Instructions for Form C-ADD "Chemical Addition Form" - Massachusetts

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Download Instructions for Form C-ADD "Chemical Addition Form" - Massachusetts

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Massachusetts Department of Environmental Protection - Drinking Water Program
310 CMR 22.15(4) Chemical Addition Reporting Requirements
Chemical Addition Form (C-ADD) Guidance and Instructions
Every Supplier of Water shall report to MassDEP at least once each month the use of chemicals added to the water
supply. Such reports shall include, but not be limited to, the name of the chemical, the amount added, the resulting
concentration of the chemical in the water, and the reason for adding the chemical to the water (310 CMR 22.15(4)).
The way in which chemicals are purchased, mixed/diluted and measured can vary from one water system to another.
MassDEP has developed a flow chart to assist operators in populating the dosage calculation appropriately. Please
refer to Appendix B.
General:
Each chemical applied requires a separate chemical addition form submission (with the exception of fluoride). If
there are multiple points of chemical application, such as pre and post-filter, a separate C-ADD form is required
for each addition point unless a single day tank is utilized.
PWS’s that fluoridate shall continue reporting on the DEP/DPH forms as required.
The frequency of measurements is daily unless otherwise approved.
Forms must be completely filled out. Use ‘not applicable’ (N/A) in any area that is not applicable to your system.
Continue to submit C-ADD forms even when a treatment plant is temporarily off-line, indicating ‘off-line’ in the
O&M comment field. Do not populate fields in Section III. Daily reporting with data when a plant is ‘off-line’ or
reports could contain erroneous data points or appear incomplete.
th
Forms must be submitted to the appropriate MassDEP Regional Office no later than the 10
of the month
following the reporting month.
Section I: PWS INFORMATION
1. Provide PWS Name, Town, PWSID
2. Treatment Plant Name and Treatment Plant ID# should correspond with the prepopulated information
from the PWS’s Annual Statistical Report (ASR) “Treatment Plants” Section. Treatment Plant ID#’s are
always the 7 digit PWS number followed by a 3 digit suffix containing a “T” at the end, for example: “-01T”.
Example: “1234567-01T Main Street Water Treatment Plant”
If treatment is applied at an individual source, booster station or other location that is not
reflected in the “Treatment Plants” section of the ASR please contact your MassDEP Regional
Office for assignment of a Treatment Plant ID number.
3. Reporting Period: The operating month and year represented in the report.
Section II: CHEMICAL & OPERATIONAL INFORMATION
It is important that all of the chemical information fields are completed as found on the safety data sheet (SDS)
for each chemical. A SDS for each chemical should be requested at the time of delivery. Compare the new SDS
to the previous one to ensure equivalent product. Make any necessary changes to the chemical addition report
if there are changes in the SDS.
4. Chemical Name: (Refer to SDS Section 1- Identification)
Example: “sodium hypochlorite”
5. Manufacturer: (Refer to SDS Section 1 – Identification )
Example: “Borden & Remington Corporation, Carus Corporation”
6. Product Name: As known by manufacturer or propriety label
Example: “Borchlor 5, Carus 8700, CAIROX”
Page 1 of 10
Massachusetts Department of Environmental Protection - Drinking Water Program
310 CMR 22.15(4) Chemical Addition Reporting Requirements
Chemical Addition Form (C-ADD) Guidance and Instructions
Every Supplier of Water shall report to MassDEP at least once each month the use of chemicals added to the water
supply. Such reports shall include, but not be limited to, the name of the chemical, the amount added, the resulting
concentration of the chemical in the water, and the reason for adding the chemical to the water (310 CMR 22.15(4)).
The way in which chemicals are purchased, mixed/diluted and measured can vary from one water system to another.
MassDEP has developed a flow chart to assist operators in populating the dosage calculation appropriately. Please
refer to Appendix B.
General:
Each chemical applied requires a separate chemical addition form submission (with the exception of fluoride). If
there are multiple points of chemical application, such as pre and post-filter, a separate C-ADD form is required
for each addition point unless a single day tank is utilized.
PWS’s that fluoridate shall continue reporting on the DEP/DPH forms as required.
The frequency of measurements is daily unless otherwise approved.
Forms must be completely filled out. Use ‘not applicable’ (N/A) in any area that is not applicable to your system.
Continue to submit C-ADD forms even when a treatment plant is temporarily off-line, indicating ‘off-line’ in the
O&M comment field. Do not populate fields in Section III. Daily reporting with data when a plant is ‘off-line’ or
reports could contain erroneous data points or appear incomplete.
th
Forms must be submitted to the appropriate MassDEP Regional Office no later than the 10
of the month
following the reporting month.
Section I: PWS INFORMATION
1. Provide PWS Name, Town, PWSID
2. Treatment Plant Name and Treatment Plant ID# should correspond with the prepopulated information
from the PWS’s Annual Statistical Report (ASR) “Treatment Plants” Section. Treatment Plant ID#’s are
always the 7 digit PWS number followed by a 3 digit suffix containing a “T” at the end, for example: “-01T”.
Example: “1234567-01T Main Street Water Treatment Plant”
If treatment is applied at an individual source, booster station or other location that is not
reflected in the “Treatment Plants” section of the ASR please contact your MassDEP Regional
Office for assignment of a Treatment Plant ID number.
3. Reporting Period: The operating month and year represented in the report.
Section II: CHEMICAL & OPERATIONAL INFORMATION
It is important that all of the chemical information fields are completed as found on the safety data sheet (SDS)
for each chemical. A SDS for each chemical should be requested at the time of delivery. Compare the new SDS
to the previous one to ensure equivalent product. Make any necessary changes to the chemical addition report
if there are changes in the SDS.
4. Chemical Name: (Refer to SDS Section 1- Identification)
Example: “sodium hypochlorite”
5. Manufacturer: (Refer to SDS Section 1 – Identification )
Example: “Borden & Remington Corporation, Carus Corporation”
6. Product Name: As known by manufacturer or propriety label
Example: “Borchlor 5, Carus 8700, CAIROX”
Page 1 of 10
7. Reason for Adding Chemical: Specify the treatment objective for each chemical applied.
Example: “oxidation”, “disinfection”, “coagulation”, “flocculation”, “softening”, “precipitation”,
“sequestering”, “pH adjustment”, “corrosion control”.
Ensure all objectives are included. For example, chlorine can be an oxidant, disinfectant, or
both.
8. Purchased Strength (Refer to SDS Section 1 – Identification )
Purchased strength must be converted to a decimal to calculate dosage (% / 100).
Example: 45% KOH/100 = 0.45 and should be reported as “0.45”. 12.5% NaOCl/100 = 0.125 and
should be reported as “0.125”.
9. Purchased Density (lbs/gal): (Refer to SDS Section 9 - Physical Characteristics).
Provide the purchased Density (not to be confused with specific gravity). If only specific gravity
or relative density is given (g/mL) then multiply by 8.34 to obtain density (lbs/gal).
Example: density of 15.7 lb/gal should be reported as “15.7”.
Example: 12.5% sodium hypochlorite does not have a reported density. The specific gravity is
reported as 1.21. Density is calculated as follows: 1.21 x 8.34 = 10.1 lbs/gal. Report the density
as “10.1”.
Use a measured value if available; otherwise, if a range is given use the average between the
high and low number.
10. Dilution Factor or Mix Ratio: Must be reported if a liquid chemical is diluted or a dry chemical is batch mixed
with water by the PWS operator prior to dosing (not to be confused with purchased strength).
For Liquid Chemical:
To calculate dilution factor, divide the amount of liquid chemical by the total volume of both
water and chemical. Dilution factor should always be expressed as a decimal.
Example: 5 parts of chemical diluted with 5 parts of water. Dilution is calculated by
(5
/[5
+5
]) = 0.50 (a 50% dilution). Report “0.5”.
chemical
chemical
water
Example: 1 parts of chemical diluted with 10 parts of water. Dilution is calculated by
(1
/[1
+10
]) = 0.09 (a 9% dilution). Report “0.09”.
chemical
chemical
water
For Dry Chemical:
Dry chemical mix ratio is calculated based on how the chemical usage is measured, via scale
weight or in a day tank.
If using a scale, the mix ratio is determined by dividing the pounds of chemical being added by
the amount of water in gallons to which it is being added. This mix ratio (lbs/gal) is then divided
by 8.34 lbs/gal to obtain a ratio represented in lbs/lb.
o Example: Mix 25 lbs of sodium hexametaphosphate in 50 gallons of water. Mix ratio is
calculated by [(25 lbs
/50 gal
)]/(8.34) = 0.06 lbs/lb
chemical
water
If using a day tank, the mix ratio is determined by dividing the pounds of chemical being added
by the amount of water in gallons to which it is being added.
o Example: Mix 25 lbs of sodium hexametaphosphate in 50 gallons of water. Mix ratio is
calculated by (25 lbs
/50 gal
)= 0.5 lbs/gal
chemical
water
11. NSF Approved (Y/N): Refer to the NSF Drinking Water Chemicals - Health Effects pdf document to identify
that the chemical being applied is NSF/ANSI 60 compliant:
http://www.nsf.org/newsroom_pdf/NSF-
ANSI_60_watemarked.pdf
12. Target Residual Range/Minimum: These parameters may be defined in permit conditions, O&M
manuals, bench top studies, pilot studies, best operational practices, etc. These residual
ranges/minimum values are measured and recorded in section III to ensure treatment effectiveness.
In some instances residuals are not monitored and therefore the target range or minimum value
refers to the chemical target dose (see footnote 13).
A particular chemical may have a target residual range, a target residual minimum, or
both.
Rev. Sept 2018
Page 2 of 10
Target residual minimum is the minimum value required to be maintained in the treated
water.
Regulatory limits, if established, should always be the primary source for target residual
range/minimum, unless there is a more stringent permit condition.
Example: Caustic Target Residual Range (7.3 to 7.8 pH); Caustic Target Residual
Minimum (7.5 pH); Chlorine Target Residual Range (0.8 to 1.0 mg/L); Orthophosphate
Target residual minimum (1.0 mg/L).
Permit conditions, if established, should be used as a source for target residual
range/minimum.
It is important that the residual readings collected in Section III are constantly compared
to the target values to ensure chemical application is optimal.
13. Target Dose: A target dose shall be identified, if established, based on regulatory requirements or
permit conditions. This must be specified in the O&M notes section (22). If no target dose is
established then the field should read “NA”.
Given that dosage for chemicals can vary for numerous reasons, such as changes in
source water, seasonal changes and additional chemical treatment in use, unexplained
or significant dosage variations should be explained in the O&M notes section (22).
Example: Permit condition requires that coagulant dose should be between 20 and 28
mg/L. Report “20-28”.
14. Alarm Settings (low/high): Enter alarm setting used to measure the chemical’s associated monitoring
parameter (pH, chlorine residual, etc.). Alarm settings should be based on availability of alarms, permit
conditions, compliance levels, max dosage levels of chemical, optimal operational chemical levels, and type
of chemical. If the system does not have alarms in place, fill out box with N/A. Alarms shall be tested
quarterly at a minimum. Refer to
http://www.mass.gov/eea/docs/dep/water/compliance/tpalarmb.doc
for
the Water Treatment Chemical Feed System Control and Alarm Testing Log.
Low/High Alarm settings should reflect operational/notification set points to ensure safe and
reliable dosage of chemical and may have a narrow range, with goals of alerting the operator or
shutting down the plant prior to failing compliance parameters, and prevention of overfeeding
and underfeeding of chemical prior to the first customer.
In addition to traditional low/high alarm settings, a High High/Low Low alarm setting can be
used with a broader range to trigger a plant shut down.
Alarm settings must not exceed the full range of the instrument. For example, a low alarm
setting at “0” would never be triggered, as the analyzer can’t read below “0”, or a high alarm at
“4 or 5”, if the analyzer can’t read above 4.
MassDEP has established immediate action levels for some chemicals. These limits are intended
for use by plant operators to identify when a situation involving chemical over-feeds or use of
the wrong chemical has occurred of sufficient gravity to require the implementation of
emergency response procedures. These levels can be found in “MassDEP Immediate Action
Levels for Water Treatment Plant Chemicals” at:
https://www.mass.gov/guides/drinking-
water-standards-and-guidelines
or at:
https://www.mass.gov/files/documents/2016/08/ur/ialwtps.pdf
15. Date of last anti-siphon valve inspection/replacement: Fill in the appropriate date. The Guidelines call for
chemical feed systems to be configured to prevent siphoning of chemicals into the water being treated. As
part of this requirement, any device intended to provide the required protection must function properly. To
ensure that the devices will function as intended, any devices used to provide the required protection need
to be inspected, maintained, and replaced as necessary. MassDEP considers that this needs to be done
annually or more frequently if recommended by the device manufacturer; including the date on the
Chemical Addition Form documents compliance with this requirement of the Guideline.
Rev. Sept 2018
Page 3 of 10
Section III: DAILY REPORTING
It is important to understand that the amount of water pumped should be measured at the same time daily as
the readings for chemical usage are collected. Although some variation in dosage is expected, the calculated
day-to-day dosage should be fairly consistent based upon the volume of Treated Water and Chemical Used
during the same operating period. For systems that take daily measurements, the usages should ideally
represent a 24-hour period. Transducers in day tanks can be used to more accurately reflect and correlate flows
with chemical usage. Ensure that chemical tanks are accurately and permanently marked at proper volumetric
increments and scales are routinely calibrated. Systems that have only weekly site visits should use the
cumulative water production from the time of the last site visit for the calculation of dosage.
Example: If water meter readings are taken at 12 AM each day via SCADA, the measured
chemical used in section III, item 17, should represent that same 24-hour period. (Water
production from 12AM – 12 AM does not appropriately correlate with an 8AM – 8AM chemical
usage reading.)
Regardless of the volume of Treated Water, the dosage should be fairly stable.
Example: On day one, 348,000 gal of treated water is calculated to have a dosage of 3.5 mg/L
of permanganate. On day two, 79,000 gal of treated water is calculated to have a dosage of
0.16 mg/L permanganate. Unless the dosage was intentionally changed by the operator, this
should be considered an indication of either improper chemical measurement, or poor chemical
feed control and the water system should take steps to rectify the situation.
16. Treated Water: Amount of water pumped and treated. The volume may be expressed as gallons or MG. If
gallons are being used they must be converted to MG before entering into the dosage calculation.
To convert gallons to MG multiply by (0.000001).
17. Measured Chemical Used:
Volume (gal/day): Must be completed for liquid chemicals where the volume used in gallons is
measured by the level in the day tank. This is the amount of chemical solution that has been
used in the day tank for the operational period being measured, i.e., 24 hour period or weekly
(for VSS systems).
“Eyeballing” or estimating day tank levels is discouraged. Day tanks must be provided with a
means to measure the amount of chemical used, such as ultrasonic level sensing, gauge rods
with floats, or visual calibration (such as increments marked on the exterior of the tank) where
the ratio of the tank height and diameter are meaningful.
Note: systems using day tanks without gallon increments scribed/permanently marked on the
tank will need to calculate gallons to inches ratio. Refer to Appendix A for guidance on volume
calculations.
Weight (lbs/day): Must be completed for dry chemical (i.e., batch mixed) and gaseous cylinders
or liquid chemicals where the chemical used is measured in pounds via scale weight.
18. Calculated Chemical Used: This value is derived from the numerator (top) portion of the dosage calculation
and is represented as pounds. This value takes into account the purchased strength (footnote 8) and
dilution factor or mix ratio (footnote 10). Refer to Appendix A and B for guidance on calculating the amount
of chemical used in pounds.
Note: For systems using scales, if the purchased strength and/or dilution factor (or mix ratio)
does not equal 1, then the value in this field should not be the same as the measured weight
value from column 17.
19. Calculated Chemical Dosage (mg/L): Reported dosages must be calculated in mg/L using the values
reported in fields (16), (17) and (18). See Appendix A and B for guidance on dosage calculations.
Rev. Sept 2018
Page 4 of 10
20. Parameters Measured, Units and Method: Report the parameter being measured, location in the
treatment train where the parameter is being monitored, and the units of measure in the column
headings.
Data should be recorded and reviewed to ensure optimal treatment dosage of the
chemical applied. Fill in boxes as appropriate.
Example: “chlorine residual post filter (mg/L)” or “chlorine residual 100 ft. tap (mg/L)
weekly grab” or “pH 100 ft. tap”.
Grab or Continuous may be indicated using the checkboxes in item (21).
Multiple columns are provided for measuring parameters at multiple locations, and the
headings should be customized by the PWS for each location.
Example: A system applies KOH for pH adjustment. There is a continuous analyzer in
place for pH. The analyzer records the average pH for each 24-hour period and weekly
pH grab samples are collected to verify analyzer accuracy. For reporting, use two
columns. First column report “pH daily average”. Second column report “pH weekly
grab sample”.
In the space provided at the bottom left of the form (a., b., c.) for each measured
parameter, describe what the result represents (daily average, daily min/max,
instantaneous analyzer reading, grab, etc.), the analyzer or sample location (entry-point,
before/after filters, tanks, clearwell, etc.) and instrumentation used (SCADA, chart
recorder, test kit, bench instrument, etc.)
Examples: “a. daily average at entry point via SCADA”, “b. instantaneous reading after
filter vessel from analyzer”, “c. daily min at entry-point from chart recorder”, “a. grab
sample before storage tank measured with test kit”, etc.
Parameters may have different target residuals at each location. If so, use sections a.,
b., c., to explain the individual targets.
For corrosion control chemicals measured at the entry point, the daily reported
parameter value must be the average of all results collected during the day (grab or
continuous).
Notes on selecting parameters for reporting:
Residual data may represent various situations. Choose the one that best reflects
operational needs for decision making and treatment adjustments. Possibilities to
consider include daily average (via SCADA), variable – routine/random instantaneous
reading of SCADA display, highest or lowest reading (via SCADA or chart recorder). If the
reported residual number is an average, a small change in day-to-day residuals can
indicate larger swings during the day. If an instantaneous or variable reading is used, it
is important to ensure that the reading represents the treatment operating under
routine conditions (i.e., avoiding spikes at start-up/backwashing etc.).
Systems optimizing corrosion control treatment must maintain water quality control
parameters (WQPs) at or above minimum values or within ranges designated by
MassDEP. Ensure that parameter measurements (i.e., pH, corrosion inhibitor, alkalinity,
calcium) are being properly recorded, in accordance with 310 CMR 22.06B(3)(g)
requirements. Please note, a water system is out of compliance if it has excursions for
any MassDEP-specified parameter for more than nine days (at any combination of entry-
point or distribution system locations) during the six-month monitoring periods of (JAN-
JUN or JUL-DEC).
On days when more than one measurement for the water quality parameter
is collected at the sampling location, the daily value shall be the average of all
results collected during the day regardless of whether they are collected
through continuous monitoring, grab sampling, or a combination of both.
Note, if continuous monitoring is present report the average of all
measurements recorded under pumping/flow conditions during chemical
application.
Rev. Sept 2018
Page 5 of 10
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