Consumer Confidence Report Template

 

This template is copyrighted with unlimited distribution and reproduction to NRWA member state associations

    

      This template is designed by sections and allows you to customize your report for your system. You must read the directions for completion of the report located on this disk in the file labeled “templatedirections.rtf”. Also included on this disk is the federal regulation labeled “ccrregulation.rtf” which provides additional detailed requirements of the regulation. These are essential to understanding the complicated regulatory requirements of the EPA.

 

     This template is set-up to allow you to use it in several ways. You may choose to use the template to make your selections then delete the selection headings and language that does not apply to your utility. You may choose to use the copy and paste function on your word processing software or to manually type in the desired selections to another document. Be sure to proofread your report to insure all non-appropriate language and section headings have been deleted before publishing.

 

 

Section 1. (Choose a title and delete the remaining choices.  This is optional.)

 

 

Quality on Tap Report

Quality Water Report

Annual Drinking Water Quality Report

The Water We Drink

(Insert name of System after your title selection)

 

 

 

Section 2. (Make a Selection from this optional language and delete the remaining choices.  It is REQUIRED that you identify the type and source of your water supply.)

 

            We're pleased to present to you this year's Annual Quality Water Report. This report is designed to inform you about the quality water and services we deliver to you every day. Our constant goal is to provide you with a safe and dependable supply of drinking water. We want you to understand the efforts we make to continually improve the water treatment process and protect our water resources. We are committed to ensuring the quality of your water. Our water source is (name the source and type, i.e., wells: Our wells draw from the Duncan Aquifer, surface water: i.e., River Jordan or we purchase our water from the City of Waterville which is treated surface water from Lake Duncan.)  (This is REQUIRED information).

   

            We’re very pleased to provide you with this year's Annual Quality Water Report. We want to keep you informed about the excellent water and services we have delivered to you over the past year. Our goal is and always has been, to provide to you a safe and dependable supply of drinking water. Our water source is (name the source and type, i.e., wells: Our wells draw from the Duncan Aquifer, surface water: i.e., River Jordan or we purchase our water from the City of Waterville which is treated surface water from Lake Duncan.)  (This is REQUIRED information).

 

(If you have a source water assessment plan you must include a statement informing the consumers of the availability of the information and means to obtain it.  If the system has received a source water assessment from the primacy agency, you must include a brief summary of the system’s susceptibility to potential sources of contamination, using language provided by the primacy agency or written by the operator).

 

 We have a source water protection plan available from our office that provides more information such as potential sources of contamination.

 

Section 3. (Make a selection from this optional language and delete the remaining choice.)

 

I'm pleased to report that our drinking water is safe and meets federal and state requirements.

  

This report shows our water quality and what it means.

 

Section 4. (Enter this REQUIRED language.  The telephone number of the owner, operator or designee must be included along with the time and place of regularly scheduled board meetings.)

 

If you have any questions about this report or concerning your water utility, please contact (give the name and number of a designee able to address the customers questions). We want our valued customers to be informed about their water utility. If you want to learn more, please attend any of our regularly scheduled meetings. They are held on (give the day, date, time and location) this is REQUIRED information.

 

 

 

Section 5. (The period the report covers is REQUIRED language.)

 

(Name of your water system) routinely monitors for constituents in your drinking water according to Federal and State laws. This table shows the results of our monitoring for the period of January 1st to December 31st, (year). All drinking water, including bottled drinking water, may be reasonably expected to contain at least small amounts of some constituents.  It's important to remember that the presence of these constituents does not necessarily pose a health risk.

 

Section 6. (For each constituent that is detected or is a violation, the level detected, unit of measurement, the MCLG, the MCL and the likely source of contamination is REQUIRED to be reported in the Test Results Table (see section 7).  This section provides definitions of the units of measurement. Include the paragraph and appropriate definitions of the unit of measurement for any constituent or detect you report in the Test Result Table.)

 

In this table you will find many terms and abbreviations you might not be familiar with. To help you better understand these terms we've provided the following definitions:

 

Non-Detects (ND) - laboratory analysis indicates that the constituent is not present.

 

Parts per million (ppm) or Milligrams per liter (mg/l) - one part per million corresponds to one minute in two years or a single penny in $10,000.

 

Parts per billion (ppb) or Micrograms per liter - one part per billion corresponds to one minute in 2,000 years, or a single penny in $10,000,000.

 

Parts per trillion (ppt) or Nanograms per liter (nanograms/l) - one part per trillion corresponds to one minute in 2,000,000 years, or a single penny in $10,000,000,000.

 

Parts per quadrillion (ppq) or Picograms per liter (picograms/l) - one part per quadrillion corresponds to one minute in 2,000,000,000 years or one penny in $10,000,000,000,000.

 

Picocuries per liter (pCi/L) - picocuries per liter is a measure of the radioactivity in water.

 

Millirems per year (mrem/yr) - measure of radiation absorbed by the body.

 

Million Fibers per Liter (MFL) - million fibers per liter is a measure of the presence of asbestos fibers that are longer than 10 micrometers.

Nephelometric Turbidity Unit (NTU) - nephelometric turbidity unit is a measure of the clarity of water. Turbidity in excess of 5 NTU is just noticeable to the average person.

 

Variances & Exemptions (V&E) - State or EPA permission not to meet an MCL or a treatment technique under certain conditions. (Only systems with a variance or exemption are REQUIRED to include this definition.  In addition, it is REQUIRED to provide an explanation of the reasons for the variance or exemption, date issued, status or remediation.)

 

Action Level (AL) - the concentration of a contaminant which, if exceeded, triggers treatment or other requirements which a water system must follow.

 

Treatment Technique (TT) - (mandatory language) A treatment technique is a required process intended to reduce the level of a contaminant in drinking water.

 

Maximum Contaminant Level - (mandatory language) The “Maximum Allowed” (MCL) is the highest level of a contaminant that is allowed in drinking water.  MCLs are set as close to the MCLGs as feasible using the best available treatment technology.

 

Maximum Contaminant Level Goal - (mandatory language) The “Goal”(MCLG) is the level of a contaminant in drinking water below which there is no known or expected risk to health.  MCLGs allow for a margin of safety.

 

Maximum Residual Disinfectant Level Goal (MRDLG) - The level of a drinking water disinfectant below which there is no known or expected risk to health. MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contaminants.

 

Maximum Residual Disinfectant Level (MRDL) - The highest level of a disinfectant allowed in drinking water. There is convincing evidence that addition of a disinfectant is necessary for control of microbial contaminants.

 

Section 7. (The information from the table below is REQUIRED for each constituent that is a violation of the MCL or detect. The results must be reported in whole numbers.  See Section 7 of the template instructions for conversion factors.)

 

For unregulated contaminants for which monitoring is required except Cryptosporidium, the table must contain the average and range at which the contaminant was detected.

 

For turbidity, lead & copper, fecal coliform and total coliform, refer to the instructions and the regulation for special requirements.

 

(For public relations purposes, it is recommended you consider printing the entire table to demonstrate the number of constituents tested for and not detected. If there are no violations or detects this table does not have to be included.)

TEST RESULTS

Contaminant

Violation

Y/N

Level

Detected

Unit

Measurement

MCLG

MCL

Likely Source of Contamination

Microbiological Contaminants

Total Coliform Bacteria                                    

 

 

 

0

(systems that collect 40 or more samples per month) 5% of monthly samples are positive; (systems that collect fewer than 40 samples per month) 1 positive monthly sample

Naturally present in the environment

Fecal coliform and             E.coli

 

 

 

0

a routine sample and repeat sample are total coliform positive, and one is also fecal coliform or E. coli positive

Human and animal fecal waste

Turbidity

 

 

 

n/a

TT

Soil runoff

Radioactive Contaminants

Beta/photon emitters

 

 

mrem/yr

0

4

Decay of natural and man-made deposits

Alpha emitters   

 

 

pCi/1

0

15

Erosion of natural deposits

Combined radium

 

 

pCi/1

0

5

Erosion of natural deposits

Uranium

 

 

ppb

0

30

Erosion of natural deposits

Inorganic Contaminants

Antimony

 

 

ppb

6

6

Discharge from petroleum refineries; fire retardants; ceramics; electronics; solder

Arsenic

* A community water system that detects arsenic above 10 ppb and up to and Including 50ppb must include the arsenic health effects language.

 

 

ppb

n/a

50

Erosion of natural deposits; runoff from orchards; runoff from glass and electronics production wastes

Asbestos

 

 

MFL

7

7

Decay of asbestos cement water mains; erosion of natural deposits

Barium

 

 

ppm

2

2

Discharge of drilling wastes; discharge from metal refineries; erosion of natural deposits

Beryllium

 

 

ppb

4

4

Discharge from metal refineries and coal-burning factories; discharge from electrical, aerospace, and defense industries

Bromate

 

 

ppb

10

0

By-product of drinking water disinfection.

Cadmium

 

 

ppb

5

5

Corrosion of galvanized pipes; erosion of natural deposits; discharge from metal refineries; runoff from waste batteries and paints

Chloramines

 

 

ppm

MRDLG = 4

MRDL = 4

Water additive used to control microbes.

Chlorine

 

 

ppm

MRDLG  = 4

MRDL = 4

Water additive used to control microbes.

Chlorine dioxide

 

 

ppb

MRDLG = 800

MRDL = 800

Water additive used to control microbes.

Chlorite

 

 

Ppm

1

0.8

By-product of drinking water disinfection.

Chromium

 

 

ppb