09/2024 Instructions for Homeowners: Lead and Copper Tap Sample Collection These samples are being collected to determine the lead and copper levels in your tap water. This sampling effort is required by the U.S. Environmental Protection Agency and your State under the Lead and Copper Rule. This is a collaboration effort between your water system and customers. Prior arrangements will be made with you, the customer, to coordinate the sample collection. Dates will be set for sample kit delivery and pick-up by your water system. Review before you collect samples: > Must be from cold water tap that has been regularly used for drinking water consumption in the past few weeks. > Collect samples from a kitchen or bathroom tap that has not been used for at least 6 hours. The best time to collect samples is either early in the morning or in the evening upon returning from work at first draw. > Do not flush the water line before the 6-hour stagnation period. This allows for accurate lead and copper concentrations within your water lines. > Do not collect from taps with water a softener or a carbon filter. Select a tap that does not have a softener or a point-of-use filter. Do not remove the aerator prior to sampling. Notify your water system if you don't have access to taps without point-of-use devices or has a whole house treatment. Sample Collection Instruction: ~ Place the opened sample bottle below the faucet and turn on the cold water tap as you would do to fill a glass of water. ~ Fill the sample bottle to the line marked "1000-mL" and turn off the water. Do not overfill the bottle. [^Tightly cap the sample bottle and place in the sample kit provided. Label sample location on the bottle if needed. ~ Review the sample kit label at this time to ensure that all information contained on the label is correct. |^Note this information on the label if any plumbing repairs or replacement has been done in the home since the previous sampling event. | |piace the sample bottles in the same location where the kit was delivered to. The water system staff will pick up the sample kit and deliver it to the laboratory. TO BE COMPLETED BY RESIDENT Water was last used: Time Date Sample was collected: Time Date Street Address: Sample Location & faucet (e.g., Bathroom sink): I have read the above directions and have taken a tap sample in accordance with these directions. Printed Name Signature Date Results will be provided to you, customer, as soon as practical but no later than 30 days after the system learns of the tap monitoring results. However, if excessive lead and/or copper levels are found, immediate notification will be provided (usually 1-2 working days after the system learns of your tap monitoring results). Call at if you have any questions regarding these instructions. Public Water System must retain these signed records for a minimum of 12 years. Please include one copy of this form with your Certification of Lead Consumer Notice to EPA. ------- |