Water System Name:
Water System Number:
The water system named above hereby certifies that its Consumer Confidence Report was distributed on 
___________________ (date) 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 Water Resources Control Board, Division 
of Drinking Water.
Certified by: Name:
Signature:
Title:
Phone Number: (           )
To summarize report delivery used and good-faith efforts taken, please complete the below by checking  
all items that apply and fill-in where appropriate:
2015 SWS CCR Forms & Instructions
CCR Certification Form – Attachment 7 
X
www.heluesd.org
used:
Student Handbook
Date:
7/27/2016
8/17/2016

X

X

ATTACHMENT 7
Consumer Confidence Report
Certification Form
(to be submitted with a copy of the CCR)
(to certify electronic delivery of the CCR, use the certification form on the State Board’s website at 
http://www.waterboards.ca.gov/drinking_water/certlic/drinkingwater/CCR.shtml)
Hughes-Elizabeth Lakes USD
1900886

James Monticone

Distribution Operator
661 724-1231

CCR was distributed by mail or other direct delivery methods.  Specify other direct delivery 
methods

“Good faith” efforts were used to reach non-bill paying consumers.  Those efforts included the 
following methods:
Posting  the  CCR  on  the  Internet  at  www.
                                                                                                                                                  
Mailing the CCR to postal patrons within the service area (attach zip codes used)
Advertising the availability of the CCR in news media (attach copy of press release)
Publication of the CCR in a local newspaper of general circulation (attach a copy of the 
published notice, including name of newspaper and date published)
Posted the CCR in public places (attach a list of locations)
Delivery of multiple copies of CCR to single-billed addresses serving several persons, such 
as apartments, businesses, and schools
Delivery to community organizations (attach a list of organizations)
Other (attach a list of other methods used)
For systems serving at least 100,000 persons:  Posted CCR on a publicly-accessible internet site at 
the  following  address:   www.
                                                                                                                                                             
Revised Jan 2016
Page 1 of 1

For privately-owned utilities:  Delivered the CCR to the California Public Utilities Commission

This form is provided as a convenience and may be used to meet the certification requirement of
 section 64483(c), California Code of Regulations.