Form DPH-DWS-LCR001 "Consumer Notice of Lead Tap Water Results" - Connecticut

What Is Form DPH-DWS-LCR001?

This is a legal form that was released by the Connecticut State Department of Public Health - a government authority operating within Connecticut. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2013;
  • The latest edition provided by the Connecticut State Department of Public Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DPH-DWS-LCR001 by clicking the link below or browse more documents and templates provided by the Connecticut State Department of Public Health.

ADVERTISEMENT
ADVERTISEMENT

Download Form DPH-DWS-LCR001 "Consumer Notice of Lead Tap Water Results" - Connecticut

822 times
Rate (4.6 / 5) 41 votes
Consumer Notice of Lead Tap Water Results
Public Water System:
PWS ID:
Sample Location:
Date Sampled:
Thank you for participating in the lead and copper
. T
tap monitoring program
he Safe Drinking Water Act requires
that water systems provide a notice of the individual lead tap results to the occupants of the site where the tap was tested.
The level of lead found at your location was
mg/L.
What Does This Mean?
Under the authority of the Safe Drinking Water Act, EPA set the action level for lead in drinking water at 0.015
milligrams of lead per liter of water (mg/L). This means utilities must ensure that water from the customer’s tap does not
exceed this level in at least 90 percent of the sites sampled (90th percentile value). The action level is the concentration of
the contaminant, which if exceeded, triggers treatment or other requirements which a water system must follow to correct
the problem. Because lead may pose serious health risks, the EPA set a Maximum Contaminant Level Goal (MCLG) of
zero for lead. The MCLG is 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.
What Are The Health Effects of Lead?
Lead can cause serious health problems if too much enters your body from drinking water or other sources. It can cause
damage to the brain and kidneys, and can interfere with the production of red blood cells that carry oxygen to all parts of
your body. The greatest risk of lead exposure is to infants, young children, and pregnant women. Scientists have linked the
effects of lead on the brain with lowered IQ in children. Adults with kidney problems and high blood pressure can be
affected by low levels of lead more than healthy adults. Lead is stored in the bones, and it can be released later in life.
During pregnancy, the child receives lead from the mother’s bones, which may affect brain development.
What Are Some Sources of Lead?
Although the primary sources of lead exposure for most children are deteriorating lead-based paint, lead-contaminated
dust, and lead-contaminated soil, the U.S. EPA estimates that 10 to 20 percent of human exposure to lead may come from
drinking water. Exposure to lead is a significant health concern, especially for young children and infants whose growing
bodies tend to absorb more lead than the average adult. Although our facility's lead levels were below the action level, if
you are concerned about lead exposure in your home, parents should ask their health care providers about testing children
to determine levels of lead in their blood.
What Can I Do To Reduce Exposure to Lead in Drinking Water?
Run Your Water To Flush Out Lead. Run water for 15-30 seconds or until it becomes cold or reaches a steady
temperature before using it for drinking or cooking. This flushes lead-containing water from the pipes.
Use Cold Water for Cooking and Preparing Baby Formula. Do not cook with or drink water from the hot water tap;
lead dissolves more easily in hot water. Do not use water from the hot water tap to make baby formula.
Do not boil water to remove lead. Boiling water will not reduce lead.
If your lead result is above 0.015 mg/L,
Look for alternative sources or treatment of water.
you may want to
consider purchasing bottled water or a water filter. Read the package to be sure the filter is approved to reduce lead or
contact NSF International at 800-NSF8010 or
www.nsf.org
for more information on performance standards for water
filters.
New faucets, fittings, and valves, may contain up to 8 percent
Identify if your plumbing fixtures contain lead.
lead including those advertised or labeled as “lead-free” and may contribute lead to drinking water.
Consumers should be aware of this when choosing fixtures and take appropriate precautions.
For More Information
Call us at
. For more information on reducing lead exposure around your home and the health effects of
lead, visit EPA's Web site at www.epa.gov/lead, call the National Lead Information Center at 800-424-LEAD, or contact
your health care provider.
DPH-DWS-LCR001
Rev. 2/1/2013
Consumer Notice of Lead Tap Water Results
Public Water System:
PWS ID:
Sample Location:
Date Sampled:
Thank you for participating in the lead and copper
. T
tap monitoring program
he Safe Drinking Water Act requires
that water systems provide a notice of the individual lead tap results to the occupants of the site where the tap was tested.
The level of lead found at your location was
mg/L.
What Does This Mean?
Under the authority of the Safe Drinking Water Act, EPA set the action level for lead in drinking water at 0.015
milligrams of lead per liter of water (mg/L). This means utilities must ensure that water from the customer’s tap does not
exceed this level in at least 90 percent of the sites sampled (90th percentile value). The action level is the concentration of
the contaminant, which if exceeded, triggers treatment or other requirements which a water system must follow to correct
the problem. Because lead may pose serious health risks, the EPA set a Maximum Contaminant Level Goal (MCLG) of
zero for lead. The MCLG is 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.
What Are The Health Effects of Lead?
Lead can cause serious health problems if too much enters your body from drinking water or other sources. It can cause
damage to the brain and kidneys, and can interfere with the production of red blood cells that carry oxygen to all parts of
your body. The greatest risk of lead exposure is to infants, young children, and pregnant women. Scientists have linked the
effects of lead on the brain with lowered IQ in children. Adults with kidney problems and high blood pressure can be
affected by low levels of lead more than healthy adults. Lead is stored in the bones, and it can be released later in life.
During pregnancy, the child receives lead from the mother’s bones, which may affect brain development.
What Are Some Sources of Lead?
Although the primary sources of lead exposure for most children are deteriorating lead-based paint, lead-contaminated
dust, and lead-contaminated soil, the U.S. EPA estimates that 10 to 20 percent of human exposure to lead may come from
drinking water. Exposure to lead is a significant health concern, especially for young children and infants whose growing
bodies tend to absorb more lead than the average adult. Although our facility's lead levels were below the action level, if
you are concerned about lead exposure in your home, parents should ask their health care providers about testing children
to determine levels of lead in their blood.
What Can I Do To Reduce Exposure to Lead in Drinking Water?
Run Your Water To Flush Out Lead. Run water for 15-30 seconds or until it becomes cold or reaches a steady
temperature before using it for drinking or cooking. This flushes lead-containing water from the pipes.
Use Cold Water for Cooking and Preparing Baby Formula. Do not cook with or drink water from the hot water tap;
lead dissolves more easily in hot water. Do not use water from the hot water tap to make baby formula.
Do not boil water to remove lead. Boiling water will not reduce lead.
If your lead result is above 0.015 mg/L,
Look for alternative sources or treatment of water.
you may want to
consider purchasing bottled water or a water filter. Read the package to be sure the filter is approved to reduce lead or
contact NSF International at 800-NSF8010 or
www.nsf.org
for more information on performance standards for water
filters.
New faucets, fittings, and valves, may contain up to 8 percent
Identify if your plumbing fixtures contain lead.
lead including those advertised or labeled as “lead-free” and may contribute lead to drinking water.
Consumers should be aware of this when choosing fixtures and take appropriate precautions.
For More Information
Call us at
. For more information on reducing lead exposure around your home and the health effects of
lead, visit EPA's Web site at www.epa.gov/lead, call the National Lead Information Center at 800-424-LEAD, or contact
your health care provider.
DPH-DWS-LCR001
Rev. 2/1/2013