Consumer Confidence Report Certification 2016• Massachusetts Department of Environmental Protection
Bureau of Resource Protection — Drinking Water Program
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Consumer Confidence Report Certification
For calendar year 2015
A. PWS Information
Northampton Water Department
PWS Name
Northampton
City/Town
The community water system named above
hereby certifies that its Consumer Confidence
Report(CCR)was distributed to customers,
appropriate agencies, and notices of availability
have been given in compliance with 310 CMR
22.16A. Furthermore, the system certifies that
the information contained in the report is correct
and consistent with the compliance monitoring
data previously submitted to MassDEP.
I certify under penalty of law that I am the person
authorized to fill out this form and the information
contained herein is true, accurate, and complete to
the best of my knowledge and belief.
B. Public Notice Certification
1214000
PWS ID#
James R. Laurila
Name
Acting Director
Title
413-587 1570 x4307
Phone#
3-16-2016
Date
Signature f Owne esponsible Party or Certified Operator
Is this system using this CCR to provide Tier 3 Public Notice?
What PN is included? Violation ❑ UCMR3 ® Other❑
Did you have a consultation with MassDEP ?❑ Yes ® No
The PN can be found on page 1 of the CCR.
®Yes ❑ No
List other
Consultation date
3-16-2016
Date of PN Occurrence
❑ 1 am reporting multiple Tier 3 PNs. I have listed the additional PN information at the end of this form.
The public water system indicated above hereby affirms that a Tier 3 public notice has been provided
within this CCR to consumers in accordance with 310 CMR 22.16(4) including: delivery, content, format
requirements, notification deadlines, and that the public water system will meet future requirements for
notifying new billing units and new customers of the violation.
C. For Systems Selling Water to Other Community Water Systems
❑ My system delivered the applicable information required at 310 CMR 22.16A(3), to the buying
system(s) no later than April 1st of this year, or by the mutually agreed upon date specifically included in
a written contract between the parties.
D. Annual Cross Connection Education
Is this CCR being used for your system's annual cross-connection education? El Yes
If no, what methods did you use to meet your annual CCCP requirements (citation)?
❑ No
Continued on next page
• E. Consumer Delivery Methods — Based on Population Served
d For systems serving fewer than 500 persons:
rts) (Choose#1 or#2) Date of delivery/publication
or ❑ 1. My system used one or more of the following methods to notify customers that the CCR would not
be mailed directly to them but is available to them upon request. (A copy of the notice is attached).
❑ Land mail ❑ Door-to-door ❑ Newspaper ❑eMail ❑ Post notices
Locations of posted notices
❑ 2. My system provided a copy of the CCR to each customer by the following methods(s):
❑ Published the full CCR in a local newspaper(the published report is attached).
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❑ Land mailed or hand-delivered the CCR to consumers.
❑ eMailed with PDF of CCR or ❑ eMailed with embedded CCR (email is attached)
❑ Posted the CCR on the web and sent the direct URL to customers by way of mail or email (notice
is attached).
List URL
For systems serving between 500 and 9,999 persons:
(Choose#1 or#2) Date of delivery/publication
❑ 1. My system provided a copy of the CCR to each customer by
❑ Land mail ❑eMail with PDF ❑eMail with embedded CCR
❑ Land mailed or ❑ eMailed a notice of availability of the CCR with a direct URL
List the URL if used.
❑ 2.My system provided the CCR to each customer by publishing the full report in a newspaper(a copy
of the published CCR is attached)and provided notice to consumers of this action by either:
❑ Published a notice of this in a local newspaper
❑ Land mailed a notice of this to consumers.
❑e-Mailed a notice of this to consumers.
3- 16
For systems serving 10,000 or more persons:
- ) o/�
Date of delivery/publication
® My system provided a copy of the CCR to each customer by:
® Land mail ❑ eMail with PDF ❑eMail with embedded CCR
❑ Land mailed or ❑ eMailed a notice of availability of the CCR with a direct URL
List the URL if used
❑ In addition to one of the delivery methods checked above, my system serves greater than 100,000
persons and, as required, has posted the CCR on a publicly accessible Internet site:
List the URL used
F. Good Faith Delivery Methods (minimum of 3 is required)
To reach people who drink our water but are not billed customers the following were conducted in
addition to the required delivery:
® Posted the CCR on a publicly accessible Internet site at the following address. (Only for systems
under 100,000 population who did not use this method as their primary method)
www.https//drive.google.com/a/northamptonma.gov/file/d/OB-
1 XA9 W g F gjL U X N N W Gdf V 2ZtU DA/v i ew
❑ Mailed the CCR to all postal patrons within the service area(list of zip codes used is attached).
❑ Mailed a postcard listing the URL where the CCR can be found, to all postal patrons within the
service area (list of zip codes used is attached).
List the URL used
❑ Advertised availability of the CCR in the following news media (the announcement is attached):
❑ Radio ❑ Newspaper ❑Television/cable ❑ Social media
❑Digital signboard
❑ Published the CCR in local newspaper(the published CCR is attached).
® Posted the CCR in public places i.e., post office, town hall, library (a list of locations is attached).
® Delivered multiple CCR copies to single-bill addresses serving several persons i.e., apartments,
businesses, large private employers(a list of locations is attached).
❑ Delivered multiple CCR copies to community organizations (A list of organizations is attached.)
❑ Posted the CCR or a notice of availability at locations within the apartment/condo complex (list of the
locations is attached)
0
Other
nat G. Mandatory Agency Delivery Requirements
• 1. Delivered 1 copy of CCR and the Certification Form to local board of health.
(Contact your board of health as to whether they would prefer and or e-delivery
of CCR.)
® 2. Delivered 1-copy of CCR and the Certification Form to MA Dept. of Public
ust Health.
on or
® Hardcopy to: 250 Washington St.; Boston, MA 02108 or
❑ PDF emailed to: dph.ccr(au)massmail.state.ma.us
nts ® 3. Delivered 1-copy of CCR, the Certification Form, and all the attachments
check-marked in this form to the MassDEP Boston Office at.
=d M Hardcopy to: CCR Program, 1 Winter St. -5th FI.; Boston, MA 02108 or
st
❑ PDF emailed to: Program.Director-DWP(ahstate.ma.us.
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3/16/2016
Date completed
3/16/2016
Date completed
® 4. If not emailed to the MassDEP Boston Office, delivered 1-copy of CCR, the 3/16/2016
Certification Form, and all the attachments check-marked in this form to your Date completed
MassDEP regional office at.
Hardcopy to: MassDEP-WERO; Statehouse West 4'n Floor; 436 Dwight
Street.; Springfield, MA 01103
❑ Hardcopy to: MassDEP-CERO; 8 New Bond St; Worcester, MA 01606
❑ Hardcopy to: MassDEP-NERO; 205-B Lowell St.; Wilmington, MA 01887
❑ Hardcopy to: MassDEP-SERO; 20 Riverside Dr.; Lakeville, MA 02347
2015 Consumer Confidence Report Distribution
Delivered 3/14/2016
:Offices
• Leeds
• Florence
• Northampton
dic Libraries
• Lilly Library
• Forbes Library
thampton Housing Authority Apartment Buildings(Large Single Billed Facilities)
• McDonald House
• Forsander and Cahill Apartments
• Tobin Manor
• Salvo House
• Hampshire and Florence Heights
y Hall