Adams County Regional Water * 9203 SR 136 * West Union, Ohio 45693 *
institution is an equal opportunity provider and employer."
If you wish to file a Civil Rights program complaint of discrimination, complete the
USDA Program Discrimination Complaint Form, found online at http://www.ascr.usda.gov/complaint
filing cust.html, or at any USDA office, or call (866) 632-9992 to request the form. You may also write a letter containing
all of the information requested in the form. Send your completed complaint form or letter to us by mail at U.S. Department
of Agriculture, Director, Office of Adjudication, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, by fax (202)
690-7442 or email at firstname.lastname@example.org."