
violation].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#	.

Date distributed:	.

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Instructions for RTCR Failure to Report Monitoring Events to the State that are
Not Related to E. coli-positive Sample Results - Template NC3-4

Template on Reverse

Description of Violation or Situation

Failure to notify the state of RTCR events that are not related to E. coli-positive sample results are reporting violations that
require Tier 3 public notification. The reporting violations addressed by this Tier 3 template require similar public
notification content and include:

Failure to provide total coliform-positive or total coliform-negative sample results to the state in a timely manner.
Failure to notify the state that an RTCR monitoring violation occurred with 10 days of when the violation occurred.
Failure to notify the state within 24 hours of a Treatment Technique (TT) violation resulting from failure to perform
assessments or corrective actions.

Failure to submit the completed assessment form or monitoring report within 30 days of triggering the assessment.
Failure to notify the state when each scheduled corrective action is completed based on the state-approved timeframe.

You must provide Tier 3 public notice to persons served within one year after you learn of the violation [40 CFR 141,204(b)!.
Check with your state to make sure you meet all requirements.

NCWSs must use all of the following methods to deliver the notice to consumers [40 CFR 141.2.04(c}1:

Posting in a conspicuous place throughout the system, or by hand delivery or mail, and

Another method as needed to reach consumers not likely to receive a notice from methods noted above and approved
in writing by the state. Such methods could include newspapers, e-mail, or delivery to community organizations.

If you:

Post the notice, it must remain posted until the violation is resolved.

Post the notice and the violation has already been resolved, you must still post the notice for at least seven days [40

CFR 141.2.04(b)1.

Mail, post, or hand deliver, EPA recommends printing your notice on your system's letterhead, if available.

Modify the notice, you must still include all required public notice elements from 40 CF	35(a) and leave the

mandatory language unchanged (see below).

Repeat notice(s) are required annually if the violation or situation persists, unless otherwise directed by the state.

Mandatory Language

You must also include standard language to encourage the distribution of the public notice to all persons served, where
applicable [40 CFR 141,205(d)1. This language is also presented in this notice in italics with an asterisk on each end.

Corrective Actions

In your notice, you must describe corrective actions you took, or are taking [40 CFR 141,205(a)(7)! including when your
water system expects to return to compliance or resolve the violation [40 CFR 141,205(a)(8)1. You can use the following
language, if appropriate, or develop your own:

We have provided the missing reports to the state and have revised our procedures to ensure we comply with
reporting requirements in the future. We are no longer in violation.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification
requirements to your state within 10 days after the original or any repeat notice(s) [40 CFR 141,31(d)1.

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RTCR Failure to Report Monitoring Events to the State that are Not Related to E.
coli-positive Sample Results - Template NC3-4

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

Reporting Requirement(s) Not Met for [Water System Name]

We are required to report [describe the information not reported, such as "the results of monitoring of your drinking water
for specific contaminants on a regular basis" or "the results of our water system's assessment by [enter date]]. Results of
[enter applicable text, such as "regular monitoring" or "the assessment", as applicable] are an indicator of whether or not
your drinking water meets health standards. During [compliance period], we did not [describe what you did not report,
such as "report the results of monitoring or of the assessment] for [contaminant(s)]"].

Our system failed to notify the state drinking water program as required by [enter date]. Although public health was not
impacted, as our customers, you have a right to know what happened and what we did to correct the situation.

What should I do?

There is nothing you need to do at this time. You do not need to boil your water or take other actions.

What is being done?

While we did not notify the state as quickly as we should have, we have [enter your corrective action] on [enter date]. We
are no longer in violation.

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#	.

Date distributed:	.

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Instructions for RTCR Failure to Provide the State a Certificate that Confirms
Seasonal System Start-up Procedures have been Completed - Template NC3-5

Template on Reverse

Description of Violation or Situation

Failure of a seasonal NCWS to certify to the state that they have completed all state-approved start up procedures before
serving water to the public is a reporting violation that requires Tier 3 public notification.

You must provide public notice to persons served within one year after you learn of the reporting violation [40 CFR
34(b)!. Check with your state to make sure you meet all requirements.

NCWSs must use all of the following methods to deliver the notice to consumers [40 CFR 141.2.04(c}1:

Posting in a conspicuous place throughout the system, or by hand delivery or mail, and

Another method as needed to reach consumers not likely to receive a notice from methods noted above and approved
in writing by the state. Such methods could include newspapers, e-mail, or delivery to community organizations.

If you:

Post the notice, it must remain posted until the violation is resolved.

Post the notice and the violation has already been resolved, you must still post the notice for at least seven days [40

CFR 141.2.04(b)!.

Mail, post, or hand deliver, EPA recommends printing your notice on your system's letterhead, if available.

Modify the notice, you must still include all required public notice elements from 40 CF	35(a) and leave the

mandatory language unchanged (see below).

Repeat notice(s) are required annually if the violation or situation persists, unless otherwise directed by the state.

Mandatory Language

You must also include standard language to encourage the distribution of the public notice to all persons served, where
applicable [40 CFR 141,20S(d)1. This language is also presented in this notice in italics with an asterisk on each end.

Corrective Actions

In your notice, you must describe corrective actions you took, or are taking [40 CFR 141,205(a)(7)! including when your
water system expects to return to compliance or resolve the violation [40 CFR 141,205(a)(8)!. You can use the following
language, if appropriate, or develop your own:

We have provided the missing certification to the state and have revised our procedures to ensure we comply with
reporting requirements in the future. We are no longer in violation.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification
requirements to your state within 10 days after the original or any repeat notice(s) [40 CFR 141.31(d)!.

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RTCR Failure to Provide the State a Certificate that Confirms Seasonal System
Start-up Procedures have been Completed - Template NC3-5

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

Reporting Requirement(s) Not Met for [Water System Name]

[Water System Name] failed to notify the state drinking water program that we completed the steps required to start-up
our water system after we'd been shut down for the off-season. We are required to notify the state that we completed the
required steps before we served water to the public.

Although this situation does not create a health risk, as our customers you have a right to know what happened and what
we did to correct the situation.

What should I do?

There is nothing you need to do at this time. If a situation arises where the water is no longer safe to drink, you will be
notified within 24 hours.

What is being done?

[Describe your corrective actions including when your water system expects to return to compliance or resolve the
violation].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#	.

Date distributed:	.

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Instructions for RTCR Failure to do Recordkeeping - Template NC3-6

Template on Reverse

Description of Violation or Situation

Failure to keep records of any assessment forms completed by you or a third-party, documentation of corrective actions, or
summary reports of sanitary defects, as well as records of repeat samples taken that meet the criteria of an extension for
the 24-hours of collecting repeat samples are recordkeeping violations that require Tier 3 public notification [40 CFR
34(a)(6)!.

You must provide public notice to persons served within one year after you learn of the recordkeeping violation [40 CFR
34(b)!. Check with your state to make sure you meet all requirements.

NCWSs must use all of the following methods to deliver the notice to consumers [40 CFR 141.2.04(c}1:

Posting in a conspicuous place throughout the system, or by hand delivery or mail, and

Another method as needed to reach consumers not likely to receive a notice from methods noted above and approved
in writing by the state. Such methods could include newspapers, e-mail, or delivery to community organizations.

If you:

Post the notice, it must remain posted until the violation is resolved.

Post the notice and the violation has already been resolved, you must still post the notice for at least seven days [40

CFR 141.204(b)l.

Mail, post, or hand deliver, EPA recommends printing your notice on your system's letterhead, if available.

Modify the notice, you must still include all required public notice elements from 40 CF	35(a) and leave the

mandatory language unchanged (see below).

Repeated notices are required annually if the violation or situation persists, unless otherwise directed by the state.

Mandatory Language

You must also include standard language to encourage the distribution of the public notice to all persons served, where
applicable [40 CFR 141,205(d)!. This language is also presented in this notice in italics with an asterisk on each end.

Corrective Actions

In your notice, you must describe corrective actions you took, or are taking [40 CFR 141,205(a)(7)1 including when your
water system expects to return to compliance or resolve the violation [40 CFR 141,205(a)(8)1. You can use the following
language, if appropriate, or develop your own:

We have contacted the laboratories that performed the water testing and requested copies of the missing reports. We
are no longer in violation.

We have revised our procedures to ensure we comply with the recordkeeping requirements in the future. We are no
longer in violation.

After Issuing the Notice

Make sure to send a copy of each type of notice and a certification that you have met all the public notification
requirements to your state within 10 days after the original or any repeat notice(s) [40 CFR 141,31(d)1.

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RTCR Failure to do Recordkeeping-Template NC3-6

IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER

Recordkeeping Requirement(s) Not Met for [Water System Name]

[Water system name] failed to keep records of [describe the information not kept, such as "our water system's assessment
conducted on [enter date]" or "monitoring following a sample with coliform bacteria in which we received an extension to
collect the sample from the state"]. We realize the importance of keeping complete records to document the quality of the
water we provide and the efforts we take to ensure the water is safe to drink.

Although this situation does not create a risk to public health, as our customers you have a right to know what happened
and what we did to correct the situation.

What should I do?

There is nothing you need to do at this time. If a situation arises where the water is no longer safe to drink, you will be
notified within 24 hours. We will announce any emergencies on [media source].

What is being done?

[Describe your corrective actions including when your water system expects to return to compliance or resolve the
violation].

For more information, please contact [name of contact] at [phone number] or [mailing address],

*Please share this information with all the other people who drink this water, especially those who may
not have received this notice directly (for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or distributing copies by hand or mail. *

This notice is being sent to you by [water system name]. State Water System ID#	.

Date distributed:	.

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Appendix B: NPDWR Violations and Other Situations Requiring
Public Notice1

Contaminant

MCL/MRDiyTT

violations2
Tier of public
notice required

MCiyMRDL/TT
violations2
Citation

Monitoring & testing
procedure violations
Tier of public notice
required

Monitoring &
testing procedure
violations
Citation

1. Violations of National Primary Drinking
Water Regulations (NPDWR):3









A. Microbiological Contaminants









l.a Total coliform bacteria*

2

141.63(a)

3

141.21(a)-(e).

l.b Total coliform (TT violations resulting
from failure to perform assessments or
corrective actions, monitoring violations,
and reporting violations)*

2

141.860(b)(1)

3

141.860(c)(1).
141.860(d)(1).

l.c Seasonal system failure to follow
State-approved start-up plan prior to
serving water to the public or failure to
provide certification to State*

2

141.860(b)(2)

3

141.860(d)(3).

2.a Fecal coliform/f. co//+

1

141.63(b)

41,3

141.21(e)

2.b E. coli (MCL, monitoring, and
reporting violations)*

1

141.860 (a)

3

141.860(c)(2)
141.860(d)(1).
141.860(d)(2).

2.c E. coli (TT violations resulting from
failure to perform level 2 Assessments or
corrective action)*

2

141.860(b)(1)





3. Turbidity MCL

2

141.13(a)

3

141.22

4. Turbidity MCL (average of 2 days'
samples >5 NTU)

52, 1

141.13(b)

3

141.22

5. Turbidity (forTT violations resulting
from a single exceedance of maximum
allowable turbidity level)

62, 1

141.71(a)(2),
141.71(c)(2)(i),
141.73(a)(2),
141.73 (b)(2),
141.73 (c)(2),
141.73(d),
141.173(a)(2),
141.173(b),
141.551(b)

3

141.74(a)(1),
141.74(b)(2),
141.74(c)(1),
141.174,
141.560(a)-(c),
141.561.

6. Surface Water Treatment Rule
violations, other than violations resulting
from single exceedance of max.
allowable turbidity level (TT)

2

141.70-141.73

3

141.74

7. Interim Enhanced Surface Water
Treatment Rule violations, other than
violations resulting from single
exceedance of max. turbidity level (TT)

72

141.170-
141.173,
141.500-
141.553

3

141.172, 141.174,
141.530-141.544,
141.560-141.564.

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Contaminant

MCL/MRDiyTT

violations2
Tier of public
notice required

MCiyMRDL/TT
violations2
Citation

Monitoring & testing
procedure violations
Tier of public notice
required

Monitoring &
testing procedure
violations
Citation

8. Filter Backwash Recycling Rule
violations

2

141.76(c)

3

141.76(b), (d)

9. Long Term 1 Enhanced Surface Water
Treatment Rule violations

2

141.500-
141.553

3

141.530-141.544,
141.560-141.564.

10. LT2ESWTR violations

2

141.710-
141.720

222, 3

141.701-141.705
and 141.708-
141.709.

11. Ground Water Rule violations

2

141.404

3

141.402(h),
141.403(d).

B. Inorganic Chemicals (lOCs)









1. Antimony

2

141.62(b)

3

141.23(a), (c)

2. Arsenic

2

8141.62(b)

3

11141.23(a), (c)

3. Asbestos (fibers >10 nm)

2

141.62(b)

3

141.23(a)-(b)

4. Barium

2

141.62(b)

3

141.23(a), (c)

5. Beryllium

2

141.62(b)

3

141.23(a), (c)

6. Cadmium

2

141.62(b)

3

141.23(a), (c)

7. Chromium (total)

2

141.62(b)

3

141.23(a), (c)

8. Cyanide

2

141.62(b)

3

141.23(a), (c)

9. Fluoride

2

141.62(b)

3

141.23(a), (c)

10. Mercury (inorganic)

2

141.62(b)

3

141.23(a), (c)

11. Nitrate

1

141.62(b)

121, 3

141.23(a), (d),
141.23(f)(2)

12. Nitrite

1

141.62(b)

121, 3

141.23(a), (e),
141.23(f)(2)

13. Total Nitrate and Nitrite

1

141.62(b)

3

141.23(a)

14. Selenium

2

141.62(b)

3

141.23(a), (c)

15. Thallium

2

141.62(b)

3

141.23(a), (c)

C. Lead and Copper Rule (Action Level for
lead is 0.015 mg/L, for copper is 1.3
mg/L)









1. Lead and Copper Rule (TT)

2

141.80-141.85

3

141.86-141.89

D. Synthetic Organic Chemicals (SOCs)









1. 2,4-D

2

141.61(c)

3

141.24(h)

2. 2,4,5-TP (Silvex)

2

141.61(c)

3

141.24(h)

3. Alachlor

2

141.61(c)

3

141.24(h)

4. Atrazine

2

141.61(c)

3

141.24(h)

5. Benzo(a)pyrene (PAHs)

2

141.61(c)

3

141.24(h)

6. Carbofuran

2

141.61(c)

3

141.24(h)

7. Chlordane

2

141.61(c)

3

141.24(h)

8. Dalapon

2

141.61(c)

3

141.24(h)

Public Notification Handbook for
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104

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Contaminant

MCL/MRDL/TT

violations2
Tier of public
notice required

MCiyMRDL/TT
violations2
Citation

Monitoring & testing
procedure violations
Tier of public notice
required

Monitoring &
testing procedure
violations
Citation

9. Di (2-ethylhexyl) adipate

2

141.61(c)

3

141.24(h)

10. Di (2-ethylhexyl) phthalate

2

141.61(c)

3

141.24(h)

11. Dibromochloropropane

2

141.61(c)

3

141.24(h)

12. Dinoseb

2

141.61(c)

3

141.24(h)

13. Dioxin (2,3,7,8-TCDD)

2

141.61(c)

3

141.24(h)

14. Diquat

2

141.61(c)

3

141.24(h)

15. Endothall

2

141.61(c)

3

141.24(h)

16. Endrin

2

141.61(c)

3

141.24(h)

17. Ethylene dibromide

2

141.61(c)

3

141.24(h)

18. Glyphosate

2

141.61(c)

3

141.24(h)

19. Heptachlor

2

141.61(c)

3

141.24(h)

20. Heptachlor epoxide

2

141.61(c)

3

141.24(h)

21. Hexachlorobenzene

2

141.61(c)

3

141.24(h)

22. Hexachlorocyclo-pentadiene

2

141.61(c)

3

141.24(h)

23. Lindane

2

141.61(c)

3

141.24(h)

24. Methoxychlor

2

141.61(c)

3

141.24(h)

25. Oxamyl (Vydate)

2

141.61(c)

3

141.24(h)

26. Pentachlorophenol

2

141.61(c)

3

141.24(h)

27. Picloram

2

141.61(c)

3

141.24(h)

28. Polychlorinated biphenyls (PCBs)

2

141.61(c)

3

141.24(h)

29. Simazine

2

141.61(c)

3

141.24(h)

30. Toxaphene

2

141.61(c)

3

141.24(h)

E. Volatile Organic Chemicals (VOCs)









1. Benzene

2

141.61(a)

3

141.24(f)

2. Carbon tetrachloride

2

141.61(a)

3

141.24(f)

3. Chlorobenzene (monochlorobenzene)

2

141.61(a)

3

141.24(f)

4. o-Dichlorobenzene

2

141.61(a)

3

141.24(f)

5. p-Dichlorobenzene

2

141.61(a)

3

141.24(f)

6. 1,2-Dichloroethane

2

141.61(a)

3

141.24(f)

7. 1,1-Dichloroethylene

2

141.61(a)

3

141.24(f)

8. cis-l,2-Dichloroethylene

2

141.61(a)

3

141.24(f)

9. trans- 1,2-Dichloroethylene

2

141.61(a)

3

141.24(f)

10. Dichloromethane

2

141.61(a)

3

141.24(f)

11. 1,2-Dichloropropane

2

141.61(a)

3

141.24(f)

12. Ethylbenzene

2

141.61(a)

3

141.24(f)

13. Styrene

2

141.61(a)

3

141.24(f)

14. Tetrachloroethylene

2

141.61(a)

3

141.24(f)

15. Toluene

2

141.61(a)

3

141.24(f)

Public Notification Handbook for
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105

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Contaminant

MCL/MRDL/TT

violations2
Tier of public
notice required

MCiyMRDL/TT
violations2
Citation

Monitoring & testing
procedure violations
Tier of public notice
required

Monitoring &
testing procedure
violations
Citation

16. 1,2,4-Trichlorobenzene

2

141.61(a)

3

141.24(f)

17. 1,1,1-Trichloroethane

2

141.61(a)

3

141.24(f)

18. 1,1,2-Trichloroethane

2

141.61(a)

3

141.24(f)

19. Trichloroethylene

2

141.61(a)

3

141.24(f)

20. Vinyl chloride

2

141.61(a)

3

141.24(f)

21. Xylenes (total)

2

141.61(a)

3

141.24(f)

F. Radioactive Contaminants









1. Beta/photon emitters

2

141.66(d)

3

141.25(a)
141.26(b)

2. Alpha emitters

2

141.66(c)

3

141.25(a)
141.26(a)

3. Combined radium (226 and 228)

2

141.66(b)

3

141.25(a)
141.26(a)

4. Uranium

92

141.66(e)

103

141.25(a)
141.26(a)

G. Disinfection Byproducts (DBPs),
Byproduct Precursors, Disinfectant
Residuals. Where disinfection is used in
the treatment of drinking water,
disinfectants combine with organic and
inorganic matter present in water to
form chemicals called disinfection
byproducts (DBPs). EPA sets standards
for controlling the levels of disinfectants
and DBPs in drinking water, including
trihalomethanes (THMs) and haloacetic
acids (HAAs).13









1. Total trihalomethanes (TTHMs)

2

14141.64(b)

3

141.132(a)-(b),
141.600-141.605,
141.620-141.629

2. Haloacetic Acids (HAA5)

2

141.64(b)

3

141.132(a)-(b),
141.600-141.605,
141.620-141.629

3. Bromate

2

141.64(a)

3

141.132(a)-(b)

4. Chlorite

2

141.64(a)

3

141.132(a)-(b)

5. Chlorine (MRDL)

2

141.65(a)

3

141.132(a), (c)

6. Chloramine (MRDL)

2

141.65(a)

3

141.132(a), (c)

7. Chlorine dioxide (MRDL), where any 2
consecutive daily samples at entrance to
distribution system only are above MRDL

2

141.65(a),
141.133(c)(3)

215, 3

141.132(a), (c),
141.133(c)(2)

8. Chlorine dioxide (MRDL), where
sample(s) in distribution system the next
day are also above MRDL

16 ^

141.65(a),
141.133(c)(3)

1

141.132(a), (c),
141.133(c)(2)

Public Notification Handbook for

Transient Noncommunity Water Systems	106

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Contaminant

MCL/MRDiyTT

violations2
Tier of public
notice required

MC17MRDL/TT
violations2
Citation

Monitoring & testing
procedure violations
Tier of public notice
required

Monitoring &
testing procedure
violations
Citation

9. Control of DBP precursors—TOC (TT)

2

141.135(a)-(b)

3

141.132(a), (d)

10. Bench marking and disinfection
profiling

N/A

N/A

3

141.172 141.530-
141.544.

11. Development of monitoring plan

N/A

N/A

3

141.132(f)

H. Other Treatment Techniques









1. Acrylamide (TT)

2

141.111

N/A

N/A

2. Epichlorohydrin (TT)

2

141.111

N/A

N/A

II. Unregulated Contaminant
Monitoring:17









A. Unregulated contaminants

N/A

N/A

3

141.40

B. Nickel

N/A

N/A

3

141.23(c), (k)

III. Public Notification for Variances and
Exemptions:









A. Operation under a variance or
exemption

3

181415, 1416,

N/A

N/A

B. Violation of conditions of a variance or
exemption

2

1415, 1416,
19142.307

N/A

N/A

IV. Other Situations Requiring Public
Notification:









A. Fluoride secondary maximum
contaminant level (SMCL) exceedance

3

143.3

N/A

N/A

B. Exceedance of nitrate MCL for non-
community systems, as allowed by state

1

141.11(d)

N/A

N/A

C. Availability of unregulated
contaminant monitoring data

3

141.40

N/A

N/A

D. Waterborne disease outbreak

1

141.2,
141.71(c)(2)(ii)

N/A

N/A

E. Other waterborne emergency20

1

N/A

N/A

N/A

F. Source Water Sample Positive for GWR
Fecal indicators: E. coli, enterococci, or
coliphage

1

141.402(g)

N/A

N/A

G. Other situations as determined by
state

211, 2, 3

N/A

N/A

N/A

Appendix B—Endnotes
t Until March 31, 2016.
t Beginning April 1, 2016.

1. Violations and other situations not listed in this table (e.g., failure to prepare Consumer Confidence Reports),
do not require notice, unless otherwise determined by the primacy agency. Primacy agencies may, at their

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107

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option, also require a more stringent public notice tier (e.g., Tier 1 instead of Tier 2 or Tier 2 instead of Tier 3) for
specific violations and situations listed in this Appendix, as authorized under §141.202(a) and §141.203(a).

2.	MCL—Maximum contaminant level, MRDL—Maximum residual disinfectant level, TT—Treatment technique

3.	The term Violations of National Primary Drinking Water Regulations (NPDWR) is used here to include
violations of MCL, MRDL, treatment technique, monitoring, and testing procedure requirements.

4.	Failure to test for fecal coliform or E. coli is a Tier 1 violation if testing is not done after any repeat sample
tests positive for coliform. All other total coliform monitoring and testing procedure violations are Tier 3.

5.	Systems that violate the turbidity MCL of 5 NTU based on an average of measurements over two consecutive
days must consult with the primacy agency within 24 hours after learning of the violation. Based on this
consultation, the primacy agency may subsequently decide to elevate the violation to Tier 1. If a system is
unable to make contact with the primacy agency in the 24-hour period, the violation is automatically elevated to
Tier 1.

6.	Systems with treatment technique violations involving a single exceedance of a maximum turbidity limit
under the Surface Water Treatment Rule (SWTR), the Interim Enhanced Surface Water Treatment Rule
(IESWTR), or the Long Term 1 Enhanced Surface Water Treatment Rule (LT1ESWTR) are required to consult with
the primacy agency within 24 hours after learning of the violation. Based on this consultation, the primacy
agency may subsequently decide to elevate the violation to Tier 1. If a system is unable to make contact with the
primacy agency in the 24-hour period, the violation is automatically elevated to Tier 1.

7.	Most of the requirements of the Interim Enhanced Surface Water Treatment Rule (63 FR 69477) (§§141.170-
141.171, 141.173-141.174) become effective January 1, 2002 for Subpart H systems (surface water systems and
ground water systems under the direct influence of surface water) serving at least 10,000 persons. However,
§141.172 has some requirements that become effective as early as April 16, 1999. The Surface Water Treatment
Rule remains in effect for systems serving at least 10,000 persons even after 2002; the Interim Enhanced Surface
Water Treatment Rule adds additional requirements and does not in many cases supersede the SWTR.

8.	The arsenic MCL citations are effective January 23, 2006. Until then, the citations are §141.11(b) and
§141.23(n).

9.	The uranium MCL Tier 2 violation citations are effective December 8, 2003 for all community water systems.

10.	The uranium Tier 3 violation citations are effective December 8, 2000 for all community water systems.

11.	The arsenic Tier 3 violation MCL citations are effective January 23, 2006. Until then, the citations are
§141.23(a), (I).

12.	Failure to take a confirmation sample within 24 hours for nitrate or nitrite after an initial sample exceeds the
MCL is a Tier 1 violation. Other monitoring violations for nitrate are Tier 3.

13.	Subpart H community and non-transient non-community systems serving >10,000 must comply with new
DBP MCLs, disinfectant MRDLs, and related monitoring requirements beginning January 1, 2002. All other
community and non-transient non-community systems must meet the MCLs and MRDLs beginning January 1,
2004. Subpart H transient non-community systems serving 10,000 or more persons and using chlorine dioxide as
a disinfectant or oxidant must comply with the chlorine dioxide MRDL beginning January 1, 2002. Subpart H
transient non-community systems serving fewer than 10,000 persons and using only ground water not under

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the direct influence of surface water and using chlorine dioxide as a disinfectant or oxidant must comply with
the chlorine dioxide MRDL beginning January 1, 2004.

14.	§§141.64(b)(1) 141.132(a)-(b) apply until §§141.620-141.630 take effect under the schedule in §141.620(c).

15.	Failure to monitor for chlorine dioxide at the entrance to the distribution system the day after exceeding the
MRDL at the entrance to the distribution system is a Tier 2 violation.

16.	If any daily sample taken at the entrance to the distribution system exceeds the MRDL for chlorine dioxide
and one or more samples taken in the distribution system the next day exceed the MRDL, Tier 1 notification is
required. Failure to take the required samples in the distribution system after the MRDL is exceeded at the entry
point also triggers Tier 1 notification.

17.	Some water systems must monitor for certain unregulated contaminants listed in §141.40.

18.	This citation refers to §§1415 and 1416 of the Safe Drinking Water Act. §§1415 and 1416 require that "a
schedule prescribed. . . for a public water system granted a variance [or exemption] shall require compliance by
the system. . ."

19.	In addition to §§1415 and 1416 of the Safe Drinking Water Act, 40 CFR 142.307 specifies the items and
schedule milestones that must be included in a variance for small systems.

20.	Other waterborne emergencies require a Tier 1 public notice under §141.202(a) for situations that do not
meet the definition of a waterborne disease outbreak given in 40 CFR 141.2 but that still have the potential to
have serious adverse effects on health as a result of short-term exposure. These could include outbreaks not
related to treatment deficiencies, as well as situations that have the potential to cause outbreaks, such as
failures or significant interruption in water treatment processes, natural disasters that disrupt the water supply
or distribution system, chemical spills, or unexpected loading of possible pathogens into the source water.

21.	Primacy agencies may place other situations in any tier they believe appropriate, based on threat to public
health.

22.	Failure to collect three or more samples for Cryptosporidium analysis is a Tier 2 violation requiring special
notice as specified in §141.211. All other monitoring and testing procedure violations are Tier 3.

Public Notification Handbook for
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109

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Appendix C: Standard Health Effects Language for Public
Notification

Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification

National Primary Drinking
Water Regulations
(NPDWR)







A. Microbiological
Contaminants







la. Total coliform +

Zero

See footnote3

Coliforms are bacteria that are naturally present in the
environment and are used as an indicator that other,
potentially-harmful, bacteria may be present. Coliforms were
found in more samples than allowed and this was a warning of
potential problems.

lb. Fecal coliform/f. coli +

Zero

Zero

Fecal coliforms and E. coli are bacteria whose presence
indicates that the water may be contaminated with human or
animal wastes. Microbes in these wastes can cause short-term
effects, such as diarrhea, cramps, nausea, headaches, or other
symptoms. They may pose a special health risk for infants,
young children, some of the elderly, and people with severely
compromised immune systems.

lc. Fecal indicators (GWR):

i.	E. coli

ii.	enterococci

iii.	coliphage

Zero

None

None

TT
TT
TT

Fecal indicators are microbes whose presence indicates that
the water may be contaminated with human or animal
wastes. Microbes in these wastes can cause short-term health
effects, such as diarrhea, cramps, nausea, headaches, or other
symptoms. They may pose a special health risk for infants,
young children, some of the elderly, and people with severely
compromised immune systems.

Id. Ground Water Rule
(GWR) TT violations

None

TT

Inadequately treated or inadequately protected water may
contain disease-causing organisms. These organisms can cause
symptoms such as diarrhea, nausea, cramps, and associated
headaches.

le. Subpart Y Coliform
Assessment and/or
Corrective Action
Violations t

N/A

TT

Coliforms are bacteria that are naturally present in the
environment and are used as an indicator that other,
potentially harmful, waterborne pathogens may be present or
that a potential pathway exists through which contamination
may enter the drinking water distribution system. We found
coliforms indicating the need to look for potential problems in
water treatment or distribution. When this occurs, we are
required to conduct assessments to identify problems and to
correct any problems that are found.

[THE SYSTEM MUST USE THE FOLLOWING APPLICABLE
SENTENCES.]

We failed to conduct the required assessment.

We failed to correct all identified sanitary defects that were

found during the assessment(s).

Public Notification Handbook for
Transient Noncommunity Water Systems

110

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification

If. Subpart Y E. coli
Assessment and/or
Corrective Action
Violations t

N/A

TT

E. coli are bacteria whose presence indicates that the water
may be contaminated with human or animal wastes. Human
pathogens in these wastes can cause short-term effects, such
as diarrhea, cramps, nausea, headaches, or other symptoms.
They may pose a greater health risk for infants, young
children, the elderly, and people with severely compromised
immune systems. We violated the standard for E. coli,
indicating the need to look for potential problems in water
treatment or distribution. When this occurs, we are required
to conduct a detailed assessment to identify problems and to
correct any problems that are found.

[THE SYSTEM MUST USE THE FOLLOWING APPLICABLE
SENTENCES.]

We failed to conduct the required assessment.

We failed to correct all identified sanitary defects that were

found during the assessment that we conducted.

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Transient Noncommunity Water Systems

111

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification

lg. E. coli t

Zero

In compliance
unless one of the
following
conditions
occurs:

(1)	The system
has an E. coli-
positive repeat
sample following
a total coliform-
positive routine
sample.

(2)	The system
has a total
coliform-positive
repeat sample
following an E.
coli- positive
routine sample.

(3)	The system
fails to take all
required repeat
samples
following an E.
coli- positive
routine sample.

(4)	The system
fails to test for E.
coli when any
repeat sample
tests positive for
total coliform.

E. coli are bacteria whose presence indicates that the water
may be contaminated with human or animal wastes. Human
pathogens in these wastes can cause short-term effects, such
as diarrhea, cramps, nausea, headaches, or other symptoms.
They may pose a greater health risk for infants, young
children, the elderly, and people with severely compromised
immune systems.

lh. Subpart Y Seasonal
System TT Violations t

N/A

TT

When this violation includes the failure to monitor for total
coliforms or E. coli prior to serving water to the public, the
mandatory language found at 141.205(d)(2) must be used.
When this violation includes failure to complete other actions,
the appropriate elements found in 141.205(a) to describe the
violation must be used.

2a. Turbidity (MCL)4

None

1 NTU5/5 NTU

Turbidity has no health effects. However, turbidity can
interfere with disinfection and provide a medium for microbial
growth. Turbidity may indicate the presence of disease-
causing organisms. These organisms include bacteria, viruses,
and parasites that can cause symptoms such as nausea,
cramps, diarrhea and associated headaches.

2b. Turbidity (SWTRTT)6

None

TT7

Turbidity has no health effects. However, turbidity can
interfere with disinfection and provide a medium for microbial
growth. Turbidity may indicate the presence of disease-
causing organisms. These organisms include bacteria, viruses,

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Transient Noncommunity Water Systems

112

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification







and parasites that can cause symptoms such as nausea,
cramps, diarrhea and associated headaches.

2c. Turbidity (IESWTRTT
and LT1ESWTRTT)8

None

TT

Turbidity has no health effects. However, turbidity can
interfere with disinfection and provide a medium for microbial
growth. Turbidity may indicate the presence of disease-
causing organisms. These organisms include bacteria, viruses,
and parasites that can cause symptoms such as nausea,
cramps, diarrhea and associated headaches.

B. Surface Water
Treatment Rule (SWTR),
Interim Enhanced Surface
Water Treatment Rule
(IESWTR), Long Term 1
Enhanced Surface Water
Treatment Rule
(LT1ESWTR) and the Filter
Backwash Recycling Rule
(FBRR) violations







3. Giardia lamblia
(SWTR/IESWTR/LT1ESWTR)

Zero

TT10

Inadequately treated water may contain disease-causing
organisms. These organisms include bacteria, viruses, and
parasites which can cause symptoms such as nausea, cramps,
diarrhea, and associated headaches.

4. Viruses

(SWTR/IESWTR/LT1ESWTR)







5. Heterotrophic plate
count (HPC) bacteria9
(SWTR/IESWTR/LT1ESWTR)







6. Legionella

(SWTR/IESWTR/LT1ESWTR)







7. Cryptosporidium
(IESWTR/FBRR/LT1ESWTR)







C. Inorganic Chemicals
(lOCs)







8. Antimony

0.006

0.006

Some people who drink water containing antimony well in
excess of the MCL over many years could experience increases
in blood cholesterol and decreases in blood sugar.

9. Arsenic11

0

0.010

Some people who drink water containing arsenic in excess of
the MCL over many years could experience skin damage or
problems with their circulatory system, and may have an
increased risk of getting cancer.

10. Asbestos (10 nm)

7 MFL12

7 MFL

Some people who drink water containing asbestos in excess of
the MCL over many years may have an increased risk of
developing benign intestinal polyps.

11. Barium

2

2

Some people who drink water containing barium in excess of
the MCL over many years could experience an increase in their
blood pressure.

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification

12. Beryllium

0.004

0.004

Some people who drink water containing beryllium well in
excess of the MCL over many years could develop intestinal
lesions.

13. Cadmium

0.005

0.005

Some people who drink water containing cadmium in excess
of the MCL over many years could experience kidney damage.

14. Chromium (total)

0.1

0.1

Some people who use water containing chromium well in
excess of the MCL over many years could experience allergic
dermatitis.

15. Cyanide

0.2

0.2

Some people who drink water containing cyanide well in
excess of the MCL over many years could experience nerve
damage or problems with their thyroid.

16. Fluoride

4.0

4.0

Some people who drink water containing fluoride in excess of
the MCL over many years could get bone disease, including
pain and tenderness of the bones. Fluoride in drinking water
at half the MCL or more may cause mottling of children's
teeth, usually in children less than nine years old. Mottling,
also known as dental fluorosis, may include brown staining
and/or pitting of the teeth, and occurs only in developing
teeth before they erupt from the gums.

17. Mercury (inorganic)

0.002

0.002

Some people who drink water containing inorganic mercury
well in excess of the MCL over many years could experience
kidney damage.

18. Nitrate

10

10

Infants below the age of six months who drink water
containing nitrate in excess of the MCL could become
seriously ill and, if untreated, may die. Symptoms include
shortness of breath and blue baby syndrome.

19. Nitrite

1

1

Infants below the age of six months who drink water
containing nitrite in excess of the MCL could become seriously
ill and, if untreated, may die. Symptoms include shortness of
breath and blue baby syndrome.

20. Total Nitrate and
Nitrite

10

10

Infants below the age of six months who drink water
containing nitrate and nitrite in excess of the MCL could
become seriously ill and, if untreated, may die. Symptoms
include shortness of breath and blue baby syndrome.

21. Selenium

0.05

0.05

Selenium is an essential nutrient. However, some people who
drink water containing selenium in excess of the MCL over
many years could experience hair or fingernail losses,
numbness in fingers or toes, or problems with their
circulation.

22. Thallium

0.0005

0.002

Some people who drink water containing thallium in excess of
the MCL over many years could experience hair loss, changes
in their blood, or problems with their kidneys, intestines, or
liver.

D. Lead and Copper Rule







23. Lead

Zero

TT13

Infants and children who drink water containing lead in excess
of the action level could experience delays in their physical or

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification







mental development. Children could show slight deficits in
attention span and learning abilities. Adults who drink this
water over many years could develop kidney problems or high
blood pressure.

24. Copper

1.3

IT14

Copper is an essential nutrient, but some people who drink
water containing copper in excess of the action level over a
relatively short amount of time could experience
gastrointestinal distress. Some people who drink water
containing copper in excess of the action level over many
years could suffer liver or kidney damage. People with
Wilson's Disease should consult their personal doctor.

E. Synthetic Organic
Chemicals (SOCs)







25. 2,4-D

0.07

0.07

Some people who drink water containing the weed killer 2,4-D
well in excess of the MCL over many years could experience
problems with their kidneys, liver, or adrenal glands.

26. 2,4,5-TP (Silvex)

0.05

0.05

Some people who drink water containing silvex in excess of
the MCL over many years could experience liver problems.

27. Alachlor

Zero

0.002

Some people who drink water containing alachlor in excess of
the MCL over many years could have problems with their
eyes, liver, kidneys, or spleen, or experience anemia, and may
have an increased risk of getting cancer.

28. Atrazine

0.003

0.003

Some people who drink water containing atrazine well in
excess of the MCL over many years could experience problems
with their cardiovascular system or reproductive difficulties.

29. Benzo(a)pyrene (PAHs)

Zero

0.0002

Some people who drink water containing benzo(a)pyrene in
excess of the MCL over many years may experience
reproductive difficulties and may have an increased risk of
getting cancer.

30. Carbofuran

0.04

0.04

Some people who drink water containing carbofuran in excess
of the MCL over many years could experience problems with
their blood, or nervous or reproductive systems.

31. Chlordane

Zero

0.002

Some people who drink water containing chlordane in excess
of the MCL over many years could experience problems with
their liver or nervous system, and may have an increased risk
of getting cancer.

32. Dalapon

0.2

0.2

Some people who drink water containing dalapon well in
excess of the MCL over many years could experience minor
kidney changes.

33. Di(2-ethylhexyl)
adipate

0.4

0.4

Some people who drink water containing di(2-ethylhexyl)
adipate well in excess of the MCL over many years could
experience toxic effects such as weight loss, liver enlargement
or possible reproductive difficulties.

34. Di(2-ethylhexyl)
phthalate

Zero

0.006

Some people who drink water containing di(2-ethylhexyl)
phthalate well in excess of the MCL over many years may have

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification







problems with their liver, or experience reproductive
difficulties, and may have an increased risk of getting cancer.

35. Dibromochloropropane
(DBCP)

Zero

0.0002

Some people who drink water containing DBCP in excess of
the MCL over many years could experience reproductive
difficulties and may have an increased risk of getting cancer.

36. Dinoseb

0.007

0.007

Some people who drink water containing dinoseb well in
excess of the MCL over many years could experience
reproductive difficulties.

37. Dioxin (2,3,7,8-TCDD)

Zero

3xl0"8

Some people who drink water containing dioxin in excess of
the MCL over many years could experience reproductive
difficulties and may have an increased risk of getting cancer.

38. Diquat

0.02

0.02

Some people who drink water containing diquat in excess of
the MCL over many years could get cataracts.

39. Endothall

0.1

0.1

Some people who drink water containing endothall in excess
of the MCL over many years could experience problems with
their stomach or intestines.

40. Endrin

0.002

0.002

Some people who drink water containing endrin in excess of
the MCL over many years could experience liver problems.

41. Ethylene dibromide

Zero

0.00005

Some people who drink water containing ethylene dibromide
in excess of the MCL over many years could experience
problems with their liver, stomach, reproductive system, or
kidneys, and may have an increased risk of getting cancer.

42. Glyphosate

0.7

0.7

Some people who drink water containing glyphosate in excess
of the MCL over many years could experience problems with
their kidneys or reproductive difficulties.

43. Heptachlor

Zero

0.0004

Some people who drink water containing heptachlor in excess
of the MCL over many years could experience liver damage
and may have an increased risk of getting cancer.

44. Heptachlor epoxide

Zero

0.0002

Some people who drink water containing heptachlor epoxide
in excess of the MCL over many years could experience liver
damage, and may have an increased risk of getting cancer.

45. Hexachlorobenzene

Zero

0.001

Some people who drink water containing hexachlorobenzene
in excess of the MCL over many years could experience
problems with their liver or kidneys, or adverse reproductive
effects, and may have an increased risk of getting cancer.

46. Hexachlorocyclo-
pentadiene

0.05

0.05

Some people who drink water containing
hexachlorocyclopentadiene well in excess of the MCL over
many years could experience problems with their kidneys or
stomach.

47. Lindane

0.0002

0.0002

Some people who drink water containing lindane in excess of
the MCL over many years could experience problems with
their kidneys or liver.

48. Methoxychlor

0.04

0.04

Some people who drink water containing methoxychlor in
excess of the MCL over many years could experience
reproductive difficulties.

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification

49. Oxamyl (Vydate)

0.2

0.2

Some people who drink water containing oxamyl in excess of
the MCL over many years could experience slight nervous
system effects.

50. Pentachlorophenol

Zero

0.001

Some people who drink water containing pentachlorophenol
in excess of the MCL over many years could experience
problems with their liver or kidneys, and may have an
increased risk of getting cancer.

51. Picloram

0.5

0.5

Some people who drink water containing picloram in excess of
the MCL over many years could experience problems with
their liver.

52. Polychlorinated
biphenyls (PCBs)

Zero

0.0005

Some people who drink water containing PCBs in excess of the
MCL over many years could experience changes in their skin,
problems with their thymus gland, immune deficiencies, or
reproductive or nervous system difficulties, and may have an
increased risk of getting cancer.

53. Simazine

0.004

0.004

Some people who drink water containing simazine in excess of
the MCL over many years could experience problems with
their blood.

54. Toxaphene

Zero

0.003

Some people who drink water containing toxaphene in excess
of the MCL over many years could have problems with their
kidneys, liver, or thyroid, and may have an increased risk of
getting cancer.

F. Volatile Organic
Chemicals (VOCs)







55. Benzene

Zero

0.005

Some people who drink water containing benzene in excess of
the MCL over many years could experience anemia or a
decrease in blood platelets, and may have an increased risk of
getting cancer.

56. Carbon tetrachloride

Zero

0.005

Some people who drink water containing carbon tetrachloride
in excess of the MCL over many years could experience
problems with their liver and may have an increased risk of
getting cancer.

57. Chlorobenzene
(monochloro- benzene)

0.1

0.1

Some people who drink water containing chlorobenzene in
excess of the MCL over many years could experience problems
with their liver or kidneys.

58. o-Dichlorobenzene

0.6

0.6

Some people who drink water containing o-dichlorobenzene
well in excess of the MCL over many years could experience
problems with their liver, kidneys, or circulatory systems.

59. p-Dichlorobenzene

0.075

0.075

Some people who drink water containing p-dichlorobenzene
in excess of the MCL over many years could experience
anemia, damage to their liver, kidneys, or spleen, or changes
in their blood.

60. 1,2-Dichloroethane

Zero

0.005

Some people who drink water containing 1,2-dichloroethane
in excess of the MCL over many years may have an increased
risk of getting cancer.

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification

61. 1,1-Dichloroethylene

0.007

0.007

Some people who drink water containing 1,1-dichloroethylene
in excess of the MCL over many years could experience
problems with their liver.

62. cis-1,2-
Dichloroethylene

0.07

0.07

Some people who drink water containing cis-1,2-
dichloroethylene in excess of the MCL over many years could
experience problems with their liver.

63. trans-1,2-
Dichloroethylene

0.1

0.1

Some people who drink water containing trans-1,2-
dichloroethylene well in excess of the MCL over many years
could experience problems with their liver.

64. Dichloromethane

Zero

0.005

Some people who drink water containing dichloromethane in
excess of the MCL over many years could have liver problems
and may have an increased risk of getting cancer.

65. 1,2-Dichloropropane

Zero

0.005

Some people who drink water containing 1,2-dichloropropane
in excess of the MCL over many years may have an increased
risk of getting cancer.

66. Ethylbenzene

0.7

0.7

Some people who drink water containing ethylbenzene well in
excess of the MCL over many years could experience problems
with their liver or kidneys.

67. Styrene

0.1

0.1

Some people who drink water containing styrene well in
excess of the MCL over many years could have problems with
their liver, kidneys, or circulatory system.

68. Tetrachloroethylene

Zero

0.005

Some people who drink water containing tetrachloroethylene
in excess of the MCL over many years could have problems
with their liver, and may have an increased risk of getting
cancer.

69. Toluene

1

1

Some people who drink water containing toluene well in
excess of the MCL over many years could have problems with
their nervous system, kidneys, or liver.

70. 1,2,4-Trichlorobenzene

0.07

0.07

Some people who drink water containing 1,2,4-
trichlorobenzene well in excess of the MCL over many years
could experience changes in their adrenal glands.

71. 1,1,1-Trichloroethane

0.2

0.2

Some people who drink water containing 1,1,1-
trichloroethane in excess of the MCL over many years could
experience problems with their liver, nervous system, or
circulatory system.

72. 1,1,2-Trichloroethane

0.003

0.005

Some people who drink water containing 1,1,2-
trichloroethane well in excess of the MCL over many years
could have problems with their liver, kidneys, or immune
systems.

73. Trichloroethylene

Zero

0.005

Some people who drink water containing trichloroethylene in
excess of the MCL over many years could experience problems
with their liver and may have an increased risk of getting
cancer.

74. Vinyl chloride

Zero

0.002

Some people who drink water containing vinyl chloride in
excess of the MCL over many years may have an increased risk
of getting cancer.

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification

75. Xylenes (total)

10

10

Some people who drink water containing xylenes in excess of
the MCL over many years could experience damage to their
nervous system.

G. Radioactive
Contaminants







76. Beta/photon emitters

Zero

4 mrem/yr15

Certain minerals are radioactive and may emit forms of
radiation known as photons and beta radiation. Some people
who drink water containing beta and photon emitters in
excess of the MCL over many years may have an increased risk
of getting cancer.

77. Alpha emitters

Zero

17 pCi/L17

Certain minerals are radioactive and may emit a form of
radiation known as alpha radiation. Some people who drink
water containing alpha emitters in excess of the MCL over
many years may have an increased risk of getting cancer.

78. Combined radium (226
& 228)

Zero

5 pCi/L

Some people who drink water containing radium 226 or 228 in
excess of the MCL over many years may have an increased risk
of getting cancer.

79. Uranium16

Zero

30 ng/L

Some people who drink water containing uranium in excess of
the MCL over many years may have an increased risk of
getting cancer and kidney toxicity.

H. Disinfection Byproducts
(DBPs), Byproduct
Precursors, and
Disinfectant Residuals:
Where disinfection is used
in the treatment of
drinking water,
disinfectants combine with
organic and inorganic
matter present in water to
form chemicals called
disinfection byproducts
(DBPs). EPA sets standards
for controlling the levels of
disinfectants and DBPs in
drinking water, including
trihalomethanes (THMs)
and haloacetic acids
(HAAs)18







80. Total trihalomethanes
(TTHMs)

N/A

0.08019 20

Some people who drink water containing trihalomethanes in
excess of the MCL over many years may experience problems
with their liver, kidneys, or central nervous system, and may
have an increased risk of getting cancer.

81. Haloacetic Acids (HAA)

N/A

0.06021

Some people who drink water containing haloacetic acids in
excess of the MCL over many years may have an increased risk
of getting cancer.

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification

82. Bromate

Zero

0.010

Some people who drink water containing bromate in excess of
the MCL over many years may have an increased risk of
getting cancer.

83. Chlorite

0.08

1.0

Some infants and young children who drink water containing
chlorite in excess of the MCL could experience nervous system
effects. Similar effects may occur in fetuses of pregnant
women who drink water containing chlorite in excess of the
MCL. Some people may experience anemia.

84. Chlorine

4

(MRDLG)22

4.0 (MRDL)23

Some people who use water containing chlorine well in excess
of the MRDL could experience irritating effects to their eyes
and nose. Some people who drink water containing chlorine
well in excess of the MRDL could experience stomach
discomfort.

85. Chloramines

4

(MRDLG)

4.0 (MRDL)

Some people who use water containing chloramines well in
excess of the MRDL could experience irritating effects to their
eyes and nose. Some people who drink water containing
chloramines well in excess of the MRDL could experience
stomach discomfort or anemia.

86a. Chlorine dioxide,
where any 2 consecutive
daily samples taken at the
entrance to the
distribution system are
above the MRDL

0.8

(MRDLG)

0.8 (MRDL)

Some infants and young children who drink water containing
chlorine dioxide in excess of the MRDL could experience
nervous system effects. Similar effects may occur in fetuses of
pregnant women who drink water containing chlorine dioxide
in excess of the MRDL. Some people may experience anemia.
Add for public notification only: The chlorine dioxide violations
reported today are the result of exceedances at the treatment
facility only, not within the distribution system which delivers
water to consumers. Continued compliance with chlorine
dioxide levels within the distribution system minimizes the
potential risk of these violations to consumers.

86b. Chlorine dioxide,
where one or more
distribution system
samples are above the
MRDL

0.8

(MRDLG)

0.8 (MRDL)

Some infants and young children who drink water containing
chlorine dioxide in excess of the MRDL could experience
nervous system effects. Similar effects may occur in fetuses of
pregnant women who drink water containing chlorine dioxide
in excess of the MRDL. Some people may experience anemia.
Add for public notification only: The chlorine dioxide violations
reported today include exceedances of the EPA standard
within the distribution system which delivers water to
consumers. Violations of the chlorine dioxide standard within
the distribution system may harm human health based on
short-term exposures. Certain groups, including fetuses,
infants, and young children, may be especially susceptible to
nervous system effects from excessive chlorine dioxide
exposure.

87. Control of DBP
precursors (TOC)

None

TT

Total organic carbon (TOC) has no health effects. However,
total organic carbon provides a medium for the formation of
disinfection byproducts. These byproducts include
trihalomethanes (THMs) and haloacetic acids (HAAs). Drinking
water containing these byproducts in excess of the MCL may

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Contaminant

MCLG1
mg/L

MCL2 mg/L

Standard health effects language for public notification







lead to adverse health effects, liver or kidney problems, or
nervous system effects, and may lead to an increased risk of
getting cancer.

1. Other Treatment
Techniques







88. Acrylamide

Zero

TT

Some people who drink water containing high levels of
acrylamide over a long period of time could have problems
with their nervous system or blood, and may have an
increased risk of getting cancer.

89. Epichlorohydrin

Zero

TT

Some people who drink water containing high levels of
epichlorohydrin over a long period of time could experience
stomach problems, and may have an increased risk of getting
cancer.

Appendix C—Endnotes
t Until March 31, 2016.
t Beginning April 1, 2016.

1.	MCLG—Maximum contaminant level goal

2.	MCL—Maximum contaminant level

3.	For water systems analyzing at least 40 samples per month, no more than 5.0 percent of the monthly samples
may be positive for total coliforms. For systems analyzing fewer than 40 samples per month, no more than one
sample per month may be positive for total coliforms.

4.	There are various regulations that set turbidity standards for different types of systems, including 40 CFR
141.13, and the 1989 Surface Water Treatment Rule, the 1998 Interim Enhanced Surface Water Treatment Rule
and the 2002 Long Term 1 Enhanced Surface Water Treatment Rule. The MCL for the monthly turbidity average
is 1 NTU; the MCL for the 2-day average is 5 NTU for systems that are required to filter but have not yet installed
filtration (40 CFR 141.13).

5.	NTU—Nephelometric turbidity unit

6.	There are various regulations that set turbidity standards for different types of systems, including 40 CFR
141.13, and the 1989 Surface Water Treatment Rule, the 1998 Interim Enhanced Surface Water Treatment Rule
and the 2001 Long Term 1 Enhanced Surface Water Treatment Rule. Systems subject to the Surface Water
Treatment Rule (both filtered and unfiltered) may not exceed 5 NTU. In addition, in filtered systems, 95 percent
of samples each month must not exceed 0.5 NTU in systems using conventional or direct filtration and must not
exceed 1 NTU in systems using slow sand or diatomaceous earth filtration or other filtration technologies
approved by the primacy agency.

7.	TT—Treatment technique

8.	There are various regulations that set turbidity standards for different types of systems, including 40 CFR
141.13, the 1989 Surface Water Treatment Rule (SWTR), the 1998 Interim Enhanced Surface Water Treatment

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Rule (IESWTR) and the 2002 Long Term 1 Enhanced Surface Water Treatment Rule (LT1ESWTR). For systems
subject to the IESWTR (systems serving at least 10,000 people, using surface water or ground water under the
direct influence of surface water), that use conventional filtration or direct filtration, after January 1, 2002, the
turbidity level of a system's combined filter effluent may not exceed 0.3 NTU in at least 95 percent of monthly
measurements, and the turbidity level of a system's combined filter effluent must not exceed 1 NTU at any time.
Systems subject to the IESWTR using technologies other than conventional, direct, slow sand, or diatomaceous
earth filtration must meet turbidity limits set by the primacy agency. For systems subject to the LT1ESWTR
(systems serving fewer than 10,000 people, using surface water or ground water under the direct influence of
surface water) that use conventional filtration or direct filtration, after January 1, 2005, the turbidity level of a
system's combined filter effluent may not exceed 0.3 NTU in at least 95 percent of monthly measurements, and
the turbidity level of a system's combined filter effluent must not exceed 1 NTU at any time. Systems subject to
the LT1ESWTR using technologies other than conventional, direct, slow sand, or diatomaceous earth filtration
must meet turbidity limits set by the primacy agency.

9.	The bacteria detected by heterotrophic plate count (HPC) are not necessarily harmful. HPC is simply an
alternative method of determining disinfectant residual levels. The number of such bacteria is an indicator of
whether there is enough disinfectant in the distribution system.

10.	SWTR, IESWTR, and LT1ESWTR treatment technique violations that involve turbidity exceedances may use
the health effects language for turbidity instead.

11.	These arsenic values are effective January 23, 2006. Until then, the MCL is 0.05 mg/L and there is no MCLG.

12.	Millions fibers per liter.

13.	Action Level = 0.015 mg/L

14.	Action Level = 1.3 mg/L

15.	Millirems per years

16.	The uranium MCL is effective December 8, 2003 for all community water systems.

17.	Picocuries per liter

18.	Surface water systems and ground water systems under the direct influence of surface water are regulated
under subpart H of 40 CFR 141. Subpart H community and non-transient non-community systems serving
>10,000 must comply with subpart L DBP MCLs and disinfectant maximum residual disinfectant levels (MRDLs)
beginning January 1, 2002. All other community and non-transient non-community systems must comply with
subpart L DBP MCLs and disinfectant MRDLs beginning January 1, 2004. Subpart H transient non-community
systems serving >10,000 that use chlorine dioxide as a disinfectant or oxidant must comply with the chlorine
dioxide MRDL beginning January 1, 2002. All other transient non-community systems that use chlorine dioxide
as a disinfectant or oxidant must comply with the chlorine dioxide MRDL beginning January 1, 2004.

19.	Community and non-transient non-community systems must comply with subpart V TTHM and HAA5 MCLs
of 0.080 mg/L and 0.060 mg/L, respectively (with compliance calculated as a locational running annual average)
on the schedule in §141.620.

20.	The MCL for total trihalomethanes is the sum of the concentrations of the individual trihalomethanes.

21.	The MCL for haloacetic acids is the sum of the concentrations of the individual haloacetic acids.

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22.	MRDLG—Maximum residual disinfectant level goal.

23.	MRDL—Maximum residual disinfectant level.

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Appendix D: Translated Phrases

As part of the Washington State Department of Health Office of Drinking Water's implementation of the Public
Notification Rule, they have developed a Web site to provide information to assist water systems in
communicating important water system information to non-English speaking populations. It consists of four
basic drinking water messages, which have been translated into 27 different languages. Image files of the
translated phrases are available on their Web site at:

http://www.doh.wa.gov/CommunitvandEnvironment/DrinkingWater/DrinkingWaterEmergencies/PublicNotifica

tion/TranslationsforPublicNotification

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'h

Wasfu'figton Stste Department of	Translated Drinking

r0Health	Water Warnings

Uivrton iyf Environnmiiai Health	DOH PUB. #331-246

Office of Drmkmg Water

July 2004

English

This report contains important information
about your drinking w ater.

Have someone translate it for you.
or speak with someone who understands it.

Boil your water
before using.

Don't drink the w ater.

Children under 12 months old should not
drink the water.

Don't use the water to make formula.

Amharic

inn fiA°T,rnnvV
JKiJA - t\A

ro.e.9° .e.e.T.> -

IM.V i'fi-ft.-Tf ::

h.f,rnrn- ::

6.p;n.fT«> hi2 ®£t rur- pm. i\'?f
ro-H©^ ODmfllt fftnT®-?" » m?TA ^"l-fl
(CCOD-t) ft°WSt ©M®^ ft£m+0D- ::

Arabic

(—ijmJI e.L» (jc- jiaj jjjSil) liiA

jl 4 ^ 1 A '¦ A * ^ * "** ' *"

aJLmuaJ ^JiS

.oUt i_jjiSSV

J^J' 12 ijj (jj '.'T-J
4 ^A-fc u.i 1 ^ _c-Loli k-^A

.( JUL.VI

Cambodian
(Khmer)

TtntiTmrruliss tnswimaiswnw fi^miraawswin-
OT89CU818 1 Of Jfiti SCimm RBJtlRtfpfl StCLtl R-Hfi

tjnBsinmfliatBij8tuii|iR ftJwmwBi'slmssBjiMraiM i

OiHisnBJtlJMS
HSsmppM 1

gJfi?|HJ8"IS§fi 1

tni3t|jn0jriq9l9{3 §s§isjfrfi§ms i
arfttptSifTfuitncSiBttrttJjlSfiiuis i

Chinese
Simplified

JL ifAffflSiM*, i£ii*«

mmmt
m

^USS&S*.



Chinese
Traditional

mm 11 & # t

in •

¦fltfli 0



*;#» 12 MM •

Farsi

. 1 x fjlrA .>*'">» - .t -I . 1 . ¦ *1. i ft t i*v .. t <. Vi iJ ..it

- ^ y • ***** «*>-

1 4aIa \ f j)j jjU
tf>fI.VC ^->1 •

.(AmX) ejliLjl ( Vij^jS )4s>u

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English

1'his report contains important information
about your drinking water.

Have someone translate it for you.
or speak with someone who understands it.

Boil your water
before using.

Don't drink the water.

Children under 12 months old should not
drink the water.

Don't use the water to make formula.

French

Co rapport eontient des informations

importantes a propos de votre eau potable.
Demander a quelqu'un de traduire ces
informations pour vous ou discuter avec une
personne qui comprend ces informations.

Faire bouillir I'eau

avant de l'utiliser.

No pas boire l'eau.

Les enfaiits des moins de 12 mois ne
doivent pas boire l'eau. Ne pas utiliser
l'eau dans une preparation lactee pour
nourrisson.

Greek

Amti r] ava(|)opd TtepiXajipavei
OT|LiaviiKt:q itXTipodopicq axetiKa pc to
jcooijio vepo oat;. Ztiitigte cmo kottoiov va
oag xt] ,ueta<|)pdo£u n ni/^iote |ib kootoiov
jtou ti]v KataXapaivei.

Bpd^eie to vepo

Tip I V TO

%pT)Ol|107i:0lfio£Te.

Mr|V TtlVETE TO VHpO.

Ta JiaiSia k«tq) tmv 12 jirfvcov 8ev 0a
jtpejtei va 7uvouv to vepo. Mr|
Xp"n3»\y ijw>» oy

o>nn tin n'mn> v>
. W»> W» >3£)b

.o>on nn nirivyt? y>H

.12 nrwn o>i» o>*nw o>on
ON-±>n ^>nn jronb o>m woiwrt? y>H

Hindi

wfi"##

Ml-ll sW-tcWM -ft

m*il *T Mily 1

12 hsHh t w aw i tfi-ft qi'

-H-Ml 4H*ul 81 fcfc# t) yjellci

Mfep) pH

mI-11 W+Ml =<» (mi« m-fl eUs'll

yirf! sfl 3'« H =4Id +1l.

5'HcIhim H +ll

Hmong

Dlaim ntawv tshaabxu nuav muaj lug
tseemceeb heev nyob rua huv kws has txug
cov dlej mej haus. Kuas ib tug paab txhais
rua koj, los nnig ib tug kws paub lug thaam.

Uantej kws yuav siv
mej cov dlej nuav
yuav tau muab nwg
rhaub kuas ripau.

Tsi txhob haus cov
dlej nuav.

Cov mivnyuas kws tsi tau muaj 12 xyoo tsi
txhob haus cov dlej nuav. Txhob muab cov
dlej nuav moog tov mig.

Japanese

ZO)>)'iSC

lift fA Jj t It "f ta T

/jcttMis-rstff

MNfc lX
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12 Hnft 3" filial

wten sww y
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5	/ihhofo,
HKa poayMie fioro i.vicT.

Ki-inVnTi, iso'iy pro
KopHCTyBaHHa.

He niiHTe BOfly.

y Biu,i jjo 12 .vricsrui b He noBHHHi iihth
nojiy. He KopiicTyftTecfl bojioio jyist
npHroTyBaHHa a^airroBaHoi' ,ihtjroi cyMiini
("rjiopMyjiH").

Vietnamese

Tai lieu nay co tin tu'c quan trong ve nifdc
uong cua quy vi. Hay nhd ngi/di dich cho
quy vj, ho|c hoi ngifdi nao hieu tai lieu
nay.

Dun soi ntfde trtfdc
khi dung.

Ditag uong nifdc
nay.

Tre em drfdi 12 thang khong nen uong
nifdc nay. DuCng dung niidc nay de pha sffa
formula.

The water glass and faucet may be useful in a posted notice "N^
that would be seen by many non-English speaking people

to illustrate that they should not drink the water. [ J 1 1

-------