"Long Term 2 Enhanced Surface Water Treatment Rule Sampling Sites - Greater Than 10,000" - Oklahoma

Long Term 2 Enhanced Surface Water Treatment Rule Sampling Sites - Greater Than 10,000 is a legal document that was released by the Oklahoma Department of Environmental Quality - a government authority operating within Oklahoma.

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Download "Long Term 2 Enhanced Surface Water Treatment Rule Sampling Sites - Greater Than 10,000" - Oklahoma

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Long Term 2 Enhanced Surface Water Treatment Rule Sampling Sites
Instructions: Source water samples must be collected from each plant intake. Samples must be taken prior to
chemical treatment and point of backwash water addition. For more than 4 sources make additional copies of
this form. Include a schematic of the intake(s) identifying raw water source, intake, sampling site, re-entry
of recycle backwash water, pretreatment etc.
County: _______________________
System Name:
PWS ID: OK
Mailing Address: _____________________________City: _______________ State: __ Zip: ____________
Contact Name: ____________________________________ Contact Phone Number: __________________
Contact Email: ___________________________________________________________________________
Source 1
Source 2
(if applicable)
1. Raw Water Source Name
2. State Assigned ID No.
(ex. IN001)
Flowing Stream
Flowing Stream
3. Source Type
Lake/Reservoir
Lake/Reservoir
All year
All year
4. Usage
Seasonal
Seasonal
Emergency
Emergency
5. Proportion of typical daily flow:
(If only 1 source, 100%)
Presedimentation
Presedimentation
6. Pretreatment Practices
If yes, indicate location on
Bank Filtration
Bank Filtration
schematic
Off- stream Storage
Off- stream Storage
Yes
Yes
7. Recycling Practices:
If yes, indicate location on schematic
No
No
Yes
Yes
8. Chemical Pretreatment:
If yes, indicate location on
No
No
schematic
Source 3
Source 4
(if applicable)
(if applicable)
1. Source Name
(Facility Name)
2. State Assigned ID No.
(ex. IN001)
Flowing Stream
Flowing Stream
3. Source Type
Lake/Reservoir
Lake/Reservoir
All year
All year
4. Usage
Seasonal
Seasonal
Emergency
Emergency
5. Proportion of typical daily flow:
(If only 1 source, 100%)
Presedimentation
Presedimentation
6. Pretreatment Practices:
If yes, indicate location on
Bank Filtration
Bank Filtration
schematic
Off- stream Storage
Off- stream Storage
Yes
Yes
7. Recycling Practices:
If yes, indicate location on schematic
No
No
Yes
Yes
8. Chemical Pretreatment:
If yes, indicate location on
No
No
schematic
Long Term 2 Enhanced Surface Water Treatment Rule Sampling Sites
Instructions: Source water samples must be collected from each plant intake. Samples must be taken prior to
chemical treatment and point of backwash water addition. For more than 4 sources make additional copies of
this form. Include a schematic of the intake(s) identifying raw water source, intake, sampling site, re-entry
of recycle backwash water, pretreatment etc.
County: _______________________
System Name:
PWS ID: OK
Mailing Address: _____________________________City: _______________ State: __ Zip: ____________
Contact Name: ____________________________________ Contact Phone Number: __________________
Contact Email: ___________________________________________________________________________
Source 1
Source 2
(if applicable)
1. Raw Water Source Name
2. State Assigned ID No.
(ex. IN001)
Flowing Stream
Flowing Stream
3. Source Type
Lake/Reservoir
Lake/Reservoir
All year
All year
4. Usage
Seasonal
Seasonal
Emergency
Emergency
5. Proportion of typical daily flow:
(If only 1 source, 100%)
Presedimentation
Presedimentation
6. Pretreatment Practices
If yes, indicate location on
Bank Filtration
Bank Filtration
schematic
Off- stream Storage
Off- stream Storage
Yes
Yes
7. Recycling Practices:
If yes, indicate location on schematic
No
No
Yes
Yes
8. Chemical Pretreatment:
If yes, indicate location on
No
No
schematic
Source 3
Source 4
(if applicable)
(if applicable)
1. Source Name
(Facility Name)
2. State Assigned ID No.
(ex. IN001)
Flowing Stream
Flowing Stream
3. Source Type
Lake/Reservoir
Lake/Reservoir
All year
All year
4. Usage
Seasonal
Seasonal
Emergency
Emergency
5. Proportion of typical daily flow:
(If only 1 source, 100%)
Presedimentation
Presedimentation
6. Pretreatment Practices:
If yes, indicate location on
Bank Filtration
Bank Filtration
schematic
Off- stream Storage
Off- stream Storage
Yes
Yes
7. Recycling Practices:
If yes, indicate location on schematic
No
No
Yes
Yes
8. Chemical Pretreatment:
If yes, indicate location on
No
No
schematic
Long Term 2 Enhanced Surface Water Treatment Rule
Sampling Schedule
System Name:
PWS ID: OK
Lab Name:
Lab Contact Name: ____________________________________ Lab Phone Number: __________________
Lab Email: ___________________________________________________________________________
Instruction: 1. Indicate all dates, which you plan to collect samples for once a month for 24 months.
2. Check the two months, which additional matrix spiked sample will be collected.
Sample Number
Matrix Spike
Sample Date (MM/DD/YYYY)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Additional Information:
The information submitted on this form is correct to the best of my knowledge:
Signature: ________________________________________ Date: ___________________________
Printed Name: ____________________________________ Title: ____________________________
Please submit the complete sample site form, sample schedule and schematic to Drinkingwater@deq.ok.gov. Remember
to keep a copy of all documents for your record. DEQ will send you a letter once your LT2 sampling plan has been
approved.
Sample Plan Approved by DEQ: _________________________________________ Date: _____________________
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