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COMPLIANCE INFO_2015-2022
EnvironmentalHealth
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PR0543206
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COMPLIANCE INFO_2015-2022
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Last modified
10/14/2022 1:23:30 PM
Creation date
6/14/2022 11:16:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4600 - Public Water System Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2022
RECORD_ID
PR0543206
PE
4630
FACILITY_ID
FA0007111
FACILITY_NAME
FRENCH CAMP GOLF COURSE
STREET_NUMBER
3919
Direction
E
STREET_NAME
FRENCH CAMP
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231
APN
20103014
CURRENT_STATUS
01
SITE_LOCATION
3919 E FRENCH CAMP RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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ATTACHMENT 7 <br />Consumer Confidence Report <br />Certification Form <br />(to be submitted with a copy of the CCR) <br />Water System Name.: <br />JUN 1 1 2015 <br />ENVIRONMENTAL HEALTH <br />I'ERMI?7SERVICES <br />URS <br />Water System Number: G X0 U N a CO la f -Q 'fes W 2 L ( �* 1 <br />The water system named above hereby certifies that its Consumer Confidence Report was distributed on <br />:FUNe 12t 2.eDt5 (date) to customers (and appropriate notices of availability have been given). <br />Further, the system certifies that the information contained in the report is correct and consistent with the <br />compliance monitoring data previously submitted to the State Water Resources Control Board, Division <br />of Drinking Water. <br />Certified by: Name: <br />Signature: <br />Phone Number: (109 Sq g - 24 4 4 Date: It, tN e (2 I 2.01S <br />To summarize report delivery used and good faith efforts taken, please complete the below by checking <br />all items that apply and fill-in where appropriate: <br />❑ CCR was distributed by mail or other direct delivery methods. Specify other direct delivery <br />methods used: <br />"Good faith" efforts were used to reach non -bill paying consumers. Those efforts included the <br />following methods: <br />❑ Posting the CCR on the Intern <br />et at www. <br />❑ Mailing the CCR to postal patrons within the service area (attach zip codes used) <br />❑ Advertising the availability of the CCR in news media (attach copy of press release) <br />❑ Publication of the CCR in a local newspaper of general circulation (attach a copy of the <br />published notice, including name of newspaper and date published) <br />Posted the CCR in public places (attach a list of locations) <br />❑ Delivery of multiple copies of CCR to single -billed addresses serving several persons, such <br />as apartments, businesses, and schools <br />❑ Delivery to community organizations (attach a list of organizations) <br />❑ Other (attach a list of other methods used) <br />❑ For systems serving at least 700, 000 persons: Posted CCR on apublicly-accessible Internet site at <br />the fol <br />lowing address: www. <br />❑ For privately -owned utilities: Delivered the CCR to the California Public Utilities Commission <br />Thisjorm is prov7ded as a rosrvenieace and maybe used to met the cer[ficanou requiremea <br />t of <br />section 64483(c), Calms mia Code ofRcynlations. <br />2074 SWS CCR Forms &instructions Revised Jan 2015 <br />CCR Certifrcation Form —Attachment 7 Page 1 ofY <br />
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