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EMERGENCY x , iIFICATION PLAN FOR SMALL . <ATER SYSTEMS To: Small Water System Owners/Managers Date: I propose to notify my water consumers by the following method: 1. 2. • Name Address Phone day/night EH0336 9/94 Provide names, addresses, and day/night phone numbers for two contacts this Department could reach in an emergency. Your Plan must include specific information regarding how an emergency water situation would be handled at your site and the procedure to be followed for notifying and protecting customers. Post warnings in a conspicuous place Shutting off all water Door to door contact Written hand outs Telephone Phone day/night 'T/M Name An appropriate method of notifying small water system users of imminent danger from unsafe water must be used. Users must be informed that water must not be consumed until it is safe to do so. Please acknowledge methods you will use to notify your water system users in the event you must initiate your Emergency Notification Plan. Please return this form to this Department within 7 days of receipt. .3//3-/^^ Date The California Health and Safety Code, Division 5, Part 1, Chapter 7, Article 5, Section 4029, requires all water systems to have an Emergency Notification Plan submitted to and aporoved by San Joaquin County Public Health Services, Environmental Health Division (Department) and updated annually. This plan is to be implemented whenever the State or Department determines that your water supply fails to meet water quality standards and represents an imminent danger to the health of the water users. I propose to notify my ^/ater consumers by the following alternate method: I concur with the above mentioned plan « Name of Water System Signature/ Title Address /