Annual Water Quality Report Template

for Community Water Systems Serving 1,000 or more Service Connections

Instructions: This template was created by the New York State Department of Health (DOH) for New York State Community Water Systems serving 1,000 or more service connections. This template should be used in conjunction with the DOH’s “Preparing Your Drinking Water Annual Water Quality Report – Guidance for Water Suppliers.” This template was created for typical water systems; operators of more complicated systems (e.g. multiple distribution systems, multiple sampling points) may need to alter the Table of Detected Contaminants to conform to their system. You will need to read the different sections of this template closely to determine which sections should be rewritten and which should be deleted. Instructions for the template are in red text and should be deleted from your final version. You should read the sections written in blue text and edit these sections as appropriate. Please read the directions for each section to determine if you may delete a specific section from your report. If you have any questions regarding this template or need technical assistance please call your local health department.

Annual Drinking Water Quality Report for 2017

System Name

System Address

(Public Water Supply ID# )

INTRODUCTION

To comply with State regulations, system name, will be annually issuing a report describing the quality of your drinking water. The purpose of this report is to raise your understanding of drinking water and awareness of the need to protect our drinking water sources. Last year, your tap water met all State drinking water health standards. We are proud to report that our system did not violate a maximum contaminant level or any other water quality standard. Or if you had a violation - Last year, we conducted tests for over 80 contaminants (modify as appropriate). We detected __ of those contaminants, and only found __ of those contaminants at a level higher than the State allows. As we told you at that time, our water temporarily exceeded a drinking water standard and we rectified the problem by …(include appropriate explanation). This report provides an overview of last year’s water quality. Included are details about where your water comes from, what it contains, and how it compares to State standards.

If you have any questions about this report or concerning your drinking water, please contact[name, title, phone #]. We want you to be informed about your drinking water. If you want to learn more, please attend any of our regularly scheduled village board meetings (modify meeting type as appropriate). The meetings are held [date, time and location]. (If you are a small system (e.g. mobile home park, apartment complex, or subdivision) and you do not have meetings, we encourage you to tell customers that you would discuss any drinking water issues with them in person).

WHERE DOES OUR WATER COME FROM?

In general, the sources of drinking water (both tap water and bottled water) include rivers, lakes, streams, ponds, reservoirs, springs, and wells. As water travels over the surface of the land or through the ground, it dissolves naturally occurring minerals and, in some cases, radioactive material, and can pick up substances resulting from the presence of animals or from human activities. Contaminants that may be present in source water include: microbial contaminants; inorganic contaminants; pesticides and herbicides; organic chemical contaminants; and radioactive contaminants. In order to ensure that tap water is safe to drink, the State and the EPA prescribe regulations which limit the amount of certain contaminants in water provided by public water systems. The State Health Department’s and the FDA’s regulations establish limits for contaminants in bottled water which must provide the same protection for public health.

Our water source is (name the source and type, e.g. groundwater wells: groundwater drawn from four 50-foot deep drilled wells or for surface water: e.g. is surface water drawn from Maple Pond) which is located (include general location of source, e.g. located near Mill Road and Main Street). During 2017, our system did not experience any restriction of our water source. Or if you had a water source restriction – During 2017, (explain the water source restriction – see page 19 of the State Guidance document). The water is (briefly describe treatment see page 5 of State Guidance document) prior to distribution.

Your report must include a brief summary of your source water’s susceptibility to contamination based on the findings of your system’s source water assessment, if such assessment is available. The summary must be included annually despite no updates or changes from the previous year’s report. Your county or district health department office will provide this summary. You should also inform your customers of the availability of the source water assessment and how they can obtain a copy of it. You may wish to describe any current or on-going source water protection activities in this section of your report.

FACTS AND FIGURES

Our water system serves (include the number of people and service connection, e.g. 5,900 people through 1,300 service connections). The total water produced in 2017 was (include a description of water use, e.g. The total amount of water produced in 2017 was 267 million gallons. The daily average of water treated and pumped into the distribution system was 725,000 gallons per day. Our highest single day was 898,000 gallons). The amount of water delivered to customers was (include an accounting of the total annual amount of water delivered and lost from the system, e.g. The amount of water delivered to customers was 260 million gallons. This leaves an unaccounted for total of 7 million gallons. This water was used to flush mains, fight fires and leakage, accounts for the remaining 7 million gallons (3% of the total amount produced). In 2017, water customers (describe water charge in annual charge per 1,000 gal and annual user costs if determinable) were charged $ per 1,000 gallons of water and the annual average water charge per user was $ … .

ARE THERE CONTAMINANTS IN OUR DRINKING WATER?

As the State regulations require, we routinely test your drinking water for numerous contaminants. These contaminants include: total coliform, turbidity, inorganic compounds, nitrate, nitrite, lead and copper, volatile organic compounds, total trihalomethanes, haloacetic acids, radiological and synthetic organic compounds. (modify this section appropriately you may wish to list the contaminant groups, you may even want to include the number of contaminants in each group, or you may wish to refer to another portion of the report where you list the name of each contaminant analyzed for but not detected). The table presented below depicts which compounds were detected in your drinking water. The State allows us to test for some contaminants less than once per year because the concentrations of these contaminants do not change frequently. Some of our data, though representative, are more than one year old. If you have prepared an Annual Water Quality Report Supplement (see page 22 of the State Guidance document for a description of what a supplement is and what type of data it contains) your Annual Water Quality Report should reference the supplement and provide information on how it can be accessed by your customers. This section of the report may be a good place to make this reference.

It should be noted that all drinking water, including bottled drinking water, may be reasonably expected to contain at least small amounts of some contaminants. The presence of contaminants does not necessarily indicate that water poses a health risk. More information about contaminants and potential health effects can be obtained by calling the EPA’s Safe Drinking Water Hotline (800-426-4791) or the (name of county or district office) Health Department at (phone number for local health department).

The table should be completed using pages 7-14, Table 1 and Appendix B of the State Guidance Document. Anything listed in Table 1 must be included in your report. Pages 7-14 describe the required contents for the Table, Table 1 provides you with the MCL (converted to a whole number), the units of the MCL, the MCLG, and the likely source of the contaminant. For each detected contaminant you should consult Table 1 to obtain this information and insert (type) it into your Table of Detected Contaminants. If your results are reported in units that differ from the MCL in Table 1 you must convert your results so that they are in the same units as the MCL. A conversion table is presented on page 8 of the State Guidance Document). The table should only include information on detected contaminants. (It must not include data that are not detected (i.e. represented on a lab report with a less than sign “<”, or denoted by the letters “LT” or “ND”). We have provided you with the table headings and are asking you to use the above referenced sections of the Guidance Document to fill in the table. We encourage you to separate contaminant categories with applicable headings (e.g. Microbiological Contaminants, Inorganic Compounds, Synthetic Organic Compounds, Volatile Organic Compounds, Disinfection Byproducts, Other Principal Organic Contaminants, and Unspecified Organic Contaminants). For the level detected heading we have provided subheadings of Average and Range. Please feel free to change these subheadings, if your reporting criteria do not match these subheadings (see page 12 of Guidance Document).

For reporting of lead and copper you must include the 90th percentile level, present the range of detects and explain how many of your samples were above the Action Level (see Appendix B of the Guidance Document). Appendix B also provides information on how to report multiple sampling sites with one sampling date; one sampling site at multiple sampling dates; multiple sampling sites with multiple sampling dates; and how to report turbidity and total coliform.

You must report your most recent data from the reporting year (for example reports published in 2018 would report on 2017 data). If you did not sample for a compound in 2017 you must report the most recent sampling (going back 5 years). For example, if you sampled for inorganic compounds in 2017 you would include that data. If you did not sample for volatile organic compounds in 2017, but did in 2013 you must include the 2013 data.

If you have not detected any contaminants you do not need to include this table, but you may want to include a paragraph like this:

As the State regulations require, we routinely test your drinking water for numerous contaminants. These contaminants include: total coliform, turbidity, inorganic compounds, nitrate, nitrite, lead and copper, volatile organic compounds, total trihalomethanes, and synthetic organic compounds. (modify this section appropriately, you may wish to list the contaminant groups, you may even want to include the number of contaminants in each group) None of the compounds we analyzed for were detected in your drinking water.

Table of Detected Contaminants
Contaminant / Violation
Yes/No / Date of Sample / Level Detected
(Avg/Max)
(Range) / Unit
Measure-ment / MCLG / Regulatory Limit (MCL, TT or AL) / Likely Source of Contamination

Notes:

Footnotes should be used to expand on some of the information in your table. Surface water systems may wish to include footnotes to explain turbidity (what it is and why you monitor it). All systems may wish to use footnotes to discuss lead and copper results (define what the 90th percentile value means and report how many lead or copper results exceeded the action level). Systems may also wish to use the notes to clarify what the level detected represents (e.g. # of samples collected, type of average calculated). We have included some sample footnote language. Please note that these statements must be modified to conform to your system.

1 – Turbidity is a measure of the cloudiness of the water. We test it because it is a good indicator of the effectiveness of our filtration system. Our highest single turbidity measurement (0.9 NTU) for the year occurred on (give date). State regulations require that turbidity must always be below 1 NTU. The regulations require that 95% of the turbidity samples collected have measurements below 0.3 NTU. Although (give date) was the month when we had the fewest measurements meeting the treatment technique for turbidity, the levels recorded were within the acceptable range allowed and did not constitute a treatment technique violation.

2 – The level presented represents the 90th percentile of the 10 sites tested. A percentile is a value on a scale of 100 that indicates the percent of a distribution that is equal to or below it. The 90th percentile is equal to or greater than 90% of the copper values detected at your water system. In this case, (include number of samples, e.g. ten samples) samples were collected at your water system and the 90th percentile value was the (include what sample had the highest value, e.g. second highest value) value (include level detected e.g. 1.1 mg/l). The action level for copper was not exceeded at any of the sites tested.

3 – The level presented represents the 90th percentile of the (include number of samples, e.g. ten samples) samples collected. The action level for lead was exceeded at two of the 10 sites tested.

4 – This level represents the highest locational runningannual average calculated from data collected.

Definitions:

The definitions for MCL, MCLG, MRDL, and MRDLG are required in all Annual Water Quality Reports. Include the other definitions if you use them in your table. If you do not use them you may choose to delete them. For example, if you are not regulated under a Treatment Technique requirement or if you do not measure turbidity (NTU) you could delete those definitions (see page 6 of Guidance Document).

Maximum Contaminant Level (MCL): The highest level of a contaminant that is allowed in drinking water. MCLs are set as close to the MCLGs as feasible.

Maximum Contaminant Level Goal (MCLG): The level of a contaminant in drinking water below which there is no known or expected risk to health. MCLGs allow for a margin of safety.

Maximum Residual Disinfectant Level (MRDL): The highest level of a disinfectant allowed in drinking water. There is convincing evidence that addition of a disinfectant is necessary for control of microbial contaminants.

Maximum Residual Disinfectant Level Goal (MRDLG): The level of a drinking water disinfectant below which there is no known or expected risk to health. MRDLGs do not reflect the benefits of the use of disinfectants to control microbial contamination.

Action Level (AL): The concentration of a contaminant which, if exceeded, triggers treatment or other requirements which a water system must follow.

Treatment Technique (TT): A required process intended to reduce the level of a contaminant in drinking water.

Level 1 Assessment:A Level 1 assessment is anevaluation of the water system to identify potential problems and determine, if possible, why total coliform bacteria have been found in our water system.

Level 2 Assessment: A Level 2 assessment is an evaluation of the water system to identify potential problems and determine, if possible, why an E. coli MCL violation has occurred and/or why total coliform bacteria have been found in our water system on multiple occasions.

Non-Detects (ND): Laboratory analysis indicates that the constituent is not present.

Nephelometric Turbidity Unit (NTU): A measure of the clarity of water. Turbidity in excess of 5 NTU is just noticeable to the average person.

Milligrams per liter (mg/l): Corresponds to one part of liquid in one million parts of liquid (parts per million - ppm).

Micrograms per liter (ug/l): Corresponds to one part of liquid in one billion parts of liquid (parts per billion - ppb).

Nanograms per liter (ng/l): Corresponds to one part of liquid to one trillion parts of liquid (parts per trillion - ppt).

Picograms per liter (pg/l): Corresponds to one part per of liquid to one quadrillion parts of liquid (parts per quadrillion – ppq).

Picocuries per liter (pCi/L): A measure of the radioactivity in water.

Millirems per year (mrem/yr): A measure of radiation absorbed by the body.

Million Fibers per Liter (MFL): A measure of the presence of asbestos fibers that are longer than 10 micrometers.

WHAT DOES THIS INFORMATION MEAN?

This section of your report should explain what the results of the table mean. If you had a MCL, Treatment Technique or Action Level violation, you are REQUIRED to have an explanation of the violation including, duration of the violation, potential adverse health effects and actions taken to address the violation. The health effects language must be included word for word and is included in Table 1 of the State Guidance Document. If there is no health effects language for a contaminant listed in Table 1 and the contaminant is detected above the MCL you should contact the State Health Department at 518-402-7650 to obtain the appropriate language.

If you had violations you may wish to include the following type of statement:

The table shows that our system uncovered some problems this year. (describe problem). The duration of the violation was ... the potential adverse health effects are... (restate from health effects language in Table 1 of Guidance Document) We (have corrected/are correcting) this by ...

If you had a detect but no violations and did not detect arsenic, nitrate, or fluoride above the specified threshold levels (see below):

As you can see by the table, our system had no violations. We have learned through our testing that some contaminants have been detected; however, these contaminants were detected below the level allowed by the State.

If contaminants were detected below the MCL but you detected arsenic, nitrate or fluoride above the levels specified below you must include the following statements: