NH Online Forms System - NHDES - Public Water Systems

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New Hampshire Department of Environmental Services Drinking Water Public Notice Forms

Public Notice Forms

The following templates are provided to assist water systems in meeting your public notice requirements. The Notice of Violation (NOV) directs you to the correct template and contains the information needed to complete the public notice. Please carefully read the instructions accompanying each template. If you have any questions, please refer to your NOV for contact information.

Contact Information

Address: New Hampshire Department of Environmental Services
29 Hazen Drive, PO Box 95
Concord, NH 03302-0095

Contacts: Drinking Water Monitoring Program: dwmonitoring@des.nh.gov

Forms

Acute PN - Boil Order Notice (E. coli)

Public Notice Template for Boil Order Notice (E. coli)

Acute PN - Boil Order Notice (Precautionary)

Public Notice Template for Boil Order Notice (Precautionary)

Acute PN - Chlorine Dioxide

Acute Public Notice for Chlorine Dioxide Maximum Residual Disinfectant Level

Acute PN – Cyanotoxins/Cyanobacteria

Public Notice Template and Instructions for Cyanotoxins/Cyanobacteria.

Acute PN - Nitrate/Nitrite MCL

Public Notice Template for Nitrate/Nitrite MCL

Arsenic MCL

Public Notice Template for Arsenic MCL Violation

Arsenic MCL with POU or POE

Public Notice Template for Arsenic MCL Violation with POU or POE

Disinfectant Level Less Than 0.2mg/L for Over 4 Hours

Public Notice Template for Disinfectant Level Less Than 0.2mg/L For Over 4 hours

E. coli Level 1/Level 2 Assessments

Public Notice Template for E. coli Level 1/Level 2 Assessments

Failure to Certify Service Line Material Notifications

Template and instructions for a failure to certify the completion of service line material notifications public notice.

Failure to Complete Lead and/or Copper Exceedance Actions

Public Notice Template for Failure to Complete Lead and/or Copper Exceedance Actions

Failure to Complete/Submit Service Line Inventory

Template and instructions for a failure to complete or submit a service line inventory public notice.

Failure to Distribute Lead Education

Public Notice Template for Failure to Distribute Lead Education

Failure to Maintain 4-log Treatment

Public Notice Template for Failure to Maintain 4-log Treatment

Fluoride MCL with POU or POE

Public Notice Template for Fluoride MCL with POU or POE

Fluoride Secondary MCL

Public Notice Template for Fluoride Secondary MCL Violation

General Chemical MCL

Public Notice Template for General Chemical MCL Violation

General MCL with POU or POE

Public Notice Template for General MCL Violation with POU or POE

Lead Action Level Exceedance

Template and instructions for a lead 90th percentile exceedance public notice.

Monitoring/Reporting (M/R)

Public Notice Template for Monitoring/Reporting Violation

Monthly Average Disinfectant Level Too Low

Public Notice Template for Monthly Average Disinfectant Level Too Low

Monthly Average Turbidity

Public Notice Template for Monthly Average Turbidity Violation

MtBE MCL

Public Notice Template for MtBE MCL Violation

Non-Acute PN - Chlorine Dioxide

Non-Acute Public Notice for Chlorine Dioxide Maximum Residual Disinfectant Level

PFAS MCL (PFOA, PFOS, PFNA, PFHxS)

Public Notice Template for PFAS MCL

PFAS MCL with POU or POE

Public Notice Template for PFAS MCL with POU or POE

PN - Chlorite

Chlorite Maximum Contaminate Level Public Notice

Radionuclide MCL (Compliance Gross Alpha, Combined Radium, Uranium)

Public Notice Template for Radionuclide MCL Violation

Radionuclide MCL with POU or POE

Public Notice Template for Radionuclide MCL with POU or POE

Sanitary Survey Significant Deficiency

Public Notice Template for Sanitary Survey Significant Deficiency Violation

Sanitary Survey Significant Deficiency (for lower health based deficiencies)

Public Notice Template for Sanitary Survey Significant Deficiency Violation (for lower health based deficiencies)

Seasonal Water System Start-up Procedure and Certification

Public Notice Template for Seasonal Water System Start-up Procedure and Certification

Single Turbidity

Public Notice Template for Single Turbidity Violation

TOC Removal

Public Notice Template for TOC Removal Violation

Total Coliform Level 1/Level 2 Assessments

Public Notice Template for Total Coliform Level 1/Level 2 Assessments

TTHM and/or HAA5 MCL

Public Notice Template for TTHM and/or HAA5 MCL Violation

Unregulated Contaminant Monitoring Rule Public Notification

Public Notice Template for Availability of UCMR Results

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NH Online Forms System - NHDES - Public Water Systems - Public Notice

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New Hampshire Department of Environmental Services Drinking Water Public Notice Forms

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