ADEQ Form DWAR20B "Long Term 2 Enhanced Surface Water Treatment Rule - Monthly Reporting Form for E. Coli for Schedule 4 System (Serving Less Than 10,000 People)" - Arizona

What Is ADEQ Form DWAR20B?

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 January 26, 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 DWAR20B by clicking the link below or browse more documents and templates provided by the Arizona Department of Environmental Quality.

ADVERTISEMENT
ADVERTISEMENT

Download ADEQ Form DWAR20B "Long Term 2 Enhanced Surface Water Treatment Rule - Monthly Reporting Form for E. Coli for Schedule 4 System (Serving Less Than 10,000 People)" - Arizona

1425 times
Rate (4.7 / 5) 86 votes
Long Term 2 Enhanced Surface Water Treatment Rule (LT2ESWTR)
Monthly Reporting Form for E. coli
For Schedule 4 System (serving less than 10,000 people)
PWS ID #
PWS Name
Month/Year Reported:
Contact Name
E-Mail Address
PWS Contact Phone #
Treatment Plant Surface Water (TPSW) ID#
TPSW Name
Plant operated entire monitoring period and sampled according to schedule.
Plant operated entire monitoring period and sampled outside of 5 day window.◊
Plant operated partial monitoring period and sampled according to schedule.
Plant operated partial monitoring period and sampled outside of 5 day window.◊
Plant did not operate any day of this monitoring period due to normal events.*
Plant did not operate any day of this monitoring period due to unusual events.**
◊ Must notify ADEQ or MCESD when sending LT2ESWTR (LT2) sampling to laboratory. *LT2 samples not required. **LT2 sampling required if source is available.
Laboratory Analysis Results for E. coli
Specimen
Sample
Analysis Run
Method
Lab ID
Check Source Type
Method Type
E. coli per 100 mL
Number
Date/Time
Date/Time
Number
Flowing Stream/Canal
Lake/Reservoir
GUDI
Laboratory Information (to be completed by laboratory personnel)
Certified Lab ID#
Lab Name
Lab Contact (print name)
Date Lab Notified PWS
Lab Phone #
Lab Contact Signature
Comments:
Please send completed form to ADEQ via mail or e-mail
Mail: Arizona Department of Environmental Quality, 1110 W. Washington St., Mail Code 5415 B-2, Phoenix, AZ 85007
E-mail: WQD_Compliance_data@azdeq.gov
DWAR 20B (Monthly Report)
January 26, 2017
Long Term 2 Enhanced Surface Water Treatment Rule (LT2ESWTR)
Monthly Reporting Form for E. coli
For Schedule 4 System (serving less than 10,000 people)
PWS ID #
PWS Name
Month/Year Reported:
Contact Name
E-Mail Address
PWS Contact Phone #
Treatment Plant Surface Water (TPSW) ID#
TPSW Name
Plant operated entire monitoring period and sampled according to schedule.
Plant operated entire monitoring period and sampled outside of 5 day window.◊
Plant operated partial monitoring period and sampled according to schedule.
Plant operated partial monitoring period and sampled outside of 5 day window.◊
Plant did not operate any day of this monitoring period due to normal events.*
Plant did not operate any day of this monitoring period due to unusual events.**
◊ Must notify ADEQ or MCESD when sending LT2ESWTR (LT2) sampling to laboratory. *LT2 samples not required. **LT2 sampling required if source is available.
Laboratory Analysis Results for E. coli
Specimen
Sample
Analysis Run
Method
Lab ID
Check Source Type
Method Type
E. coli per 100 mL
Number
Date/Time
Date/Time
Number
Flowing Stream/Canal
Lake/Reservoir
GUDI
Laboratory Information (to be completed by laboratory personnel)
Certified Lab ID#
Lab Name
Lab Contact (print name)
Date Lab Notified PWS
Lab Phone #
Lab Contact Signature
Comments:
Please send completed form to ADEQ via mail or e-mail
Mail: Arizona Department of Environmental Quality, 1110 W. Washington St., Mail Code 5415 B-2, Phoenix, AZ 85007
E-mail: WQD_Compliance_data@azdeq.gov
DWAR 20B (Monthly Report)
January 26, 2017