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Adobe PDF   Notice of Adverse Test Results and Issue ResolutionThe file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill, Print & Save179.0 kb

Form Classification
Classification / Identification:
 Form Number:014-4580-64EEdition date: 2017/08 
 Title:Notice of Adverse Test Results and Issue Resolution
 Ministry:Health and Long-Term Care  
 Branch/ABC:Public Health  
 Program:Food Safety And Safe Water Unit  
 Purpose of Form:The Notice of Adverse Test Results and Issue Resolution form is to be used by licensed laboratories and owners/operators of small drinking water systems to support required written notifications pertaining to small drinking water system adverse water quality incidents (AWQI).  

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