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A major problem associated with water supply systems in the United States in water quality, especially for small water supplies. The establishment of regional water authorities in England and Wales has clearly shown the advantages of regional water management; they provide water of good quality efficiently and economically. In North Carolina, there are almost 3,000 public water supply systems and only 2% of these systems serve over 10,000 people. Most of the systems in the state (79%) serve fewer than 500 people. The North Carolina Department of Natural Resources has reported that quite a few systems in North Carolina are deficient in quantity, quality and/or operation and maintenance. The report examines regional water management in one county to assess the possibility of regionalization in North Carolina.