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
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
(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 (
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 |
|
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 |
|
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.)
(A) Systems which detect
nitrates at levels above 5 mg/l, but below the MCL, the following language is
REQUIRED:
Nitrate in drinking water at levels above 10 ppm is a health risk for infants of less than six months of age. High nitrate levels in drinking water can cause blue baby syndrome. Nitrate levels may rise quickly for short periods of time because of rainfall or agricultural activity. If you are caring for an infant you should ask advice from your health care provider.
(B) Systems
which detect lead above the action level in more than 5%, and up to and
including 10%, of homes sampled, the following language is REQUIRED:
Infants
and young children are typically more vulnerable to lead in drinking water than
the general population. It is possible that lead levels at your home may be
higher than at other homes in the community as a result of materials used in
your home’s plumbing. If you are concerned about elevated lead levels in your
home’s water, you may wish to have your water tested and flush your tap for 30
seconds to 2 minutes before using tap water. Additional information is
available from the Safe Drinking Water Hotline (1-800-426-4791).
(C) Systems that have performed
any monitoring for Cryptosporidium must indicate that Cryptosporidium may be
present in the source water or the finished water and include the summary of
the result and an explanation of the significance.
We constantly monitor the water supply
for various constituents. We have detected cryptosporidium in the __________ (finished water or source water). We
detected this constituent in _____ out of _____ samples tested. We believe it
is important for you to know that cryptosporidum may
cause serious illness in immuno-compromised persons
such as persons with cancer undergoing chemotherapy, persons who have undergone
organ transplants, people with HIV/AIDS or other immune system disorders. These
people should seek advice from their health care providers.
(D) Systems that have performed any monitoring for radon that
indicates that radon may be present in the finished water must include the
results of the monitoring and an explanation of the significance of the
results.
We constantly monitor the water supply
for various constituents. We have detected radon in the finished water supply
in _____ out of _____ samples tested. There is no federal regulation for radon
levels in drinking water. Exposure to air transmitted radon over a long period
of time may cause adverse health effects.
Section 10. (Select the appropriate explanation for the Test Results
Chart. If you had a violation, you are REQUIRED to have an explanation of the
violation including, duration of the violation, potential adverse health
effects and actions taken to address the violation. This is not required for
detects.)
What
does this mean?
If you had violations:
The
table shows that our system uncovered some problems this year. The duration of
the violation was ... the potential adverse health effects are... (restate from
health effects language in section 8) We (have corrected/are correcting) this
by ................
If you had a detect but no violations:
As
you can see by the table, our system had no violations. We’re proud that your
drinking water meets or exceeds all Federal and State requirements. We have
learned through our monitoring and testing that some constituents have been
detected. The EPA has determined that your water IS SAFE at these levels.
If you had monitoring or
reporting violations:
We constantly monitor for various constituents in the water supply
to meet all regulatory requirements. This past year we (describe the
violation). This does not pose a threat to the quality of our water supply.
If you had no violations or detects the table
is not required.
Section 11. (Insert this REQUIRED Language.)
All
drinking water, including bottled water, may reasonably be expected to contain
at least small amounts of some contaminants.
The presence of contaminants does not necessarily indicate that the
water poses a health risk. More information about contaminants and potential
health effects can be obtained by calling the Environmental Protection Agency’s
Safe Drinking Water Hotline at 1-800-426-4791.
Section 12. (It is recommended that this explanation be included.)
MCL’s are set at very
stringent levels. To understand the possible health effects described for many
regulated constituents, a person would have to drink 2 liters of water every
day at the MCL level for a lifetime to have a one-in-a-million chance of having
the described health effect.
Section 13. (This tempered language is recommended in addition to
the required language if you had a violation or detect of Total Coliform, Nitrates or Lead.)
Total Coliform:
The Total Coliform Rule requires water systems to
meet a stricter limit for coliform bacteria. Coliform bacteria are usually harmless, but their presence
in water can be an indication of disease-causing bacteria. When coliform bacteria are found, special follow-up tests are
done to determine if harmful bacteria are present in the water supply. If this
limit is exceeded, the water supplier must notify the public by newspaper,
television or radio. To comply with the stricter regulation, we have increased
the average amount of chlorine in the distribution system.
Nitrates:
As a precaution we always notify physicians and health care providers in this
area if there is ever a higher than normal level of nitrates in the water
supply.
Lead: Lead in drinking water is rarely the sole
cause of lead poisoning, but it can add to a person's total lead exposure. All
potential sources of lead in the household should be identified and removed,
replaced or reduced.
Section 14. (If there is a significant number of non-English
speaking customers, it is REQUIRED that they be informed in their language that
the report is available. The State Primacy Agency determines the inclusion of
this provision.)
(If
necessary include language for non-English speaking customers)
Section 15. (This section offers an opportunity to inform your
customers about the system, future expansion and/or rate increases. It is not a
requirement of the report.)
In
our continuing efforts to maintain a safe and dependable water supply it may be
necessary to make improvements in your water system. The costs of these
improvements may be reflected in the rate structure. Rate adjustments may be
necessary in order to address these improvements.
Thank
you for allowing us to continue providing your family with clean, quality water
this year. In order to maintain a safe and dependable water supply we sometimes
need to make improvements that will benefit all of our customers. These
improvements are sometimes reflected as rate structure adjustments. Thank you
for understanding.
Section 16. (Include this REQUIRED Language.)
Some
people may be more vulnerable to contaminants in drinking water than the
general population. Immuno-compromised persons such
as persons with cancer undergoing chemotherapy, persons who have undergone
organ transplants, people with HIV/AIDS or other immune system disorders, some
elderly, and infants can be particularly at risk from infections. These people
should seek advice about drinking water from their health care providers.
EPA/CDC guidelines on appropriate means to lessen the risk of infection by
cryptosporidium and other microbiological contaminants are available from the
Safe Drinking Water Hotline (800-426-4791).
Section 17. (Recommended language to end your report on a positive
note.)
Please
call our office if you have questions.
We
at (name of system) work around the clock to
provide top quality water to every tap, said (name of
water official). We ask that all our customers help us protect our water
sources, which are the heart of our community, our way of life and our
children’s future.