Replace the bracketted text with your information.

[Date]

Notice Notice Notice

[Name of System]

Public Water Supply

[Clear explanation of the problem]

[Paste Health Effects language here]

The following steps are being taken to correct the problem:

[Steps]

Preventative Measures you should take:

[Measures]

For further information please contact:

Owner: [Name, phone]
Operator: [Name, phone]
Dutchess County Health Department: 845-486-3404

[Date]