"Monthly Dbp Reporting Form" - Montana

Monthly Dbp Reporting Form is a legal document that was released by the Montana Department of Environmental Quality - a government authority operating within Montana.

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Download "Monthly Dbp Reporting Form" - Montana

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STATE OF MONTANA: DEPARTMENT OF ENVIRONMENTAL QUALITY
Return Completed Form to Public Water Supply & Subdivisions Bureau, Public Water Supply Program,
Attention: DBP Rule Manager 1520 E. 6th Ave, P.O. Box 200901, Helena, MT 59620-0901
Monthly DBP Rule & Maximum Residual Disinfection Limit
(MRDL) Chlorine Residual Measurements Reporting Form
Month
System Name:
Year
PWS ID #
Submitted by:
Check one:
Nontransient Noncommunity
Transient NonCommunity
Community
Monthly Chlorine Residual Sampling
Provide the Number of Residuals Taken
and the Average of those Chlorine
Quarterly
Residuals Taken With All Bacti / TCR
Sample Location
Average
Sampling Event(s)
(mg/l)
Number of
Average Residual
Residuals
(mg/l)
January
February
March
April
May
June
July
August
September
October
November
December
Average of the Last 4-Quarterly Averages =
Was the MRDL of 4.0 mg/l Exceeded?
YES
NO
If Yes:
mg/l
Monthly chlorine residual measurement(s) to be taken at the same location, and same
1
Reminder:
frequency as the Bacti / TCR sample(s)
* Fill in three-month values for quarter and submit to the Department as follows:
Quarter 1 - 10th of April
Quarter 2 - 10th of July
Deadlines:
Quarter 3 - 10th of October
Quarter 4 - 10th of January
Note: Running Annual Average (RAA) can begin during any quarter.
The RAA consists of the last four quarters.
Any Questions? Please call (406)444-4400, Public Water Supply & Subdivisions Bureau.
http://deq.mt.gov/Water/pwsub/pws/pwsMonitoringForms
Website:
Submit by email
STATE OF MONTANA: DEPARTMENT OF ENVIRONMENTAL QUALITY
Return Completed Form to Public Water Supply & Subdivisions Bureau, Public Water Supply Program,
Attention: DBP Rule Manager 1520 E. 6th Ave, P.O. Box 200901, Helena, MT 59620-0901
Monthly DBP Rule & Maximum Residual Disinfection Limit
(MRDL) Chlorine Residual Measurements Reporting Form
Month
System Name:
Year
PWS ID #
Submitted by:
Check one:
Nontransient Noncommunity
Transient NonCommunity
Community
Monthly Chlorine Residual Sampling
Provide the Number of Residuals Taken
and the Average of those Chlorine
Quarterly
Residuals Taken With All Bacti / TCR
Sample Location
Average
Sampling Event(s)
(mg/l)
Number of
Average Residual
Residuals
(mg/l)
January
February
March
April
May
June
July
August
September
October
November
December
Average of the Last 4-Quarterly Averages =
Was the MRDL of 4.0 mg/l Exceeded?
YES
NO
If Yes:
mg/l
Monthly chlorine residual measurement(s) to be taken at the same location, and same
1
Reminder:
frequency as the Bacti / TCR sample(s)
* Fill in three-month values for quarter and submit to the Department as follows:
Quarter 1 - 10th of April
Quarter 2 - 10th of July
Deadlines:
Quarter 3 - 10th of October
Quarter 4 - 10th of January
Note: Running Annual Average (RAA) can begin during any quarter.
The RAA consists of the last four quarters.
Any Questions? Please call (406)444-4400, Public Water Supply & Subdivisions Bureau.
http://deq.mt.gov/Water/pwsub/pws/pwsMonitoringForms
Website: