ADEQ Form DWAR2A "Drinking Water Analysis Report - Water Quality Parameters (Wqp)" - Arizona

What Is ADEQ Form DWAR2A?

This is a legal form that was released by the Arizona Department of Environmental Quality - a government authority operating within Arizona. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2017;
  • The latest edition provided by the Arizona Department of Environmental Quality;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of ADEQ Form DWAR2A by clicking the link below or browse more documents and templates provided by the Arizona Department of Environmental Quality.

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Download ADEQ Form DWAR2A "Drinking Water Analysis Report - Water Quality Parameters (Wqp)" - Arizona

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DRINKING WATER ANALYSIS REPORT
WATER QUALITY PARAMETERS (WQP)
PUBLIC WATER SYSTEM INFORMATION
***
***
>>>> TO BE FILLED OUT BY SYSTEM PERSONNEL <<<<
[_______________]
________________________________________________
PWS ID Number
PWS Name
[_______________]
[_____:________]
________________________________________________
Sample Date
Sample Time
Owner/Contact Person
(24HR CLOCK)
__________________________________
(_____)__________________________________
Owner/Contact Email Address
Owner/Contact Phone Number
SAMPLE TYPE
SAMPLE COLLECTION POINT
Entry Point to the Distribution System [EPDS:_________ ]
Compliance Monitoring
Distribution System [RTCR Site/Location: ___________ ]
*** WATER QUALITY PARAMETERS ANALYSIS ***
>>> TO BE COMPLETED BY LABORATORY PERSONNEL <<<
Analysis
Contaminant
Cont.
Analysis
Result
Method
Name
Code
Run Date
FIELD
pH **
1925
Temperature (°C) **
1996
FIELD
Alkalinity
1927
Calcium *
1919
1064
Conductivity
Orthophosphate *
1044
Silica *
1049
Iron ***
1028
Manganese ***
1032
Chloride ***
1017
Sulfate ***
1055
*** LABORATORY INFORMATION ***
>>> TO BE COMPLETED BY LABORATORY PERSONNEL <<<
[________________________]
Specimen Number
Lab ID Number [AZ________]
Lab Name [_______________________]
Phone Number [_________________]
Lab Contact, Printed Name [___________________]
Authorized Signature [_____________________________]
Comments [___________________________________________________________________________________]
PWS Notification Date [_______________]
PWS Person Notified [____________________________________]
* All units must be reported in milligrams per liter (mg/L)
Submit completed form to:
** Field Measurements
Email
:
WQD_COMPLIANCE_DATA@AZDEQ.GOV
*** ADEQ Recommended
Mail:
ADEQ Water Quality Compliance Data Unit (MC 5415B-1), 1110 W.
DWAR 2A: Revised 12/2017
Washington St., Phoenix, AZ 85007
For Questions, Call: (602) 771-9200
.
DRINKING WATER ANALYSIS REPORT
WATER QUALITY PARAMETERS (WQP)
PUBLIC WATER SYSTEM INFORMATION
***
***
>>>> TO BE FILLED OUT BY SYSTEM PERSONNEL <<<<
[_______________]
________________________________________________
PWS ID Number
PWS Name
[_______________]
[_____:________]
________________________________________________
Sample Date
Sample Time
Owner/Contact Person
(24HR CLOCK)
__________________________________
(_____)__________________________________
Owner/Contact Email Address
Owner/Contact Phone Number
SAMPLE TYPE
SAMPLE COLLECTION POINT
Entry Point to the Distribution System [EPDS:_________ ]
Compliance Monitoring
Distribution System [RTCR Site/Location: ___________ ]
*** WATER QUALITY PARAMETERS ANALYSIS ***
>>> TO BE COMPLETED BY LABORATORY PERSONNEL <<<
Analysis
Contaminant
Cont.
Analysis
Result
Method
Name
Code
Run Date
FIELD
pH **
1925
Temperature (°C) **
1996
FIELD
Alkalinity
1927
Calcium *
1919
1064
Conductivity
Orthophosphate *
1044
Silica *
1049
Iron ***
1028
Manganese ***
1032
Chloride ***
1017
Sulfate ***
1055
*** LABORATORY INFORMATION ***
>>> TO BE COMPLETED BY LABORATORY PERSONNEL <<<
[________________________]
Specimen Number
Lab ID Number [AZ________]
Lab Name [_______________________]
Phone Number [_________________]
Lab Contact, Printed Name [___________________]
Authorized Signature [_____________________________]
Comments [___________________________________________________________________________________]
PWS Notification Date [_______________]
PWS Person Notified [____________________________________]
* All units must be reported in milligrams per liter (mg/L)
Submit completed form to:
** Field Measurements
Email
:
WQD_COMPLIANCE_DATA@AZDEQ.GOV
*** ADEQ Recommended
Mail:
ADEQ Water Quality Compliance Data Unit (MC 5415B-1), 1110 W.
DWAR 2A: Revised 12/2017
Washington St., Phoenix, AZ 85007
For Questions, Call: (602) 771-9200
.