DDW-2024-006496

Susceptibility Waiver Application for:
Name of Water System: Hooper Water ID (29006)
Name of Drinking Water Source(s) : Well #2 (WS005) and Well #3
(WS004)
I, t,/t:.......,J. jt//-W7 , Designated Person (per
R309-600) for the &oy<,v:: Ud\.�V:: ;t: 7) (-z.<1oc,�)Water System, hereby state that I am
confident that a susceptibility waiver for voes and/or pesticides will not threaten public
health.
Note: We must have a record of the monitoring results of at least one sample from the
voe and/or pesticide parameter group taken in the last five years. A non-detect result is
required.