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