Form MO780-2208 "Monthly Uv Operation Report" - Missouri

What Is Form MO780-2208?

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

Form Details:

  • Released on June 1, 2013;
  • The latest edition provided by the Missouri Department of Natural Resources;
  • 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 Form MO780-2208 by clicking the link below or browse more documents and templates provided by the Missouri Department of Natural Resources.

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MISSOURI DEPARTMENT OF NATURAL RESOURCES
WATER PROTECTION PROGRAM – PUBLIC DRINKING WATER BRANCH
MONTHLY UV OPERATION REPORT
1. PUBLIC WATER SYSTEM NAME
PWS ID
2. MONTH / YEAR
ADDRESS
TELEPHONE NUMBER WITH AREA CODE
EMAIL ADDRESS
CITY
ZIP CODE
COUNTY
3.
4.
5.
6.
7.
8.
Unit
Total Run
Total Volume
Dosage
Number of Off-
Total Off-
2
Time (hrs)
(MG)
(mJ/cm
)
Specification Events
Specification
Volume (MG)
9. TOTAL VOLUME OF OFF-SPECIFICATION WATER PRODUCED (MG) [A]
10. TOTAL VOLUME OF WATER PRODUCED (MG) [B]
11. PERCENT OF OFF-SPECIFICATION WATER PRODUCED ([A]/[B]*100)
12. PERCENT OF OFF-SPECIFICATION WATER PRODUCED <5 PERCENT
YES
NO
13. Of the ______ sensors, ______ have been checked for calibration and ______ were within the acceptable range of tolerance.
14. The following reactors had a sensor correction factor
Unit
Sensor correction factor
15. COMMENTS
16. NAME OF PERSON PREPARING REPORT
17. SIGNATURE OF RESPONSIBLE OFFICAL
DATE
MO 780-2208 (06-13)
MISSOURI DEPARTMENT OF NATURAL RESOURCES
WATER PROTECTION PROGRAM – PUBLIC DRINKING WATER BRANCH
MONTHLY UV OPERATION REPORT
1. PUBLIC WATER SYSTEM NAME
PWS ID
2. MONTH / YEAR
ADDRESS
TELEPHONE NUMBER WITH AREA CODE
EMAIL ADDRESS
CITY
ZIP CODE
COUNTY
3.
4.
5.
6.
7.
8.
Unit
Total Run
Total Volume
Dosage
Number of Off-
Total Off-
2
Time (hrs)
(MG)
(mJ/cm
)
Specification Events
Specification
Volume (MG)
9. TOTAL VOLUME OF OFF-SPECIFICATION WATER PRODUCED (MG) [A]
10. TOTAL VOLUME OF WATER PRODUCED (MG) [B]
11. PERCENT OF OFF-SPECIFICATION WATER PRODUCED ([A]/[B]*100)
12. PERCENT OF OFF-SPECIFICATION WATER PRODUCED <5 PERCENT
YES
NO
13. Of the ______ sensors, ______ have been checked for calibration and ______ were within the acceptable range of tolerance.
14. The following reactors had a sensor correction factor
Unit
Sensor correction factor
15. COMMENTS
16. NAME OF PERSON PREPARING REPORT
17. SIGNATURE OF RESPONSIBLE OFFICAL
DATE
MO 780-2208 (06-13)
INSTRUCTIONS FOR COMPLETING MONTHLY UV OPERATION REPORT
This form must be completed and forwarded to the Missouri Department of Natural Resources, Water Protection Program
- Public Drinking Water Branch, P.O. Box 176, Jefferson City, MO 65102-0176 as soon as the water system's monthly
monitoring is completed, but in no case later than the 10th day of the month following the month for which monitoring was
done
1. Address Block - Complete the name, 7-digit public water system identification number and address of the public
water system.
2. Month - Enter the month and year for which the monitoring was completed.
3. Unit - Enter the unit name/number identifying each UV reactor unit.
4. Total Run Time (hrs) – Enter the total number of hours that each UV reactor unit was operating.
5. Total Volume (MG) – Enter the total volume of water passing through each UV reactor unit in million gallons.
2
6. Dosage (mJ/cm
) – Enter the lowest UV dosage delivered by each UV reactor unit in millijoules per square
centimeter. (This will be below the dosage required for log removal if there was an off-specification event.)
7. Number of Off-Specification Events – Enter the number of off-specification events for each UV reactor unit. An
off-specification event is when the actual dosage drops below the required dosage for log removal. (The required
dosages for log removal are provided in the table below.)
2
UV Dose Requirements (mJ/cm
)
Target
Log Inactivation
Pathogen
0.5
1.0
1.5
2.0
2.5
3.0
3..5
4.0
1.6
2.5
3.9
5.8
8.5
12
15
22
Cryptosporidium
Giardia
1.5
2.1
3.0
5.2
7.7
11
15
22
Virus
39
58
79
100
121
143
163
186
8. Total Off-Specification Volume (gal) – Enter the total volume of off-specification water produced by each UV
reactor unit in million gallons.
9. Total Volume of Off-Specification Water Produced (MG) – Enter the total sum of the volumes entered in
column 8. This is the value for [A].
10. Total Volume of Water Produced (MG) – Enter the total sum of the volumes entered in column 5. This is the
value for [B].
11. Percent of Off-Specification Water Produced – Divide [A] by [B]. Then multiply that number by 100. For
÷
example: if [A] = 2 and [B] = 150, then 2
150 x100 = 1.33 percent
12. Facility Meets Off-Specification Requirement – If item 11 is less than 5 percent, mark yes. If item 11 is greater
than 5 percent, mark no.
13. Sensor Calibration - Enter the number of sensors, how many were checked for calibration, and how many were
within the acceptable range of tolerance.
14. Sensor Correction Factor – Enter the unit name/number identifying each UV reactor unit and the corresponding
sensor correction factor if applicable.
15. Comments – Enter any additional comments.
16. Name of Person Preparing Report – Enter the name of the person who prepared the report.
17. Signature of Responsible Official – Signature of responsible official.
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