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New Hampshire Department of Environmental Services

Public Notice Forms

The following commonly used templates are provided to assist water systems in meeting their public notice requirements. Certain parts of a template may need to be modified to reflect the particular circumstances of individual cases. The instructions accompanying each template should be carefully read because certain public notice language is mandatory and cannot be changed. Since there are hundreds of contaminants, types of violations, and situations that require public notice, there may not be a template listed below that meets your needs. In such cases, it is suggested that you contact DWGB for advice. Questions regarding the Public Notification Rule or the public notice forms can be directed to

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Assessments/Sanitary Survey


Boil Orders


Disinfection Byproduct (DBP)

Lead and Copper

Seasonal Start-up

Surface Water Treatment Rule


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NH Department of Environmental Services | 29 Hazen Drive | PO Box 95 | Concord, NH 03302-0095
(603) 271-3503 | TDD Access: Relay NH 1-800-735-2964 | Hours: M-F, 8am-4pm

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