Star Harbor, TX · Henderson County
Public Notice and Certificate of Delivery for Monitoring and Reporting Violation
This public notice and delivery certificate document an operational evaluation level violation for the City of Star Harbor public water system and its customer notifications.
What this form is
The document provides public notice of a monitoring and reporting violation involving TTHM/HAA5 and includes a certificate for documenting delivery to customers. It identifies the violation periods, describes notification methods, and asks the water system to certify the notice’s accuracy and delivery. The instructions say to send completed, signed, and dated copies for review.
Who needs it
The City of Star Harbor public water system uses this document to notify customers and certify how notice of the violation was delivered.
How to submit it
Reply to the email with completed, signed, and dated copies of all documents for review. The document does not provide an email address.
About notarization
This document is signed without a notary; its certificate includes a statement made under penalty of law, but no notarized attachment or step is specified.
How to submit this form
- 1
Download The Document
Download the public notice and certificate of delivery.
- 2
Complete The Notice
Complete the public notice and certificate with the information requested in the document.
- 3
Sign And Date
Sign and date the completed documents as instructed.
- 4
Reply With The Documents
Reply to the email with completed, signed, and dated copies of all documents for review.
Frequently asked questions
- What is the Star Harbor public notice form for?
- It provides notice of a monitoring and reporting violation involving TTHM/HAA5 and includes a certificate for documenting how the public notice was delivered to customers.
- How do I submit the completed documents?
- The instructions say to reply to the email with completed, signed, and dated copies of all documents for review. The document does not list an email address.
- Do I need a notary for the Star Harbor public notice?
- No. The document is signed without a notary. Its certificate includes a statement under penalty of law, but it does not specify a notarized attachment or step.