Bucoda, WA · Thurston County
Consumer Confidence Report Certification Form 2025
Bucoda water systems use this form to certify delivery and accuracy of their 2024 Consumer Confidence Report to customers and the regional office.
What this form is
The form certifies that a water system delivered its 2024 Consumer Confidence Report to customers and that the report's information and monitoring data are correct. The document says to send the completed form with the CCR to the regional office by October 1, 2025, and notes that sending both documents together before July 1 helps properly credit the system. It asks for water system details, delivery date, URL if delivered electronically, and a certification signature.
Who needs it
The person certifying a water system's 2024 Consumer Confidence Report for Bucoda must complete and send this form with the report.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed without a notary; the signer certifies the report and signs the form, with no notarized or sworn attachment identified.
How to submit this form
- 1
Download The Form
Download the Consumer Confidence Report Certification Form PDF.
- 2
Complete The Form
Enter the water system details and delivery information, then complete the certification and sign.
- 3
Gather The Report
Include the 2024 Consumer Confidence Report with the completed certification form.
- 4
Send To The Regional Office
Send both documents to the regional office for the county as directed by the form.
Frequently asked questions
- Do I need a notary for the Consumer Confidence Report Certification Form?
- No. The form has a certification signature and does not require notarization; no notarized or sworn attachment is identified.
- How do I submit the Consumer Confidence Report Certification Form?
- The form says to send it with the CCR to the regional office for the county. Check the city website for current contact details.
- What information does the certification form request?
- It asks for the water system name, ID number, county, delivery date, electronic-delivery URL if applicable, and the certifier's signature and printed name.