LOW WATER IMPACT

PUBLIC OUTREACH FOR INFORMATION

MUNICIPALITY

Admaston/Bromley

Arnprior

Bonnechere Valley

Brudenell, Lyndoch & Raglan

Deep River

Greater Madawaska

Head, Clara & Maria

Horton

Killaloe, Hagarty & Richards

Laurentian Hills

Laurentian Valley

Madawaska Valley

McNab/Braeside

North Algona Wilberforce

Pembroke

Petawawa

Renfrew

Whitewater Region

SOURCE OF WATER

Municipal

Individual Well g Dug Drilled

Communal Well g Dug Drilled

Surface Water g Waterbody Name:

PROPERTY DETAILS

Residential

Detached House

Duplex

Townhouse

Apartment

# Residents:

# Bathrooms:

Agriculture

Crops

Type:

Acreage:

Livestock

Type:

Number:

Commercial/Industrial

Type of Use:

Water Rqmnts:

Tourism/Recreation

Type of Use:

Peak Season:

CONSEQUENCES AND/OR ACTIONS TAKEN TO DATE (Check all that apply)

New Drilled Well

Dry Dug Well

Dry Drilled Well

Hauling in of Non Drinking Water (Non Potable)

Hauling in of Drinking Water (Potable)

Hauling in of Water for Livestock

Selling off Livestock

Relocating of Livestock

Buying Feed (Hay/Grain)

Using Winter Feed Stock

Reduced Lawn & Garden Watering

Bringing Laundry to Laundromat

Purchasing Bottled Water

Reduced Flushing of Toilets

Have not taken any action or made any conservation efforts to date

Other actions, consequences or comments (use reverse side as needed):

RATE THE EFFECTIVENESS OF YOUR CONSERVATION EFFORTS

Ineffective – Supply Less than Demand g Example: Creek flow not recovering

Adequate – Supply Equals Demand g Example: Dug well level has recovered to normal level

Effective – Supply Greater than Demand

Not Applicable/Not Available/Difficult to Rate

GENERAL CONTACT INFORMATION

Name: Phone Number:

Civic/911 Address:

Roll number: Twp: Lot: Concession:

Check if you agree to be contacted for follow up inquiries as needed

Pembroke District Water Response Team

The Ministry of Natural Resources and the County of Renfrew have implemented the Pembroke District Water Response Team (WRT) to respond to this year’s low water conditions and to communicate with water managers throughout the County. Understanding the location and issues relating to low water are important and every municipality has representation on the WRT. Documenting impacts of low water and conservation efforts to mitigate impacts is an essential role of the WRT and you can help us do that.

Residents throughout the County are strongly encouraged to report (by way of this form) on:

·  Conservation measures taken to date and/or;

·  Impacts felt as a result of the low water conditions and/or;

·  The effectiveness of the measures taken.

Completed forms can be dropped in the available drop boxes at events where this form is available or forwarded to their municipality.

MNR Pembroke District and the County of Renfrew encourage everybody to use water wisely and apply water conservation measures. Non-essential water uses should be suspended until natural water supplies have recovered. Residents throughout the watershed should also make themselves aware of any bans or bylaws in place in their municipalities regarding fires or water use.

To learn more about Ontario’s Low Water Response program including its criteria, visit:

http://www.mnr.gov.on.ca/en/Business/Water/2ColumnSubPage/STEL02_164583.html or contact Karen Handford, Water Response Team Information Coordinator by calling

613-732-5510 or through email at .