DDW-2025-004476

CCR Certification FormCWS Name: North Fork SSD PWSID No: UTAH25109
The community water system named above hereby confirms that its consumer confidence report has been distributed to customers (and appropriate notices of availability have been given).
Further, the system certifies that the information contained in the report is correct and consistent with the compliance monitoring data previously submitted to the state/primacy agency.
Certified by:Name: Aubree LincolnTitle: Public Works Supervisor Phone #: [phone]Date: 5/7/2025
Please check all items that apply. CCR was distributed by mail.Date completed:CCR was distributed byother direct delivery method. Specify direct delivery methods: Date completed:5/7/2025
Mail – notification that CCR is available on Website via a direct uniform resource locator (URL) E-mail – direct URL to CCR E-mail – CCR sent as an attachment to the e-mail E-mail –
CCR sent embedded in the e-mailOther: ____________________________________If the CCR was provided by a direct URL, please provide the direct URL Internet address:wwwIf the CCR was provided
electronically, please describe howa customer requests paper CCR delivery: They just need to email [e-mail] request a mailed copy"Good faith" efforts were used to reach non-bill
paying consumers. Those efforts included the following methods as recommended by the state/primacy agency:Date completed:5/7/2025posting the CCR on the Internet at www.northforkdistrictutah.gov_______________________________mailing
the CCR to postal patrons within the service area (attach a list of zip codes used)advertising availability of the CCR in news media (attach copy of announcement)publication of CCR in
local newspaper (attach copyof newspaper announcement)posting the CCR in public places (attach a list of locations)delivery of multiple copies to single bill addresses serving several
persons such as:apartments, businesses, and large private employersdelivery to community organizations (attach a list)electronic city newsletter or electronic community newsletteror
listserv (attach a copy of the article or notice)electronic announcement of CCR availability via social media outlets (attach list of social media outlets utilized)(for systems serving
at least 100,000 persons) Posted CCR on a publicly-accessible Internet site at the address: www.__________________________________________________Date completed:Delivered CCR to other
agencies as required by the state/primacy agency (attach a list)
Date completed: