DDW-2025-004703

CCR Certification FormCWS Name:Lizard Bench Water AssociationPWSID No:UTAH21050
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: Scott HansenTitle: Certified Water OperatorPhone:435-633-3212Date:05/06/2025
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: 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: Notification was mailed out with the water bill that the CCR is available and would be hand delivered or emailed to anyone that is interested.Date completed:April
28th, 2025If 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: "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:April
28th 2025posting the CCR on the Internet at www._______________________________________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)(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: