Star Harbor, TX · Henderson County
Public Notice and Certificate of Delivery for Surface Water Treatment Technique Violation
This form provides mandatory public notice language and a delivery certificate for a water system reporting a non-acute surface water treatment technique violation.
What this form is
This document provides mandatory language for a Tier 2, non-acute surface water treatment technique public notice and includes a Certificate of Delivery. The water system inserts violation details and corrective-action information, distributes the notice, and documents delivery methods. The text says the initial notice is due as soon as possible, no later than 30 days after identifying the violation, and the certificate is due ten days after posting.
Who needs it
A public water system reporting a Tier 2, non-acute surface water treatment technique violation uses this form to notify customers and document notice delivery.
How to submit it
Reply to the email with copies of all completed, signed, and dated documents for review. The text says the Certificate of Delivery is due ten days from the notice posting date.
About notarization
No notary is required; the signer signs and dates the Certificate of Delivery, which includes a certification under penalty of law.
How to submit this form
- 1
Download The Form
Download the public notice language and Certificate of Delivery.
- 2
Complete The Notice
Insert the violation information and any pertinent, factual corrective-action details in the indicated spaces.
- 3
Distribute The Notice
Provide the notice using the distribution methods described in the document and record the methods on the certificate.
- 4
Sign And Submit
Sign and date the Certificate of Delivery, then reply to the email with copies of all completed, signed, and dated documents for review.
Frequently asked questions
- Do I need a notary for the public notice and delivery certificate?
- No. The document has no notary block; the signer signs and dates the Certificate of Delivery, which includes a certification under penalty of law.
- How do I submit the completed documents?
- The document says to reply to the email with copies of all completed, signed, and dated documents for review.
- When is the initial public notice due?
- The instructions say to issue the initial notice as soon as possible, but no later than 30 days after the violation was identified.
- What does the Certificate of Delivery document?
- It records the violation and how the public notice was distributed, including delivery to customers and good-faith efforts to reach non-bill-paying consumers.