Public Notification Certification Form - Tiers 1, 2 & 3 (Page 2 of 3) in pdf

Instructions for Unresolved Total Coliform Notice – Template NC-5

Template on Reverse

This template is intended for systems where consumers will not need to boil their water or where they will not have the

facilities to do so. Since exceeding the total coliform bacteria maximum contaminant level requires a Tier 2 notification,

you must provide public notice to persons served as soon as practical and within 30 days after you learn of the violation

[40 CFR 141.203(b)]. Persistent total coliform problems can pose a serious health risk, and your state may elevate such

situations to Tier 1. Check with your state to make sure you meet all its requirements. You must issue a repeat notice

every three months for as long as the violation persists.

Noncommunity water systems must use one of the following methods [40 CFR 141.203(c)]:



Posting in conspicuous locations



Hand or direct delivery



Mail

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 modify the notice, you must still include all required PN 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 Subpart Q) must be included as written (with blanks filled in)

and is presented in this notice in italics with an asterisk on either end.

This template also includes mandatory language encouraging further distribution to persons who may not have received

the notice [40 CFR 141.205(d)] and is presented in this notice in italics and 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

The template on the reverse is intended for use by systems taking fewer than 40 coliform bacteria samples a month. You

can modify the template using the following language if you are required to take 40 or more samples per month:

We routinely monitor for the presence of drinking water contaminants. During [provide month], [give percentage]

percent of our samples showed the presence of total coliform bacteria. The standard is that no more than 5 percent of

samples may do so.

Corrective Action

In your notice, describe corrective actions you are taking. If you know what is causing the coliform problem, explain this in

the notice. Listed below are some steps commonly taken by water systems with total coliform violations. You can use one

or more of the following statements, if appropriate, or develop your own text:



We are chlorinating and flushing the water system.



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



We are repairing the wellhead seal.



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



We will inform you when additional samples show no coliform bacteria.

After Issuing the Notice

Make sure to send your state a copy of each type of notice and a certification that you have met all the public notification

requirements within ten days after issuing the notice [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 NC-7 for a “problem corrected” notice template.

Public Notification Certification Form - Tiers 1, 2 & 3 Page 2

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