Wisconsin Department of Natural Resources Drinking Water System Preliminary Routine Monitoring Requirements Period: 01/01/2027 to 12/31/2027 Subject to change -- based on information provided to DNR as of 04/22/2026 Attachment 1 04/22/2026 09:42:23 PM

If any of the following information has changed, please contact your DNR representative with any corrections:
RYNISH, KATHERINE GREEN BAY, WI 54313-6727
Phone: (920) 466-6435 Email: KATHERINE.RYNISH@WISCONSIN.GOV

System Name: COUNTRYSIDE MOTEL PWS ID#: 41518829 Population: 25

Sampler: RALPH WENDRICKS Owner: KATHY WENDRICKS

The following is a table of the routine monitoring required for this water system (additional monitoring may be required based on results of this monitoring). Each row represents a DNR monitoring requirement. Failure to complete a requirement may result in a monitoring violation. Please make sure that you are using the correct lab sheet for each sample, based on the correct time period, sample location and sample group.

Completed? Monitoring Period Sample Source Sample Group # of samples # of contams
Waivers: