"Consumer Confidence Report Certification" - Maryland

Consumer Confidence Report Certification is a legal document that was released by the Maryland Department of the Environment - a government authority operating within Maryland.

Form Details:

  • Released on March 1, 2021;
  • The latest edition currently provided by the Maryland Department of the Environment;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Maryland Department of the Environment.

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Consumer Confidence Report Certification
Water System Name:
Water System Number:
I confirm that the Consumer Confidence Report (CCR) for the year 2020 has been delivered to customers (and
appropriate notices of availability have been given) in accordance with COMAR 26.04.01.20-2 by July 1, 2021.
I further certify that the report is correct and consistent with compliance monitoring data previously submitted to
the Maryland Department of the Environment (MDE). Submit completed form to
watersupply.sampleresults@maryland.gov.
Certified by (print name):
Certified by (signature):
Date
Title:
Telephone:
Email:
CCR delivery information (must include completion dates for all applicable delivery actions; see reverse for
delivery requirements):
Date CCR was delivered to MDE
Date CCR was delivered to customers
Indicate method(s) used to deliver CCR to customers:
Postal mail
Electronic delivery*. Describe electronic delivery method:
(*An electronic delivery plan must be approved by MDE prior to implementation of electronic delivery.)
Other delivery methods (e.g., door-to-door delivery, posting in an appropriate location). Describe
delivery method:
Date a notice of CCR availability was published
Date CCR published in local newspaper (attach copy)
Date CCR delivered to other agencies (if required by the State)
Attach list or description (optional).
“Good faith” efforts:
Indicate the date(s) that any of the following “good faith” efforts were used to reach non bill-paying consumers:
CCR posted on the Internet (include Internet address:
)
CCR mailed to postal patrons (bulk mail) within the service area (attach zip codes).
Advertising availability of the CCR in news media (attach copy of announcement).
CCR published in local newspaper (attach copy).
Delivery of multiple copies to single bill addresses serving several persons, such as
apartments, businesses, and large private employers.
Delivery to community organizations (attach a list).
Other (describe delivery method):
Tier 3 Public Notices:
Check here
if a monitoring or reporting violation public notice, fluoride secondary maximum contaminant level
notice, special notice for the availability of unregulated contaminant monitoring date, or other Tier 3 Public Notice
was included with the CCR.
Mandatory for systems serving 100,000 or more persons:
CCR must be posted on a publicly accessible Internet site. Indicate the date the CCR was made available on the
Internet:
. Include Internet address:
Consumer Confidence Report Certification
Water System Name:
Water System Number:
I confirm that the Consumer Confidence Report (CCR) for the year 2020 has been delivered to customers (and
appropriate notices of availability have been given) in accordance with COMAR 26.04.01.20-2 by July 1, 2021.
I further certify that the report is correct and consistent with compliance monitoring data previously submitted to
the Maryland Department of the Environment (MDE). Submit completed form to
watersupply.sampleresults@maryland.gov.
Certified by (print name):
Certified by (signature):
Date
Title:
Telephone:
Email:
CCR delivery information (must include completion dates for all applicable delivery actions; see reverse for
delivery requirements):
Date CCR was delivered to MDE
Date CCR was delivered to customers
Indicate method(s) used to deliver CCR to customers:
Postal mail
Electronic delivery*. Describe electronic delivery method:
(*An electronic delivery plan must be approved by MDE prior to implementation of electronic delivery.)
Other delivery methods (e.g., door-to-door delivery, posting in an appropriate location). Describe
delivery method:
Date a notice of CCR availability was published
Date CCR published in local newspaper (attach copy)
Date CCR delivered to other agencies (if required by the State)
Attach list or description (optional).
“Good faith” efforts:
Indicate the date(s) that any of the following “good faith” efforts were used to reach non bill-paying consumers:
CCR posted on the Internet (include Internet address:
)
CCR mailed to postal patrons (bulk mail) within the service area (attach zip codes).
Advertising availability of the CCR in news media (attach copy of announcement).
CCR published in local newspaper (attach copy).
Delivery of multiple copies to single bill addresses serving several persons, such as
apartments, businesses, and large private employers.
Delivery to community organizations (attach a list).
Other (describe delivery method):
Tier 3 Public Notices:
Check here
if a monitoring or reporting violation public notice, fluoride secondary maximum contaminant level
notice, special notice for the availability of unregulated contaminant monitoring date, or other Tier 3 Public Notice
was included with the CCR.
Mandatory for systems serving 100,000 or more persons:
CCR must be posted on a publicly accessible Internet site. Indicate the date the CCR was made available on the
Internet:
. Include Internet address:
Consumer Confidence Report Certification
Page 2
Code of Maryland Regulations (COMAR)
26.04.01.20-2 Consumer Confidence Report Delivery
(G.) Report Delivery and Record Keeping.
(1) Except as provided in §H of this regulation, each supplier of water to a community water system
shall mail or otherwise directly deliver* one copy of the report to each customer.
(2) The supplier of water to a community water system shall make a good faith effort to reach
consumers who do not get water bills, using means recommended by the State. Good faith effort will
be tailored to the consumers who are served by the system but are not bill-paying customers, such as
renters or workers. A good faith effort to reach consumers would include a mix of methods appropriate
to the particular system such as: posting the reports on the Internet; mailing to postal patrons in
metropolitan areas; advertising the availability of the report in the news media; publication in a local
newspaper; posting in public places such as cafeterias or lunch rooms of public buildings; delivery of
multiple copies for distribution by single-biller customers such as apartment buildings or large private
employers; or delivery to community organizations.
(3) Not later than the date the system is required to distribute the report to its customers, each
supplier of water for a community water system shall mail a copy of the report to the State, followed
within 3 months by a certification that the report has been distributed to customers, and that the
information is correct and consistent with the compliance monitoring data previously submitted to the
State.
(4) Not later than the date the system is required to distribute the report to its customers, each
community water system shall deliver the report to any other agency or clearinghouse identified by the
State.
(5) Each community water system shall make its reports available to the public upon request.
(6) Each community water system serving 100,000 or more persons shall post its current year’s
report to a publicly accessible site on the Internet.
(7) Any supplier of water subject to this regulation shall retain copies of its consumer confidence
report for no less than 3 years.
SYSTEMS SERVING < 10,000
(H.) The requirement of §G(1), (5) and (6) of this regulation for a supplier of water to a community water
systems serving less than 10,000 persons has been waived. Such systems shall:
(1) Publish the reports in one or more local newspapers serving the area in which the system is
located;
(2) Publish a notice in the newspaper, or by other means approved by the State, that informs the
customers that the reports will not be mailed; and
(3) Make the reports available to the public upon request.
SYSTEMS SERVING ≤ 500
(I.) Supplier of water to systems serving 500 or fewer persons may forego the requirements of
paragraphs §H (1) and (2) if they provide notice at least once per year to their customers by mail, door-
to-door delivery or by posting in an appropriate location that the report is available upon request.
* Electronic delivery may be used to fulfill direct delivery requirements. However, each water system
must obtain approval from MDE prior to implementation of electronic delivery. Refer to the following
document for information regarding acceptable electronic delivery methods:
https://www.epa.gov/ccr/how-water-utilities-can-electronically-delivery-their-ccr
(Revised 3/2021)
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