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Nformation concerning the notice. A statement encouraging recipients to distribute the notice to other persons served, using standard language from the rule. 5. Attach a copy of the completed Public Notice(s) to this certification form. The public water system named above hereby certifies that public notification has been provided to its consumers in accordance with all delivery, content, and format requirements specified in 40 CFR Part 141 and NJAC 7:10. Owner/Executive Director Signature:.

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How to fill out the NJ BSDW 53 online

The NJ BSDW 53 form is a crucial document for public water systems in New Jersey to certify notification regarding violations to their customers. This guide will provide a detailed step-by-step process to ensure that users can complete this form accurately and effectively while filing online.

Follow the steps to successfully complete your NJ BSDW 53 online.

  1. Press the ‘Get Form’ button to acquire the NJ BSDW 53 form and open it for editing.
  2. Fill in the Public Water System Identification Number (PWSID#) at the top of the form, followed by the name of your water system in the designated field.
  3. Indicate the violation number and the date the violation or situation occurred. Make sure to enter accurate information.
  4. Identify the individual contaminant or contaminant group involved and specify the monitoring period related to the violation.
  5. Check the appropriate box under 'Violation or Situation Type' to indicate the relevant category, which includes MRDL, MCL, or E. coli positive source water sample.
  6. For RTCR assessment violations, specify the treatment technique and monitoring type by checking the relevant boxes.
  7. Choose the correct Public Notification Tier by marking the applicable box for Tier 1, Tier 2, or Tier 3.
  8. If applicable, indicate if this is ongoing public notification by checking the corresponding box.
  9. Complete the sections regarding consultations with the Department of Environmental Protection, including dates and necessary information.
  10. Indicate how the public notice was distributed, along with the respective dates, ensuring to meet the distribution requirements for each tier.
  11. Follow the 10 required elements checklist to confirm that the public notice content meets all necessary requirements.
  12. Attach a copy of the completed Public Notice to the certification form.
  13. Finally, ensure all signatures, printed names, titles, contact information, and dates are filled out before submitting the form online.

Complete your NJ BSDW 53 form online today to ensure compliance with all public notification requirements.

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