In addition, because this report is being used to meet Tier 3 Public Notification requirements, the CWS certifies that public notification has been provided to its consumers in accordance with the requirements of 40 CFR 141.204(d).

The Community Water System (CWS) named above hereby confirms that all provisions under 40 CFR parts 141 and 142 requiring the development of, distribution of, and notification of a consumer confidence report have been executed. Further, the CWS certifies the information contained in the report is correct and consistent with the compliance monitoring data previously submitted to the primacy agency by their NC certified laboratory.

Further, the CWS certifies the information contained in the report is correct and consistent with the compliance monitoring data previously submitted to the primary agency by their NC certified laboratory.

Check the box if Tier 3 Public Notification is included

Certified By: