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Monthly Report Of Operation Sequencing Batch Reactor Wastewater Treatment Plant 53339 - Indiana

Monthly Report Of Operation Sequencing Batch Reactor Wastewater Treatment Plant Form. This is a Indiana form and can be used in Water Department Of Enviromental Management Statewide .
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Name of Facility Permit Number Monthly Report of Operation Sequencing Batch Reactor Wastewater Treatment Plant State Form 53339 (8-07) Month Year Plant Design Flow Telephone Number January 2008 Class mgd Certificate Number Expiration Date 1/1/200Facility's e-mail address (if available): Certified Operator: Name Man-Hours at Plant (Plants less than 1 MGD only) Bypass At Plant Site ("x" If Occurred) Collection System Overflow ("x" If Occurred) Total= Air Temperature (optional) CHEMICALS USED Lbs or Gal Lbs or Gal RAW SEWAGE Precipitation - Inches Susp. Solids - mg/l Phosphorus - mg/l Influent Flow Rate (if metered) MGD Susp. Solids - lbs 29 30 31 Sat Sun Mon Fill in December's effluent data on page 3 as necessary for correct weekly average calculations. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Average Maximum Minimum No. of Data Signature of Certified Operator I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the persons who manage the system, or those persons directly Signature of principal executive officer or authorized responsible for gathering the information, the information submitted is, to the best of my agent knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Page 1 of 4 Date (month, day, year ) Date (month, day, year ) American LegalNet, Inc. www.FormsWorkflow.com Ammonia - mg/l Chlorine - Lbs CBOD5 - mg/l Day Of Month Day of Week CBOD5 - lbs pH Monthly Report of Operation Sequencing Batch Reactor Wastewater Treatment Plant State Form 53339 (8-07) Name of Facility Permit Number For Month Of: Year Signature of Certified Operator Date (month, day, year ) Signature of principal executive officer or authorized agent Date (month, day, year ) January REACTOR # 1 Sludge Vol. Index - ml/gm Settleable Solids % in 30 minutes Settleable Solids % in 30 minutes 2008 REACTOR # 3 Sludge Vol. Index - ml/gm Settleable Solids % in 30 minutes REACTOR # 2 Sludge Vol. Index - ml/gm FINAL EFFLUENT E. Coli - colony/100 ml pH - daily high (if multiple samples) Dissolved Oxygen mg/l Dissolved Oxygen mg/l Dissolved Oxygen mg/l Dissolved Oxygen mg/l Residual Chlorine Contact Tank Residual Chlorine Final Susp. Solids - mg/l Susp. Solids - mg/l Susp. Solids - mg/l 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Avg. Max. Min. Data Comments for the Month (major repairs, breakdowns, process upsets and their causes, inplant treatment process bypass, etc.): Page 2 of 4 American LegalNet, Inc. www.FormsWorkflow.com Phosphorus - mg/l pH - daily low (or single sample) Temperature in Reactors Day Of Month Monthly Report of Operation Sequencing Batch Reactor Wastewater Treatment Plant State Form 53339 (8-07) Name of Facility Permit Number For Month Of: Year Signature of Certified Operator Date (month, day, year ) Signature of principal executive officer or authorized agent Date (month, day, year ) January 2008 FINAL EFFLUENT Total Suspended Solids Susp. Solids - lbs/day Weekly Average Susp. Solids - mg/l Susp. Solids - mg/l Weekly Average Flow BOD Ammonia Ammonia - lbs/day Weekly Average Other Effluent Flow Rate (MGD) Susp. Solids - lbs CBOD5 - lbs/day Weekly Average Effluent Flow Weekly Average CBOD5 - mg/l Weekly Average Ammonia - mg/l Weekly Average Ammonia - mg/l 29 Sat 30 Sun 31 Mon 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Avg Max Min Data Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu MONTHLY REMOVAL SUMMARY BOD5 S.S. Ammonia Percent Removal Total Monthly Flow: Phosphorus (million gallons) Percent Capacity (actual flow/design) Page 3 of 4 Ammonia - lbs CBOD5 - mg/l Day Of Month Day of Week CBOD5 - lbs American LegalNet, Inc. www.FormsWorkflow.com Monthly Report of Operation Sequencing Batch Reactor Wastewater Treatment Plant State Form 53339 (8-07) Name of Facility Permit Number For Month Of: Year Signature of Certified Operator Date (month, day, year ) Signature of principal executive officer or authorized agent Date (month, day, year ) January SLUDGE TO DIGESTER 2008 DIGESTER OPERATION Digested Sludge Withdrawn hrs. or Gal. x 1000 Anaerobic Only Total Solids in Incoming Sludge - % Supernatant BOD5 mg/l or NH3-N mg/l Volatile Solids in Incoming Sludge - % Total Solids in Digested Sludge - % Waste Act. Sludge Gal. x 1000 Gas Production Cubic Ft. x 1000 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Avg. Max. Min. Data Send completed forms by the 28th of the month to: Indiana Department of Environmental Management Office of Water Quality, Mail Code 65-42 100 North Senate Avenue Indianapolis, Indiana 46204-2251 Temperature - F Day Of Month pH Page 4 of 4 Volatile Solids in Digested Sludge - % Supernatant Withdrawn hrs. or Gal. x 1000 American LegalNet, Inc. www.FormsWorkflow.com
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