irections for completing

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 1^st to December 31^st, (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	100	100	Discharge from steel and pulp mills; erosion of natural deposits
Copper			ppm	1.3	AL=1.3	Corrosion of household plumbing systems; erosion of natural deposits.
Cyanide			ppb	200	200	Discharge from steel/metal factories; discharge from plastic and fertilizer factories
Fluoride			ppm	4	4	Erosion of natural deposits; water additive which promotes strong teeth; discharge from fertilizer and aluminum factories
Lead			ppb	0	AL=15	Corrosion of household plumbing systems, erosion of natural deposits
Mercury (inorganic)			ppb	2	2	Erosion of natural deposits; discharge from refineries and factories; runoff from landfills; runoff from cropland
Nitrate (as Nitrogen)			ppm	10	10	Runoff from fertilizer use; leaching from septic tanks, sewage; erosion of natural deposits
Nitrite (as Nitrogen)			ppm	1	1	Runoff from fertilizer use; leaching from septic tanks, sewage; erosion of natural deposits
Selenium			ppb	50	50	Discharge from petroleum and metal refineries; erosion of natural deposits; discharge from mines
Thallium			ppb	0.5	2	Leaching from ore-processing sites; discharge from electronics, glass, and drug factories
Synthetic Organic Contaminants including Pesticides and Herbicides
2,4-D			ppb	70	70	Runoff from herbicide used on row crops
2,4,5-TP (Silvex)			ppb	50	50	Residue of banned herbicide
Acrylamide				0	TT	Added to water during sewage/wastewater treatment
Alachlor			ppb	0	2	Runoff from herbicide used on row crops
Atrazine			ppb	3	3	Runoff from herbicide used on row crops
Benzo(a)pyrene (PAH)			nanograms/l	0	200	Leaching from linings of water storage tanks and distribution lines
Carbofuran			ppb	40	40	Leaching of soil fumigant used on rice and alfalfa
Chlordane			ppb	0	2	Residue of banned termiticide
Dalapon			ppb	200	200	Runoff from herbicide used on rights of way
Di(2-ethylhexyl) adipate			ppb	400	400	Discharge from chemical factories
Di(2-ethylhexyl) phthalate			ppb	0	6	Discharge from rubber and chemical factories
Dibromochloropropane			nanograms/1	0	200	Runoff/leaching from soil fumigant used on soybeans, cotton, pineapples, and orchards
Dinoseb			ppb	7	7	Runoff from herbicide used on soybeans and vegetables
Diquat			ppb	20	20	Runoff from herbicide use
Dioxin [2,3,7,8-TCDD]			picograms/l	0	30	Emissions from waste incineration and other combustion; discharge from chemical factories
Endothall			ppb	100	100	Runoff from herbicide use
Endrin			ppb	2	2	Residue of banned insecticide
Epichlorohydrin				0	TT	Discharge from industrial chemical factories; an impurity of some water treatment chemicals
Ethylene dibromide			nanograms/1	0	50	Discharge from petroleum refineries
Glyphosate			ppb	700	700	Runoff from herbicide use
Heptachlor			nanograms/1	0	400	Residue of banned termiticide
Heptachlor epoxide			nanograms/1	0	200	Breakdown of heptachlor
Hexachlorobenzene			ppb	0	1	Discharge from metal refineries and agricultural chemical factories
Hexachlorocyclo- pentadiene			ppb	50	50	Discharge from chemical factories
Lindane			nanograms/l	200	200	Runoff/leaching from insecticide used on cattle, lumber, gardens
Methoxychlor			ppb	40	40	Runoff/leaching from insecticide used on fruits, vegetables, alfalfa, livestock
Oxamyl [Vydate]			ppb	200	200	Runoff/leaching from insecticide used on apples, potatoes and tomatoes
PCBs [Polychlorinated biphenyls]			nanograms/1	0	500	Runoff from landfills; discharge of waste chemicals
Pentachlorophenol			ppb	0	1	Discharge from wood preserving factories
Picloram			ppb	500	500	Herbicide runoff
Simazine			ppb	4	4	Herbicide runoff
Toxaphene			ppb	0	3	Runoff/leaching from insecticide used on cotton and cattle
Volatile Organic Contaminants
Benzene			ppb	0	5	Discharge from factories; leaching from gas storage tanks and landfills
Carbon tetrachloride			ppb	0	5	Discharge from chemical plants and other industrial activities
Chlorobenzene			ppb	100	100	Discharge from chemical and agricultural chemical factories
o-Dichlorobenzene			ppb	600	600	Discharge from industrial chemical factories
p-Dichlorobenzene			ppb	75	75	Discharge from industrial chemical factories
1,2 – Dichloroethane			ppb	0	5	Discharge from industrial chemical factories
1,1 – Dichloroethylene			ppb	7	7	Discharge from industrial chemical factories
cis-1,2-ichloroethylene			ppb	70	70	Discharge from industrial chemical factories
trans - 1,2 –Dichloroethylene			ppb	100	100	Discharge from industrial chemical factories
Dichloromethane			ppb	0	5	Discharge from pharmaceutical and chemical factories
1,2-Dichloropropane			ppb	0	5	Discharge from industrial chemical factories
Ethylbenzene			ppb	700	700	Discharge from petroleum refineries
Styrene			ppb	100	100	Discharge from rubber and plastic factories; leaching from landfills
Haloacetic Acids (HAA)			ppb	n/a	60	Byproduct of drinking water disinfection
Tetrachloroethylene			ppb	0	5	Discharge from factories and dry cleaners
1,2,4 –Trichlorobenzene			ppb	70	70	Discharge from textile-finishing factories
1,1,1 – Trichloroethane			ppb	200	200	Discharge from metal degreasing sites and other factories
1,1,2 –Trichloroethane			ppb	3	5	Discharge from industrial chemical factories
Trichloroethylene			ppb	0	5	Discharge from metal degreasing sites and other factories
TTHM [Total trihalomethanes]			ppb	n/a	80	By-product of drinking water chlorination
Toluene			ppm	1	1	Discharge from petroleum factories
Vinyl Chloride			ppb	0	2	Leaching from PVC piping; discharge from plastics factories
Xylenes			ppm	10	10	Discharge from petroleum factories; discharge from chemical factories

Section 8- Health Effects Language (If there is a violation, the corresponding health effects language to that violation is required. This REQUIRED language must be included word for word as stated below. This language is not required for detects except for those listed in Section 9.

Microbiological Contaminants:

Total Coliform. 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.

Fecal coliform/E.Coli. 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, and people with severely compromised immune systems.

Turbidity. 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.

Radioactive Contaminants:

Beta/photon emitters. 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.

Alpha emitters. 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.

Combined Radium. 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.

Uranium. Some people who drink water containing uranium in excess of the MCL over many years may have an increased risk of cancer and kidney toxicity.

Inorganic Contaminants:

Antimony. 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.

Arsenic. 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.

Asbestos. 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.

Barium. Some people who drink water containing barium in excess of the MCL over many years could experience an increase in their blood pressure.

Beryllium. Some people who drink water containing beryllium well in excess of the MCL over many years could develop intestinal lesions.

Bromate. Some people who drink water containing bromate in excess of the MCL over many years may have an increased risk of cancer.

Cadmium. Some people who drink water containing cadmium in excess of the MCL over many years could experience kidney damage.

Chloramines. 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 in excess of the MRDL could experience stomach discomfort or anemia.

Chlorine. 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 in excess of the MRDL could experience stomach discomfort.

Chlorine dioxide. 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.

Chlorite. 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.

Chromium. Some people who use water containing chromium well in excess of the MCL over many years could experience allergic dermatitis.

Copper. 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.

Cyanide. 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.

Fluoride. 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. Children may get mottled teeth.

Lead. Infants and children who drink water containing lead in excess of the action level could experience delays in their physical or 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.

Mercury (inorganic). Some people who drink water containing inorganic mercury well in excess of the MCL over many years could experience kidney damage.

Nitrate. 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.

Nitrite. 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.

Selenium. 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.

Thallium. 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.

Synthetic organic contaminants including pesticides and herbicides:

2,4-D. 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.

2,4,5-TP (Silvex). Some people who drink water containing silvex in excess of the MCL over many years could experience liver problems.

Acrylamide. 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.

Alachlor. 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.

Atrazine. 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.

Benzo(a)pyrene [PAH]. 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.

Carbofuran. 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.

Chlordane. 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.

Dalapon. Some people who drink water containing dalapon well in excess of the MCL over many years could experience minor kidney changes.

Di (2-ethylhexyl) adipate. 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.

Di (2-ethylhexyl) phthalate. Some people who drink water containing di (2-ethylhexyl) phthalate in excess of the MCL over many years may have problems with their liver, or experience reproductive difficulties, and may have an increased risk of getting cancer.

Dibromochloropropane (DBCP). 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.

Dinoseb. Some people who drink water containing dinoseb well in excess of the MCL over many years could experience reproductive difficulties.

Dioxin (2,3,7,8-TCDD). 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.

Diquat. Some people who drink water containing diquat in excess of the MCL over many years could get cataracts.

Endothall. Some people who drink water containing endothall in excess of the MCL over many years could experience problems with their stomach or intestines.

Endrin. Some people who drink water containing endrin in excess of the MCL over many years could experience liver problems.

Epichlorohydrin. 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.

Ethylene dibromide. 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.

Glyphosate. Some people who drink water containing glyphosate in excess of the MCL over many years could experience problems with their kidneys or reproductive difficulties.

Heptachlor. 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.

Heptachlor epoxide. 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.

Hexachlorobenzene. 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.

Hexachlorocyclopentadiene. Some people who drink water containing hexachlorocyclopentadiene well in excess of the MCL over many years could experience problems with their kidneys or stomach.

Lindane. Some people who drink water containing lindane in excess of the MCL over many years could experience problems with their kidneys or liver.

Methoxychlor. Some people who drink water containing methoxychlor in excess of the MCL over many years could experience reproductive difficulties.

Oxamyl [Vydate]. Some people who drink water containing oxamyl in excess of the MCL over many years could experience slight nervous system effects.

PCBs [Polychlorinated biphenyls]. 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.

Pentachlorophenol. 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.

Picloram. Some people who drink water containing picloram in excess of the MCL over many years could experience problems with their liver.

Simazine. Some people who drink water containing simazine in excess of the MCL over many years could experience problems with their blood.

Toxaphene. 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.

Volatile Organic Contaminants:

Benzene. 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.

Carbon Tetrachloride. 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.

Chlorobenzene. Some people who drink water containing chlorobenzene in excess of the MCL over many years could experience problems with their liver or kidneys.

o-Dichlorobenzene. 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.

p-Dichlorobenzene. 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.

1,2-Dichloroethane. 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.

1,1-Dichloroethylene. Some people who drink water containing 1,1-dichloroethylene in excess of the MCL over many years could experience problems with their liver.

cis-1,2-Dichloroethylene. Some people who drink water containing cis-1,2-dichloroethylene in excess of the MCL over many years could experience problems with their liver.

trans-1,2-Dicholoroethylene. 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.

Dichloromethane. 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.

1,2-Dichloropropane. 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.

Ethylbenzene. Some people who drink water containing ethylbenzene well in excess of the MCL over many years could experience problems with their liver or kidneys.

Haloacetic Acids (HAA). Some people who drink water containing haloacetic acids in excess of the MCL over many years may have an increased risk of getting cancer

Styrene. 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.

Tetrachloroethylene. 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.

1,2,4-Trichlorobenzene. 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.

1,1,1,-Trichloroethane. 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.

1,1,2-Trichloroethane. 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.

Trichloroethylene. 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.

TTHMs [Total Trihalomethanes]. 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 systems, and may have an increased risk of getting cancer.

Toluene. 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.

Vinyl Chloride. Some people who drink water containing vinyl chloride in excess of the MCL over many years may have an increased risk of getting cancer.

Xylenes. Some people who drink water containing xylenes in excess of the MCL over many years could experience damage to their nervous system.

For systems which have failed to install adequate filtration or disinfection equipment or processes, or have had a failure of such equipment or processes which constitutes a violation, the following language is REQUIRED:

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.

Section 9. (This section is REQUIRED for detects of nitrates, lead, cryptosporidium and radon. If these are detected, you are REQUIRED to provide a short informational statement about the impact of the contaminant as below. The language may be modified only in consultation with the State Primacy Agency.)