2.3 ERMUSR 06-13-2017 - Laserfiche WebLink

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4.1 N N f OTA MDH 2017 CERTIFICATION FORM Name of System: Elk River PWSID: 1710004 The information in the attached Consumer Confidence Report(CCR) is accurate and has been distributed to customers served by our water supply in the following manner. You must check at least one option, however check ALL that apply:• ❑ Paper copy individually mailed to all customers. El Mailed notification(postcard,newsletter,etc.)that CCR is available via direct URL.You MUST provide a direct link to your system's CCR (i.e. www.minneapolismn.gov/www/groups/public/©publicworks/documents/webcontent/wcroslp- 125811.pdf)and give the option for the customer to request a paper copy.You can also provide other links to the CCR (i.e.www.minneapolismn.gov)beyond the required direct link. Direct URL:http://www.elkriverutilities.com/paoes/water-quality-report • ❑ Emailed a direct URL to CCR for bill-paying customers; emailed the CCR as a file attachment(PDF)or directly inserted CCR into the body of the email message. URL Options should include how a paper copy of the CCR can be obtained If one is not provided. Efforts must be made to reach customers who do not receive water bills, (such as apartment tenants,nursing home residents, etc.). This can be done by publicizing the availability of the CCR in the media, posting in public places, delivering multiple copies of the CCR for distribution by single-biller customers, delivering CCR to community organizations, posting on the Internet, and/or including within the CCR a request for recipients to share information with non-billing customers. li COMPLETE THE FOLLOW! Signature: Print Name: Eric Volk Job Title:Wat r Superintendent Phone: 763-635-1361 Date: May 26,2017 Email address: evolk@elkriverutilities.com Please print clearly PLEASE NOTE: Although MDH sent a CCR to your system,we need a"final"copy of the CCR that your system distributed for our records. Whether you reformatted the CCR, or simply added a phone number for your system on the CCR, you must return a copy of the CCR and this form to MDH. Return this form and a copy of the CCR or newspaper clipping of the CCR, by July 1,2017. Mailing Address: Fax: 651/201-4701 Minnesota Department of Health Email: health.drinkingwateradvisory@state.mn.us do Ms. Nancy Kadrlik Drinking Water Protection Section P.0. Box 64975 St. Paul, Minnesota 55164-0975 30