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r '4 <br />To:Small Water System Managers Date: <br />From: <br />concurrence and acceptance with this means of <br />Name of Mate Utili <br />A <br />70'3^0 <br />Oxujcc/xLy - °|%2,0Sl?x <br />Please acknowledge your <br />notification. <br />implemented whenever the State"" <br />your water supply fails to meet <br />imminent danger to the health <br />requires that you develop and submit <br />approval. <br />*************** <br />STANDARD PLAN <br />I concur with the abovementioned plan. <br />Signature £ Title- <br />****** <br />iSeJc /a <br />Date <br />telephone — dsy/night <br />Kane of person residing in the <br />of the Notification Plan: <br />name eddress <br />city <br />«ATER QU/iLITY EMERGENCY NOTIFICATION i <br />FOR <br />SMALL WATER SYSTEMS <br />area to be contacted regarding inpiementation <br />&CT / o * ( <br />Si <br />* <br />ALTERNATE FLAN <br />I propose to notify r.y water consumers by the following method: <br />the <br />written handout sheets, or telephone. <br />: or local Department of Health determines that <br />water quality stanaards and represents an <br />of the water users. The legislation further <br />a Notification Plan to this Department for