Tier 1 Templates

Tier 1 notices must be issued for the following violations or
situations:

-   **Total coliform MCL violations where fecal coliform or *E. coli***
    are present, or failure to test for fecal coliform or *E. coli* when
    any repeat sample tests positive for coliform (some times referred
    to as an acute violation of the Total Coliform Rule);

-   **Nitrate, nitrite, or total nitrate and nitrite MCL** violations,
    or failure to take a confirmation sample for nitrate or nitrite
    within 24 hours after learning that an initial sample exceeded the
    MCL;

-   Exceedance of the **nitrate MCL by non-community water systems**
    that have been granted permission by the primacy agency to continue
    to exceed the MCL of 10 mg/l, although they must not exceed 20 mg/l;

-   **Chlorine dioxide MRDL** violations when one or more of the samples
    **taken in the distribution system** exceeded the MRDL on the day
    after a chlorine dioxide measurement taken at the entrance to the
    distribution system exceeded the MRDL, or when required samples are
    not taken in the distribution system;

-   **Turbidity** MCL violations of 5 NTU or more, **if elevated to Tier
    1** by the primacy agency, or if consultation does not occur within
    24 hours of the violation (see Chapter 6);

-   **Treatment technique violations** resulting from a single
    exceedance of turbidity limits, **if elevated to Tier 1** by the
    primacy agency, or if consultation does not occur within 24 hours of
    the violation (see Chapter 6);

-   The occurrence of a **waterborne disease outbreak or other
    waterborne emergency** such as a treatment failure, chemical spill
    or overfeed, sewage spill, or natural disaster; and

-   **Other violations or situations** which could cause serious health
    effects, **as determined by your primacy agency**.

The pages that follow contain templates for these Tier 1 violations or
situations, as listed below. Along with each template are instructions,
including the required method of delivery and suggestions for completing
individual sections of the notice. These instructions are designed to
supplement Chapter 5, so you may see much of the information repeated
here.

**Mandatory language on health effects, which must be included as
written with blanks filled in, is presented in italics (141.205(d)).**

You must also include the following italicized language in all notices,
where applicable (141.205(d)). Use of this language does not relieve you
of your obligation to take steps reasonably calculated to notify all
persons served:

> *Please share this information with all the other people who drink
> this water, especially those who may not have received this notice
> directly (for example, people in apartments, nursing homes, schools,
> and businesses). You can do this by posting this notice in a public
> place or distributing copies by hand or mail.*

**Templates**

Nitrate MCL Exceedance Notice--Template 1-1 33

Spanish Nitrate MCL Exceedance Notice--Template 1-1A 35

Nitrate Failure to Take a Confirmation Sample Notice--Template 1-2 37

Non-community PWSs Allowed Up to 20 mg/L Nitrate Notice--Template 1-3 39

Fecal Coliform or *E. coli* Notice--Template 1-4 41

Spanish Fecal Coliform or *E. coli* Notice--Template 1-4A 43

Waterborne Disease Outbreak Notice--Template 1-5 45

IESWTR or LT1 CFE Maximum Turbidity Exceedance, or Turbidity Single
Exceedance as Tier 1 Notice--Template 1-6 47

Chlorine Dioxide MRDL (Tier 1) Notice--Template 1-7

Tier 1 \"Problem Corrected\" Notice--Template 1-8

Number range CHAPTER**Template on Reverse**

Number range CHAPTERSince exceeding the nitrate maximum contaminant
level is a Tier 1 violation, you must provide public notice to persons
served as soon as practical but within 24 hours after you learn of the
violation (141.202(b)). During this time period you must also contact
your primacy agency. You should also coordinate with your local health
department. This template is also applicable to nitrite and total
nitrate and nitrite violations. You must use one or more of the
following methods to deliver the notice to consumers (141.202(c)):

-   Radio

-   Television

-   Hand or direct delivery

-   Posting in conspicuous locations

You may need to use additional methods (e.g., newspaper, delivery of
multiple copies to hospitals, clinics, or apartment buildings), since
notice must be provided in a manner reasonably calculated to reach all
persons served.

The notice on the reverse is appropriate for hand delivery or a
newspaper notice. However, you may wish to modify it before using it for
a radio or TV notice. If you do, you must still include all required
elements and leave the health effects language in italics unchanged.
This language is mandatory (141.205(d)). If you post or hand deliver,
print your notice on letterhead, if available.

**Alternative Sources of Water**

If you are providing alternative sources of water for infants, your
notice should say where it can be obtained. Remember that bottled water
can also be contaminated. If you are providing bottled water, make sure
it meets the standard for nitrates by contacting the bottler and asking
for the most recent test results.

**Repeat Notices**

If this is a repeat notice (as required by your primacy agency), or if
your system's nitrate levels fluctuate around the MCL, you may wish to
include an explanation similar to the following:

You were initially notified of high nitrate levels on \[give date\].
Since that time we have been monitoring the nitrate concentration every
three months. Seasonal fluctuations in nitrate concentrations have been
observed, due to nitrates contained in fertilizer. It appears that high
nitrates occur during the later summer and fall. Note that prior to
\[year\] we were meeting drinking water standards for nitrate.

**Corrective Action**

In your notice, describe corrective actions you are taking. The bullet
below describes one action commonly taken by water systems with
nitrate/nitrite violations. You can use the following language, if
appropriate, or develop your own:

-   We are investigating water treatment and other options. These may
    include drilling a new well, mixing the water with low-nitrate water
    from another source, or buying water from another water system.

**After Issuing the Notice**

Make sure to send your primacy agency a copy of each type of notice and
a certification that you have met all the public notice requirements
within ten days after issuing the notice (141.31(d)). You should also
issue a follow-up notice in addition to meeting any repeat notice
requirements your primacy agency sets.

You should notify health professionals in the area of the violation.
People may call their doctors with questions, and the doctors should
have the information they need to respond appropriately. They also need
to make sure the water is not provided to infants in their care.

**DRINKING WATER WARNING**

\[System\] water has high levels of nitrate --

DO NOT GIVE THE WATER TO INFANTS UNDER 6 MONTHS OLD OR USE IT TO MAKE
INFANT FORMULA

Water sample results received \[give date\] showed nitrate levels of
\[level and units\]. This is above the nitrate standard, or maximum
contaminant level (MCL), of \[state/federal MCL\]. Nitrate in drinking
water is a serious health concern for infants less than six months old.

Nitrate in drinking water can come from natural, industrial, or
agricultural sources (including septic systems and run-off). Levels of
nitrate in drinking water can vary throughout the year.

**What should I do? What does this mean?**

-   **DO NOT GIVE THE WATER TO INFANTS.** ***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.*** Blue baby
    syndrome is indicated by blueness of the skin. Symptoms in infants
    can develop rapidly, with health deteriorating over a period of
    days. If symptoms occur, seek medical attention immediately.

-   Water, juice, and formula for children under six months of age
    should not be prepared with tap water. Bottled water or other water
    low in nitrates should be used for infants until further notice.

-   **DO NOT BOIL THE WATER.** Boiling, freezing, filtering, or letting
    water stand does not reduce the nitrate level. Excessive boiling can
    make the nitrates more concentrated, because nitrates remain behind
    when the water evaporates.

-   Adults and children older than six months can drink the tap water
    (nitrate is a concern for infants because they can't process
    nitrates in the same way adults can). However, if you are pregnant
    or have specific health concerns, you may wish to consult your
    doctor.

    **What is being done?**

    \[Describe corrective action and when system expects to return to
    compliance.\]

    For more information, please contact \[name of contact\] at \[phone
    number\] or \[mailing address\].

    *Please share this information with all the other people who drink
    this water, especially those who may not have received this notice
    directly (for example, people in apartments, nursing homes, schools,
    and businesses). You can do this by posting this notice in a public
    place or distributing copies by hand or mail.*

This notice is being sent to you by \[system\]. State Water System ID#:
\_\_\_\_\_\_\_\_\_\_\_.

Date distributed:\_\_\_\_\_\_.

Number range CHAPTER**Template on Reverse**

Number range CHAPTERThe template on reverse is a Spanish translation of
Template 1-1 for nitrate. All the instructions of Template 1-1 apply.
This template is an exact translation of the English template, so if you
need to modify the English templates, you should modify this template
accordingly. Schools or universities may be able to provide low cost
translations. See Chapter 4 for suggestions on creating effective
multilingual notices.

**AVISO SOBRE SU AGUA POTABLE**

Agua del sistema \[system name\] tiene altos niveles de nitratos --

NO DAR DE BEBER ESTA AGUA A BEBES MENORES DE 6 MESES DE EDAD NI USARLA
PARA HACER LECHE DE FORMULA

Resultados de mustras de agua recibidos en \[date of violation in
Spanish (day-month-year)\] muestran concentraciones de nitratos en el
agua de \[level and units in Spanish\]. Este nivel está por encima de la
norma, o nivel máximo de contaminación (NMC) de \[state/federal MCL in
Spanish\]. Nitratos en agua potable puede generar serios problemas de
salud para bebés menores de 6 meses de edad.

Nitratos en el agua pueden provenir de fuentes naturales, industriales
or de la agricultura (incluyendo descargas de tanques sépticos y
lluvias). Las concentraciones de nitratos en el agua potable varían a lo
largo del año.

**¿Qué debo hacer? ¿Qué es la significa de este?**

-   **NO LE DE ESTA AGUA A BEBES.** ***Bebés menores de seis (6) meses
    que ingieran agua con nitratos en exceso del nivel máximo de
    contaminación (NMC) se pueden enfermar seriamente y, de no ser
    tratados, pueden morir. Los síntomas incluyen dificultad en respirar
    y síndrome de bebé azul.*** El síndrome de bebé azul se refiere al
    color azulado que toma la piel del bebé. Los síntomas en los bebés
    pueden desarrollarse con rapidez, con el deterioro de su salud en
    los días subsiguientes. Si los síntomas ocurren en infantes menores
    de seis (6) meses de edad, busque atención médica inmediatamente.

-   Agua, jugo o leche en polvo para bebés menores de seis (6) meses de
    edad no debe prepararse con agua del grifo. Debe emplear agua
    embotellada u otra agua baja en nitratos hasta próximo aviso.

-   **No hierva el agua**. Hervir, congelar, filtrar o dejar el agua en
    reposo no reduce el nivel de nitratos. De hecho, al hervir el agua
    puede aumentar aún más la concentración de nitratos, debido a que
    los nitratos permanecen cuando parte del agua se evapora.

-   Adultos e infantes mayores de seis (6) meses de edad pueden tomar el
    agua del grifo. (Los nitratos son peligrosos para los bebés debido a
    que ellos no pueden procesar los nitratos de la misma manera que los
    adultos). Sin embargo, si usted está embarazada o tiene algún
    problema de salud en particular, puede optar por hacer una consulta
    con su médico.

    **¿Qué se está haciéndo al respecto?**

    \[Describe corrective action and when the system expects to return
    to compliance in Spanish.\]

    Para mayor información, favor contactar a \[name of contact\] al
    teléfono \[phone number\] o escribiendo a \[mailing address\].

    *Por favor comparta esta información con otros que pueden tomar de
    esta agua, colocando este aviso en lugares visibles, o remitiéndolo
    por correo, o entregandolo manualmente. Es de particular interés
    distribuir este aviso ampliamente si usted lo recibe representando
    un negocio, un hospital u hogar de infantes u hogar de ancianos o
    comunidad residencial.*

    Este aviso ha sido enviado a usted por \[system\]. Numero de
    Identificación : \_\_\_\_\_\_\_\_\_\_\_.

    Fecha de distribución: \_\_\_\_\_\_\_\_.

**Template on Reverse**

Number range CHAPTERSince failure to take a confirmation sample for
nitrate within 24 hours after learning that an initial sample exceeded
the MCL is a Tier 1 violation, you must provide public notice to persons
served as soon as practical but within 24 hours after you learn of the
violation (141.202(b)). During this time period you must also contact
your primacy agency. You should also coordinate with your local health
department. This template is also applicable to nitrite and total
nitrate and nitrite violations. You must use one or more of the
following methods to deliver the notice to consumers (141.202(c)):

-   Radio

-   Television

-   Hand or direct delivery

-   Posting in conspicuous locations

You may need to use additional methods (e.g., newspaper, delivery of
multiple copies to hospitals, clinics, or apartment buildings), since
notice must be provided in a manner reasonably calculated to reach all
persons served.

The notice on the reverse is appropriate for hand delivery or a
newspaper notice. However, you may wish to modify it before using it for
a radio or TV notice. If you do, you must still include all required
elements and leave the health effects language in italics unchanged.
This language is mandatory (141.205(d)). If you post or hand deliver,
print your notice on letterhead, if available.

**Alternative Sources of Water**

If you are providing alternative sources of water for infants, your
notice should say where it can be obtained. Remember that bottled water
can also be contaminated. If you are providing bottled water, make sure
it meets the standard for nitrates by contacting the bottler and asking
for the most recent test results.

**Repeat Notices**

If this is a repeat notice (as required by your primacy agency), or if
your system's nitrate levels fluctuate around the MCL, you may wish to
include an explanation similar to the following:

You were initially notified of our system's failure to take a
confirmation sample following high nitrate level on \[give date\]. Since
that time we have taken a confirmation sample on \[give date\] that also
resulted in a high nitrate level. We are currently monitoring the
nitrate concentration every three months. Seasonal fluctuations in
nitrate concentrations have been observed, due to nitrates contained in
fertilizer. It appears that high nitrates occur during the later summer
and fall. Note that prior to \[year\] we were meeting drinking water
standards for nitrate.

**Corrective Action**

In your notice, describe corrective actions you are taking. The bullet
below describes one action commonly taken by water systems with
nitrate/nitrite violations. You can use the following language, if
appropriate, or develop your own:

-   We are in the process of collecting a confirmation sample to
    determine if we have high nitrate levels. If the sample shows we are
    meeting our drinking water standards, you will not receive another
    notice. However, if the sample shows that we do have high nitrate
    levels in our water, another notification will be issued within 24
    hours after we receive the results

**After Issuing the Notice**

Make sure to send your primacy agency a copy of each type of notice and
a certification that you have met all the public notice requirements
within ten days after issuing the notice (141.31(d)). You should also
issue a follow-up notice in addition to meeting any repeat notice
requirements your primacy agency sets.

You should notify health professionals in the area of the violation.
People may call their doctors with questions, and the doctors should
have the information they need to respond appropriately. They also need
to make sure the water is not provided to infants in their care.

**DRINKING WATER WARNING**

\[System\] did not take a confirmation sample to determine if the water
has high levels of nitrate --

DO NOT GIVE THE WATER TO INFANTS UNDER 6 MONTHS OLD OR USE IT TO MAKE
INFANT FORMULA

**We are required to monitor your drinking water for nitrate on a
regular basis. Results of regular monitoring are an indicator of whether
or not our drinking water meets health standards. Water sample results
received on \[give date\] showed nitrate levels of above the nitrate
standard, or maximum contaminant level (MCL), of \[MCL\]. We were
required to take a confirmation sample within 24 hours. We did not
complete the required confirmation sample monitoring and therefore
cannot be sure of the quality of our drinking water during that time.
Nitrate in drinking water is a serious health concern for infants less
than six months old.**

Nitrate in drinking water can come from natural, industrial, or
agricultural sources (including septic systems and run-off). Levels of
nitrate in drinking water can vary throughout the year.

**What should I do? What does this mean?**

-   **DO NOT GIVE THE WATER TO INFANTS.** ***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.*** Blue baby
    syndrome is indicated by blueness of the skin. Symptoms in infants
    can develop rapidly, with health deteriorating over a period of
    days. If symptoms occur, seek medical attention immediately.

-   Water, juice, and formula for children under six months of age
    should not be prepared with tap water. Bottled water or other water
    low in nitrates should be used for infants until further notice.

-   **DO NOT BOIL THE WATER.** Boiling, freezing, filtering, or letting
    water stand does not reduce the nitrate level. Excessive boiling can
    make the nitrates more concentrated, because nitrates remain behind
    when the water evaporates.

-   Adults and children older than six months can drink the tap water
    (nitrate is a concern for infants because they can't process
    nitrates in the same way adults can). However, if you are pregnant
    or have specific health concerns, you may wish to consult your
    doctor.

    **What is being done?**

    \[Describe corrective action and when system expects to return to
    compliance.\] After receiving the results of our first sample, we
    failed to collect a second sample within 24 hours to confirm the
    results of the first sample. We have since collected the second
    sample and are waiting for the results.

    For more information, please contact \[name of contact\] at \[phone
    number\] or \[mailing address\].

    *Please share this information with all the other people who drink
    this water, especially those who may not have received this notice
    directly (for example, people in apartments, nursing homes, schools,
    and businesses). You can do this by posting this notice in a public
    place or distributing copies by hand or mail.*

This notice is being sent to you by \[system\]. State Water System ID#:
\_\_\_\_\_\_\_\_\_\_\_.

Date distributed:\_\_\_\_\_\_.

Number range CHAPTER**Template on Reverse**

Non-community water systems that have received approval by their primacy
agency to exceed the nitrate maximum contaminant level of 10 mg/l but no
more than 20 mg/l are required to provide Tier 1 notification. You do
not incur a violation but are still required to provide public notice to
persons served as soon as practical but within no more than 24 hours of
learning of the situation (141.202(b)). You must use one or more of the
following methods to deliver the notice to consumers (141.202(c)):

-   Posting in conspicuous locations

-   Hand or direct delivery

-   Radio

-   Television

You may need to use additional methods if needed to reach all persons
served.

The language encouraging distribution of the notice is included on this
template; however, if you post this notice, omit the mandatory language
to encourage distribution. If you modify the notice, you must leave the
health effects language in italics unchanged. This language is mandatory
(141.205(d)).

**Alternative Sources of Water**

If you are selling or providing bottled water, your notice should say
where it can be obtained. Remember that bottled water can also be
contaminated. If you are providing bottled water, make sure it meets
U.S. Food and Drug Administration (FDA) and/or state bottled water
safety standards.

**Continuous Notices**

As long as nitrate levels exceed 10 mg/L, continuous posting of this
notice is a requirement (141.209(b))

**After Issuing the Notice**

Be sure to send your primacy agency 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 (141.31(d)).

**DRINKING WATER WARNING**

\[System\] water has high levels of nitrate --

DO NOT GIVE THE WATER TO INFANTS UNDER 6 MONTHS OLD OR USE IT TO MAKE
INFANT FORMULA

Water sample results show nitrate levels of \[level and units\]. This is
above the nitrate standard or maximum contaminant level (MCL), of 10
mg/l. Nitrate in drinking water is a serious health concern for infants
less than six months old.

We have been given permission by \[primacy agency\] to provide water in
excess of the standard as long as:

-   Nitrate levels do not exceed 20 mg/l.

-   The water is not made available to children under 6 months of age.

-   We continuously post this notice meeting all public notice
    requirements.

-   Local and state health officers are notified annually.

-   No adverse health effects result.

    **What should I do? What does this mean?**

```{=html}
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```
-   **DO NOT GIVE THE WATER TO INFANTS.** ***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.*** Blue baby
    syndrome is indicated by blueness of the skin. Symptoms in infants
    can develop rapidly, with health deteriorating over a period of
    days. If symptoms occur, seek medical attention immediately.

-   Water, juice, and formula for children under six months of age
    should not be prepared with tap water. Bottled water or other water
    low in nitrates should be used for infants until further notice.

-   **DO NOT BOIL THE WATER.** Boiling, freezing, filtering, or letting
    water stand does not reduce the nitrate level. Excessive boiling can
    make the nitrates more concentrated, because nitrates remain behind
    when the water evaporates.

-   Adults and children older than six months can drink the tap water
    (nitrate is a concern for infants because they can't process
    nitrates in the same way adults can). However, if you are pregnant
    or have specific health concerns, you may wish to consult your
    doctor.

    For more information, please contact \[name of contact\] at \[phone
    number\] or \[mailing address\].

    *Please share this information with all the other people who drink
    this water, especially those who may not have received this notice
    directly (for example, people in apartments, nursing homes, schools,
    and businesses). You can do this by posting this notice in a public
    place or distributing copies by hand or mail.*

This notice is being sent to you by \[system\]. State Water System ID#:
\_\_\_\_\_\_\_\_\_\_\_.

Date distributed:\_\_\_\_\_\_.

Number range CHAPTER**Template on Reverse**

Number range CHAPTERSince exceeding the fecal coliform or *E. coli*
maximum contaminant level is a Tier 1 violation, you must provide public
notice to persons served as soon as practical but within 24 hours after
you learn of the violation (141.202(b)). During this time, you must also
contact your primacy agency. You should also coordinate with your local
health department. You may also have to modify the template if you also
have high nitrate levels or other coliform MCL violations. You must use
one or more of the following methods to deliver the notice to consumers
(141.202(c)):

-   Radio

-   Television

-   Hand or direct delivery

-   Posting in conspicuous locations

You may need to use additional methods (e.g., newspaper, delivery of
multiple copies to hospitals, clinics, or apartment buildings), since
notice must be provided in a manner reasonably calculated to reach all
persons served.

The notice on the reverse is appropriate for hand delivery or a
newspaper notice. However, you may wish to modify it before using it for
a radio or TV notice. If you do, you must still include all required
elements and leave the health effects language in italics unchanged.
This language is mandatory (141.205(d)). If you post or hand deliver,
print your notice on letterhead, if you have it.

**Population Served**

Make sure it is clear who is served by your water system\--you may need
to list the areas you serve.

**Corrective Action**

In your notice, describe corrective actions you are taking. Listed below
are some steps commonly taken by water systems with fecal coliform or
*E. coli* violations. You can use one or more of the following actions,
if appropriate, or develop your own:

-   We are chlorinating and flushing the water system.

-   We are switching to an alternate drinking water source.

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

-   We are repairing the wellhead seal.

-   We are repairing the storage tank.

-   We are restricting water intake from the river/lake/reservoir to
    prevent additional bacteria from entering the water system and
    restricting water use to emergencies.

**After Issuing the Notice**

Send a copy of each type of notice and a certification that you have met
all the public notice requirements to your primacy agency within ten
days from the time you issue the notice (141.31(d)).

It is recommended that you notify health professionals in the area of
the violation. People may call their doctors with questions about how
the violation may affect their health, and the doctors should have the
information they need to respond appropriately. In addition, health
professionals, including dentists, use tap water during their procedures
and need to know of contamination so they can use bottled water.

It is a good idea to issue a "problem corrected" notice when the
violation is resolved. See Template 1-8.

**DRINKING WATER WARNING**

\[System\] water is contaminated with \[fecal coliform/*E. coli*\]

BOIL YOUR WATER BEFORE USING

Fecal coliform \[or *E. coli*\] bacteria were found in the water supply
on \[give date\]. These bacteria can make you sick, and are a particular
concern for people with weakened immune systems.

Bacterial contamination can occur when increased run-off enters the
drinking water source (for example, following heavy rains). It can also
happen due to a break in the distribution system (pipes) or a failure in
the water treatment process.

**What should I do? What does this mean?**

-   **DO NOT DRINK THE WATER WITHOUT BOILING IT FIRST.** Bring all water
    to a boil, let it boil for one minute, and let it cool before using,
    or use bottled water. Boiled or bottled water should be used for
    drinking, making ice, brushing teeth, washing dishes, and food
    preparation until further notice. Boiling kills bacteria and other
    organisms in the water.

-   *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 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.*

-   The symptoms above are not caused only by organisms in drinking
    water. If you experience any of these symptoms and they persist, you
    may want to seek medical advice. People at increased risk should
    seek advice about drinking water from their health care providers.

    **What is being done?**

    \[Describe corrective action.\] We will inform you when tests show
    no bacteria and you no longer need to boil your water. We anticipate
    resolving the problem within \[estimated time frame\].

    For more information, please contact \[name of contact\] at \[phone
    number\] or \[mailing address\]. General guidelines on ways to
    lessen the risk of infection by microbes are available from the EPA
    Safe Drinking Water Hotline at 1-800-426-4791.

    *Please share this information with all the other people who drink
    this water, especially those who may not have received this notice
    directly (for example, people in apartments, nursing homes, schools,
    and businesses). You can do this by posting this notice in a public
    place or distributing copies by hand or mail.*

This notice is being sent to you by \[system\]. State Water System ID#:
\_\_\_\_\_\_\_\_\_\_\_.

Date distributed: \_\_\_\_\_\_.

Number range CHAPTER**Template on Reverse**

Number range CHAPTERThe template on reverse is a Spanish translation of
Template 1-4 for fecal coliform or *E. coli*. All the instructions of
Template 1-4 apply. This template is an exact translation of the English
template, so if you need to modify the English templates, you should
modify this template accordingly. Schools or universities may be able to
provide low cost translations. See Chapter 4 for suggestions on creating
effective multilingual notices.

**AVISO SOBRE SU AGUA POTABLE**

El Agua del Sistema \[system name\] esta contaminado con \[bacterias
coliformes fecales/*E. coli*\]

HIERVAN EL AGUA ANTES DE USARLA

Bacterias coliformes fecales (o *E. coli*) fueron encontradas en su
servicio de agua el dia \[date of violation in Spanish
(day-month-year)\]. Estas bacterias pueden enfermarle, y son
especialmente peligrosas para personas con las defensas bajas o sistemas
imunológicos débiles.

Contaminación bacteriana puede ocurrir cuando exceso de aguas rebasan
sus cauces y entran a las fuentes de agua potable (por ejemplo, luego de
una lluvia fuerte). También pueden ocurrir cuando se rompe un sistema de
recolección de aguas negras, o cuando hay una falla en el tratamiento de
agua.

**¿Qué debo hacer? ¿Qué es la significa de este?**

-   **NO BEBA EL AGUA SIN ANTES HERVIRLA.** Hierva toda el agua, déjela
    hervir por un minuto, y déjela reposar antes de usarla, o utilize
    agua embotellada. Agua hervida o embotellada debe ser usada para
    beber, hacer hielo, lavarse los dientes, lavar los platos y para
    preparar la comida hasta próximo aviso. Hierviendo morta a bacteria
    y otros organismos en el agua.

-   *Coliformes fecales o E. coli son bacterias cuya presencia indica
    que el agua esta contaminada con desechos humanos o de animales.
    Microbios de esos desechos pueden causar diarrhea, cólicos, nausea,
    dolores de cabeza u otros síntomas. Pueden representar un peligro
    para la salud de bebés, niños y niñas de corta edad y personas con
    sistemas immunológicos en alto riesgo.*

-   Los síntomas descritos arriba no ocurren solamente debido a los
    microbios. También pueden ser causados por otros motivos. Si usted
    siente estos síntomas y estos persisten, usted puede optar por hacer
    una consulta con su médico. Personas en situaciones de alto riesgo
    deben consultar con sus proveedores de servicios médicos.

    **¿Qué se está haciéndo al respecto?**

    \[Describe corrective action in Spanish\] Le informaremos cuando las
    pruebas demuestren que no hay bacterias y que usted ya no necesita
    hervir su agua. Anticipamos que resolveremos el problema el \[date
    of expected resolution in Spanish day-month-year\].

    Para mayor información, por favor póngase en contacto con \[contact
    name\] al \[phone number\] o escribiendo a \[mailing address\].

    *Por favor comparta esta información con otros que pueden tomar de
    esta agua, colocando este aviso en lugares visibles, o remitiéndolo
    por correo, o entregandolo manualmente. Es de particular interés
    distribuir este aviso ampliamente si usted lo recibe representando
    un negocio, un hospital u hogar de infantes u hogar de ancianos o
    comunidad residencial.*

    Este aviso ha sido enviado a usted por \[system\]. Numero de
    Identificación : \_\_\_\_\_.

    Fecha de distribución: \_\_\_\_\_\_.

Number range CHAPTER**Template on Reverse**

Number range CHAPTERSince a waterborne disease outbreak is a Tier 1
situation, you must provide public notice to persons served as soon as
practical but within 24 hours after you learn of the situation
(141.202(b)). You must contact your primacy agency during this time. You
should coordinate with your local health department as well. **You must
also issue a public notice if you are experiencing a waterborne
emergency other than a waterborne disease outbreak, such as one caused
by flooding or treatment failure. In such cases, you may be able to
modify this template to apply to your situation.** Check with your
primacy agency for more direction. More information on waterborne
disease outbreaks and emergencies is available from the Centers for
Disease Control and Prevention (http://www.cdc.gov/health/diseases.htm,
1 (800) 311-3435). For a waterborne disease outbreak or other emergency,
you must use one or more of the following methods to deliver the notice
to consumers (141.202(c)):

-   Radio

-   Television

-   Hand or direct delivery

-   Posting in conspicuous locations

You may need to use additional methods (e.g., newspaper, delivery of
multiple copies to hospitals, clinics, or apartment buildings), since
notice must be provided in a manner reasonably calculated to reach all
persons served. If you post or hand deliver, print your notice on
letterhead, if available. The notice on the reverse is appropriate for
hand delivery or a newspaper notice. However, you may wish to modify it
before using it for a radio, TV notice, or posting.

**Describing the Outbreak**

If known, list any organisms detected, the number of affected people,
any water treatment problems contributing to the waterborne disease
outbreak, and any sources of contamination, such as flooding.

**Potential Health Effects**

No mandatory health effects language exists for waterborne disease
outbreaks. You may wish to use the sentence below, if appropriate, or
contact your primacy agency or health department. These symptoms are
common to many diseases caused by microscopic organisms:

-   Symptoms may include nausea, cramps, diarrhea, jaundice, and
    associated headaches and fatigue.

**Population at Risk**

Some people who contract waterborne diseases can be affected more
severely than others, as described on the reverse page. The specific
language on the reverse is not mandatory, but you must provide
information on the population at risk. In addition, make sure it is
clear who is served by your water system\--you may need to list the
areas you serve.

**Corrective Action**

In your notice, describe the corrective actions you are taking. Listed
below are some steps commonly taken by water systems with waterborne
disease outbreaks. You can use one or more of the following actions, if
appropriate, or develop your own:

-   We are repairing our filtration system.

-   We are increasing sampling for disease-causing organisms.

Make sure to send a copy of each type of notice and a statement
certifying that you've met all public notification requirements to your
primacy agency within ten days after issuing the notice (141.31(d)). It
is a good idea to issue a "problem corrected" notice when the waterborne
disease outbreak is under control. See Template 1-8.

It is recommended that you notify health professionals in the area of
the outbreak. People may call their doctors with questions about how the
situation may affect their health, and the doctors should have the
information they need to respond appropriately. In addition, health
professionals, including dentists, use tap water during their procedures
and need to know of contamination so they can use bottled water.

**DRINKING WATER WARNING**

BOIL YOUR WATER BEFORE USING

Disease-causing organisms have entered \[system's\] water supply.

These organisms are causing illness in people served by \[system\]. We
learned of a waterborne disease outbreak from \[agency\] on \[give
date\].

**What should I do? What does this mean?**

-   **DO NOT DRINK THE WATER WITHOUT BOILING IT FIRST.** Bring all water
    to a boil, let it boil for one minute, and let it cool before using,
    or use bottled water. Boiled or bottled water should be used for
    drinking, making ice, brushing teeth, washing dishes, and food
    preparation until further notice. Boiling kills bacteria and other
    organisms in the water.

-   \[Describe symptoms of the waterborne disease.\] If you experience
    one or more of these symptoms and they persist, contact your doctor.
    People with severely compromised immune systems, infants, and some
    elderly may be at increased risk. These people should seek advice
    about drinking water from their health care providers.

    **What is being done?**

    \[Describe the corrective action and when the outbreak might end.\]

    We will inform you when you no longer need to boil your water.

    For more information, please contact \[name of contact\] at \[phone
    number\] or \[mailing address\]. General guidelines on ways to
    lessen the risk of infection by microbes are available from the EPA
    Safe Drinking Water Hotline at 1-800-426-4791.

    *Please share this information with all the other people who drink
    this water, especially those who may not have received this notice
    directly (for example, people in apartments, nursing homes, schools,
    and businesses). You can do this by posting this notice in a public
    place or distributing copies by hand or mail.*

This notice is being sent to you by \[system\]. State Water System ID#:
\_\_\_\_\_\_\_\_\_\_\_. Date distributed: \_\_\_\_\_\_.

**Template on Reverse**

If your primacy agency has designated this turbidity single exceedance
as a Tier 1 violation (141.202(a)), you must provide public notice to
persons served within 24 hours after it has been designated Tier 1
(141.202(b)). Turbidity violations are Tier 2 by default, but may
frequently be elevated to Tier 1 by your primacy agency. In addition,
violations are automatically elevated if you are unable to consult with
your primacy agency within 24 hours. **In such cases, you must issue a
notice within the next 24 hours.** You may elevate the violation to Tier
1 yourself as well. You should also coordinate with your local health
department. One or both agencies should tell you whether to instruct
consumers to boil water. You must use one or more of the following
methods to deliver the notice to consumers (141.202(c)):

-   Radio

-   Television

-   Hand or direct delivery

-   Posting in conspicuous locations

You may need to use additional methods (e.g., newspaper, delivery of
multiple copies to hospitals, clinics, or apartment buildings), since
notice must be provided in a manner reasonably calculated to reach all
persons served. If you post or hand deliver, print your notice on
letterhead, if you have it.

The notice on the reverse is appropriate for hand delivery or a
newspaper notice. However, you may wish to modify it before using it for
a radio or TV notice or posting. If you modify the notice, you must
leave the health effects language in italics unchanged. This language is
mandatory (141.205(d)).

**Population Served**

Make sure it is clear who is served by your water system\--you may need
to list the areas you serve.

**Corrective Action**

In your notice, describe corrective actions you are taking. Listed below
are some steps commonly taken by water systems with a single turbidity
exceedance. You can use one or more of the following actions, if
appropriate, or develop your own:

-   We are adding chemicals that reduce turbidity.

-   We are sampling both untreated and treated water for the presence of
    coliform bacteria.

-   We are monitoring chlorine levels and will adjust them as needed to
    compensate for filtration problems.

    -   We are inspecting and repairing the filters.

**Source of the Problem**

If you know why the turbidity is high, explain it in your notice. For
instance, unusual conditions such as heavy rains and flooding can
overburden the water plant and treated water may therefore not meet the
standards. In addition, run-off from parts of the watershed could
contain increased concentrations of sediment and animal waste.

**After Issuing the Notice**

Send a copy of each type of notice and a certification that you have met
public notice requirements to your primacy agency within ten days after
you issue the notice (141.31(d)). It is a good idea to issue a "problem
corrected" notice when the violation is resolved. See Template 1-8.

It recommended that you notify health professionals in the area of the
violation. People may call their doctors with questions about how the
violation may affect their health, and the doctors should have the
information they need to respond appropriately. In addition, health
professionals, including dentists, use tap water during their procedures
and need to know of potential microbiological contamination so they can
use bottled water.Number range CHAPTER

**DRINKING WATER WARNING**

\[System\] has high turbidity levels

BOIL YOUR WATER BEFORE USING

We routinely monitor your water for turbidity (cloudiness). This tells
us whether we are effectively filtering the water supply. A water sample
taken \[give date\] showed turbidity levels of \[number\] turbidity
units. This is above the standard of \[standard\] turbidity units.
Because of these high levels of turbidity, there is an increased chance
that the water may contain disease-causing organisms.

**What should I do? What does this mean?**

-   DO NOT DRINK THE WATER WITHOUT BOILING IT FIRST. Bring all water to
    a boil, let it boil for one minute, and let it cool before using, or
    use bottled water. Boiled or bottled water should be used for
    drinking, making ice, washing dishes, brushing teeth, and food
    preparation until further notice.

-   *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, which can
    cause symptoms such as nausea, cramps, diarrhea, and associated
    headaches.* People with severely compromised immune systems,
    infants, and some elderly may be at increased risk. These people
    should seek advice about drinking water from their health care
    providers.

-   The symptoms above are not caused only by organisms in drinking
    water. If you experience any of these symptoms and they persist, you
    may want to seek medical advice.

**What is being done?**

\[Describe corrective action and when the system expects to return to
compliance.\]

We will inform you when turbidity returns to appropriate levels and when
you no longer need to boil your water.

For more information, please contact \[name of contact\] at \[phone
number\] or \[mailing address\]. General guidelines on ways to lessen
the risk of infection by microbes are available from the EPA Safe
Drinking Water Hotline at 1-800-426-4791.

*Please share this information with all the other people who drink this
water, especially those who may not have received this notice directly
(for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or
distributing copies by hand or mail.*

This notice is being sent to you by \[system\]. State Water System ID#:
\_\_\_\_\_\_\_\_\_\_\_.

Date distributed: \_\_\_\_\_\_.

Number range CHAPTER**Template on Reverse**

Number range CHAPTERSince exceeding the chlorine dioxide MRDL when one
or more of the samples taken in the distribution system on the day after
exceeding the MRDL at the entrance of the distribution system or when
required samples are not taken in the distribution system is a Tier 1
violation, you must provide public notice to persons served as soon as
practical but within 24 hours after you learn of the violation
(141.202(b)). (Exceeding the chlorine dioxide MRDL at the entry point to
the distribution system only is a Tier 2 violation; modify this template
or Template 2-3 to create a Tier 2 notice.) You must also contact your
primacy agency within 24 hours of learning of the violation or
situation. You should also coordinate with your local health department.
You must use one or more of the following methods to deliver the notice
to consumers (141.202(c)):

-   Radio

-   Television

-   Hand or direct delivery

-   Posting in conspicuous locations

You may need to use additional methods (e.g., newspaper, delivery of
multiple copies to hospitals, clinics, or apartment buildings), since
notice must be provided in a manner reasonably calculated to reach all
persons served. If you post or hand deliver, print your notice on
letterhead, if you have it.

The notice on the reverse is appropriate for hand delivery or a
newspaper notice. However, you may wish to modify it before using it for
a radio or TV notice. If you do, you must still include all required
elements and leave the health effects language in italics unchanged.
This language is mandatory (141.205(d)).

**Alternative Sources of Water**

If you are selling or providing bottled water, your notice should say
where it can be obtained. Remember that bottled water can also be
contaminated or be high in chlorine dioxide if the bottler uses
municipal water. Make sure the bottled water meets the standard by
contacting the bottler and asking for the most recent test results.

**Population at Risk**

The language on the reverse lists "young children" as one of the groups
at increased risk. Because the potential health effects of chlorine
dioxide are based on tests on laboratory animals, there is no way to
determine at exactly what age the water is safe to drink. If your
consumers have questions, encourage them to err on the side of caution.

**Corrective Action**

In your notice, describe corrective actions you are taking. Listed below
are some steps commonly taken by water systems with chlorine dioxide
violations. You can use one or more of the following actions, if
appropriate, or develop your own:

-   We are resetting the generator to generate the correct amount of
    chlorine dioxide.

-   We are repairing the generator.

-   We have already fixed the problem but it will take additional time
    for the extra chlorine dioxide to be flushed from the distribution
    system (pipes).

**After Issuing the Notice**

Make sure to send your primacy agency a copy of each type of notice and
a certification that you have met all the public notice requirements
within ten days after issuing the notice (141.31(d)). You should also
issue a follow-up notice in addition to meeting any repeat notice
requirements your primacy agency sets.

It is a good idea to issue a "problem corrected" notice when the
violation is resolved. See Template 1-8.

It recommended that you notify health professionals in the area of the
violation. People may call their doctors with questions about how the
violation may affect their health, and the doctors should have the
information they need to respond appropriately.

**DRINKING WATER WARNING**

PREGNANT WOMEN AND YOUNG CHILDREN

SHOULD NOT DRINK THE WATER

Sampling results received \[give date\] showed chlorine dioxide levels
of \[level and units\]. This is above the standard, or maximum residual
disinfectant level (MRDL) of 0.8 milligrams per liter. Chlorine dioxide
is used for disinfection, but too much of it over a short period of time
may harm the development of children, infants, and fetuses.

Chlorine dioxide is used in small amounts every day to kill bacteria and
other organisms that may be in your drinking water. A problem occurred
with our chlorine dioxide generator, and too much chlorine dioxide was
released.

**What should I do? What does this mean?**

-   **DO NOT USE THIS WATER IF YOU ARE PREGNANT OR GIVE IT TO YOUNG
    CHILDREN.** Bottled water should be used until further notice. 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 mothers
    who drink water containing chlorine dioxide in excess of the MRDL.
    Some people may experience anemia.

    *The chlorine dioxide violations reported today include exceedances
    of the EPA standard within the distribution system which delivers
    water to consumers. Violations of the chlorine dioxide standard
    within the distribution system may harm human health based on
    short-term exposures. Certain groups, including fetuses, infants,
    and young children, may be especially susceptible to nervous system
    effects from excessive chlorine dioxide exposure.* There are no
    obvious symptoms, but chlorine dioxide can affect development of the
    nervous system.

-   Water, juice, and formula for young children and for pregnant women
    should not be prepared with tap water.

-   Adults who are not pregnant and older children can drink the tap
    water because their nervous systems are already developed. However,
    if you have specific health concerns, you may wish to consult your
    doctor.

    **What is being done?**

    \[Describe corrective action and when you expect to return to
    compliance.\]

    For more information, please contact \[name of contact\] at \[phone
    number\] or \[mailing address\].

    *Please share this information with all the other people who drink
    this water, especially those who may not have received this notice
    directly (for example, people in apartments, nursing homes, schools,
    and businesses). You can do this by posting this notice in a public
    place or distributing copies by hand or mail.*

This notice is being sent to you by \[system\]. State Water System ID#:
\_\_\_\_\_.

Date distributed: \_\_\_\_.

Number range CHAPTER**Template on Reverse**

It is a good idea to issue a notice when a serious violation or
situation has been resolved. Although EPA regulations do not require
such notices, your primacy agency may require you to issue one. You
should coordinate with your local health department as well. Below are
some recommended methods for a "problem corrected" notice. You should
use the same delivery methods you used for the original notice.

-   Radio

-   Television

-   Newspaper

-   Hand or direct delivery

-   Posting in conspicuous locations

You may wish to use additional methods (e.g., delivery of multiple
copies to hospitals, clinics, or apartment buildings) if necessary to
reach all persons served. If you post or hand deliver, print your notice
on letterhead, if available.

The notice on the reverse is very general and can be used for any
violation or situation. However, to help restore consumers' confidence
in the water system, you should modify the notice to fit your situation.
Although the public should have seen your initial notice, there may be
additional information you learned after the notice was issued.
Therefore, you should describe the violation or situation again and
discuss how the problem was solved.

Number range CHAPTER

**DRINKING WATER PROBLEM CORRECTED**

Customers of \[system\] were notified on \[give date\] of a problem with
our drinking water and were advised to \[describe recommended action\].
We are pleased to report that the problem has been corrected and that it
is no longer necessary to \[describe recommended action\]. We apologize
for any inconvenience and thank you for your patience.

\[Add further details here when appropriate.\]

As always, you may contact \[contact name\] at \[phone number\] or
\[mailing address\] with any comments or questions.

*Please share this information with all the other people who drink this
water, especially those who may not have received this notice directly
(for example, people in apartments, nursing homes, schools, and
businesses). You can do this by posting this notice in a public place or
distributing copies by hand or mail.*

This notice is being sent to you by \[system\]. State Water System ID#:
\_\_\_\_\_\_\_\_\_\_\_. Date distributed: \_\_\_\_\_\_.