Form Approved OMB Control No. XXX Approval Expires XXX The public reporting and recordkeeping burden for this collection of information is estimated to average XXX hours per response. Burden means the total time, effort, or financial resources expended by persons to generate, maintain, retain, or disclose or provide information to or for a Federal agency. This estimate includes the time needed to review instructions, develop, acquire, install, and utilize technology and systems for the purposes of collecting, validating, and verifying information, processing and maintaining information, and disclosing and providing information; adjust the existing ways to comply with any previously applicable instructions and requirements; train personnel to be able to respond to a collection of information; search data sources; complete and review the collection of information; and transmit or otherwise disclose information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. To comment on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including the use of automated collection techniques, EPA has established a public docket for this ICR under Docket ID No. OW 2004 0035, which is available for public viewing at the Water Docket in the EPA Docket Center ( EPA/ DC), EPA West, Room B102, 1301 Constitution Ave., NW, Washington, DC 20004. The EPA Docket Center Public Reading Room is open from 8: 30 a. m. to 4: 30 p. m., Monday through Friday, excluding legal holidays. The telephone number for the Reading Room is ( 202) 566 1744, and the telephone number for the Water Docket is ( 202) 566 2426. An electronic version of the public docket is available through EPA Dockets ( EDOCKET) at http:// www. epa. gov/ edocket. Use EDOCKET to submit or view public comments, access the index listing of the contents of the public docket, and access those documents in the public docket that are available electronically. Once in the system, select " search", then key in the docket ID number identified above. Also, you can send comments to the Office of Information and Regulatory Affairs, Office of Management and Budget, 725 17th Street, NW, Washington, DC 20503, Attention: Desk Office for EPA. Please include the EPA Docket ID No. ( XXX) and OMB control number ( XXXX XXXX) in any correspondence. Attach Address Label U. S. ENVIRONMENTAL PROTECTION AGENCY DRAFT DRINKING WATER TREATMENT DETAILED SURVEY QUESTIONNAIRE EPA Form No. XXX Introduction Draft Detailed Drinking Water Treatment Survey i INTRODUCTION The U. S. Environmental Protection Agency ( EPA) is conducting a survey of drinking water treatment facilities as part of its effort to develop national effluent guidelines regulations for the drinking water treatment point source category. This survey requests information on drinking water treatment facilities operating during the 2004 calendar year.

This survey is conducted under the authority of Section 308 of the Clean Water Act ( Federal Water Pollution Control Act, 33 U. S. C. Section 1318). All facilities that receive this survey must respond to it within 45 days of receiving it. Failure to respond, late filing, or failure to comply with the instructions may result in criminal fines, civil penalties, and other sanctions, as provided by law.

OVERVIEW OF THE SURVEY The survey is divided into the following sections:

SECTION 1: General Facility Information SECTION 2: Drinking Water Treatment Operations SECTION 3: Schematics SECTION 4: Residuals Management, Cost, and Analytical Data SECTION 5: Practices that Reduce Residuals Generation SECTION 6: Comments on Survey Questions EPA will use the technical data collected in this survey to determine rates of residuals generation and residuals management and treatment. EPA will also use these technical data together with the cost data collected in this survey to estimate the costs and benefits associated with any new national effluent guidelines regulations considered by EPA.

COMPLETION OF THE SURVEY Each section should be completed by the person( s) most knowledgeable about the information requested. All facilities must have the corporate official or designee responsible for directing or supervising the response to the survey sign one of the Certification Statements on page v to either ( 1) verify and validate the information provided, or ( 2) certify that this facility did not perform drinking water treatment operations during the 2004 calendar year.

Not All Questions Will Be Applicable to Every Facility EPA prepared this survey to be applicable to a variety of facilities; therefore, not all of the questions will apply to every facility. Complete each relevant item in the survey. If a question is not applicable to your facility, write " NA."

Survey Does Not Require Performance of New or Non Routine Tests or Measurements You are not required to perform new or nonroutine tests or measurements solely for the purpose of responding to this survey. EPA intends that responses to all questions be based upon available data and information. In the event that exact data are not available, please provide best engineering estimates and note the methods that were used to make the estimates on the Comments page located in Section 6.

Keep a Copy of the Completed Survey Please keep a copy of the completed survey, including attachments. EPA will review the information submitted and may request your cooperation in answering follow up questions, if necessary, to complete analyses. Introduction Draft Detailed Drinking Water Treatment Survey ii EPA DRINKING WATER TREATMENT SURVEY E MAIL ADDRESSES AND WEBSITE Information: E Mail Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Siddiqui. Ahmar@ epa. gov Website . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . http:// www. epa. gov/ waterscience/ guide SURVEY ASSISTANCE WHEN TO RETURN THE SURVEY The response to this survey is due 45 days after receiving it.

If you wish to request an extension, you must do so in writing within 30 days of receipt of this survey. Written requests may be e mailed to Mr. Ahmar Siddiqui at Siddiqui. Ahmar@ epa. gov or may be mailed to:

Mr. Ahmar Siddiqui U. S. Environmental Protection Agency Engineering and Analysis Division ( 4303T) 1200 Pennsylvania Avenue, NW Washington, DC 20460 Extension requests will be evaluated on a case by case basis. Submittal of an extension request to EPA does not alter the due date of your survey unless and until EPA agrees to the extension and establishes a new date.

WHERE TO RETURN THE SURVEY After completing the survey and certifying the information that it contains, use the enclosed mailing label to mail the completed survey to:

U. S. Environmental Protection Agency Drinking Water Treatment Survey c/ o Eastern Research Group, Inc. 14555 Avion Parkway, Suite 200 Chantilly, VA 20151 REQUESTING AN ELECTRONIC VERSION OF THE SURVEY If you would like an electronic version of the survey, it is available on the EPA website at http:// www. epa. gov/ waterscience/ guide.

If you choose to complete an electronic version of this survey, you are still responsible for submitting a properly formatted hard copy response which matches this survey's format and pagination. The electronic formatting of this survey is complex and may require more experienced clerical support. Improperly formatted survey responses will be returned to the respondent. Therefore, we do not recommend that you complete this survey electronically. Introduction Draft Detailed Drinking Water Treatment Survey iii CONFIDENTIAL BUSINESS INFORMATION If no business confidentiality claim accompanies the information when it is received by EPA, EPA may make the information available to the public without further notice.

Regulations governing the confidentiality of business information are contained in the Code of Federal Regulations ( CFR) at Title 40 Part 2, Subpart B. You may assert a business confidentiality claim covering part or all of the information you submit, other than effluent data and information or data that is otherwise publicly available, as described in 40 CFR 2.203( b):

"( b) Method and time of asserting business confidentiality claim. A business which is submitting information to EPA may assert a business confidentiality claim covering the information by placing on ( or attaching to) the information, at the time it is submitted to EPA, a cover sheet, stamped or typed legend, or other suitable form of notice complying language such as ` trade secret,' ` proprietary,' or ` company confidential.' Allegedly confidential portions of otherwise nonconfidential documents should be clearly identified by the business, and may be submitted separately to facilitate identification and handling by EPA. If the business desires confidential treatment only until a certain date or until the occurrence of a certain event, the notice should so state."

You may claim as confidential all information included in the response to a question by checking the Confidential Business Information ( CBI) box next to the question number. Note that you may be required to justify any claim of confidentiality at a later time. Note also that facility effluent data are not eligible for confidential treatment, pursuant to Section 308( b) of the Clean Water Act, and thus will be treated as nonconfidential even if the CBI box is checked. In addition, information that is publicly available should not be claimed confidential. Note also that information claimed confidential cannot be accessed or used by the industry to evaluate data and analyses supporting the national effluent guidelines regulations.

Information covered by a claim of confidentiality will be disclosed by EPA only to the extent of, and by means of, the procedures set forth in 40 CFR Part 2, Subpart B. In general, submitted information protected by a business confidentiality claim may be disclosed to other employees, officers, or authorized representatives of the United States concerned with implementing the Clean Water Act.

Information covered by a claim of confidentiality will be made available to EPA contractors to enable the contractors to perform the work required by their contracts with EPA. All EPA contracts provide that contractor employees use the information only for the purpose of performing the work required by their contracts and will not disclose any CBI to anyone other than EPA without prior written approval from each affected business or from EPA's legal office. Introduction Draft Detailed Drinking Water Treatment Survey iv GENERAL INSTRUCTIONS FOR SURVEY Read all question specific instructions and definitions of key terms. Carefully read the definitions of key terms ( found on the following pages) and any instructions for specific questions.

Mark responses for each question. Fill in the appropriate response( s) to each question. Please use black ink or type in the spaces provided. Answer the questions in sequence unless you are directed to SKIP. Do not leave any entry blank. If the answer is zero, write " 0" or " zero". If a question is not applicable to your facility, write " NA."

Include any clarifying attachments. If additional attachments are required to clarify a response, please place the associated question number and your facility SDWIS identification number in the top right corner of each page of the attachments. The following list contains examples of items which may be included as attachments to this survey:   Facility brochure, pamphlet, general description;   Piping and residual/ wastewater treatment flow diagrams;   Hard copy summaries of analytical data collected from monitoring locations;   Residual/ wastewater treatment operation and maintenance logs;   Electronic analytical data collected from monitoring locations; and   Pollution prevention or management practices policies or data.

Provide best estimates when data are not available. EPA intends that responses to all questions be based upon available data and information. Please provide best estimates when exact data are not available. If you provide an estimate, note the methods that were used to make the estimate, along with the section and question number to which the estimate refers, on the Comments page in Section 6. You are not required to perform new or non routine tests or measurements solely for the purpose of responding to this survey.

You may need to make copies of some pages before responding. Some pages in the survey will need to be photocopied before you respond. Indicate how many copies of the page you are submitting by completing the entry " Copy ___ of ___" in the top right corner.

Pay close attention to the measurement units requested ( e. g., cubic meters, kilograms). Report answers in the units that are specified, unless the question requires you to specify the units.

Indicate information that should be treated as confidential. You may claim as confidential all information included in the response to a question by checking the Confidential Business Information ( CBI) box next to the question number. Note that you may be required to justify any claim of confidentiality at a later time. See the CONFIDENTIAL BUSINESS INFORMATION section on page iii.

Questions? If you have any questions regarding the completion of this survey, see the SURVEY ASSISTANCE section on page xx for the e mail addresses.

BE SURE TO RETAIN A COPY OF THE COMPLETED SURVEY FOR YOUR RECORDS.

CERTIFICATION STATEMENT The individual responsible for directing or supervising the preparation of the survey must read and sign the Certification Statement listed below. The certifying official must be a responsible corporate official or his/ her authorized representative. Introduction Draft Detailed Drinking Water Treatment Survey v Certification Statement # 1 should be completed and signed if this facility performed drinking water treatment operations during the 2004 calendar year.

Certification Statement # 2 should be completed and signed if this facility did not perform drinking water treatment operations during the 2004 calendar year.

Certification Statement # 1 I certify under penalty of law that the attached survey was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. The information submitted is, to the best of my knowledge and belief, accurate and complete. In those cases where we did not possess the requested information, we provided best estimates. We have to the best of our ability indicated what we believe to be company confidential business information as defined under 40 CFR Part 2, Subpart B. We understand that we may be required at a later time to justify our claim in detail with respect to each item claimed confidential. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment as explained in Section 308 of the Clean Water Act.

Signature of Certifying Official Date ( ) Printed Name of Certifying Official Telephone Number Title of Certifying Official Facility Name ( Continue to Section 1 of the survey)

Certification Statement # 2 I certify under penalty of law that this facility did not perform drinking water treatment operations during the 2004 calendar year. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment as explained in Section 308 of the Clean Water Act.

Signature of Certifying Official Date ( ) Printed Name of Certifying Official Telephone Number Title of Certifying Official Facility Name ( Return the survey along with the signed Certification Statement # 2 to the address provided on page ii) Introduction Draft Detailed Drinking Water Treatment Survey vi DEFINITIONS OF KEY TERMS Barrel  42 gallons Batch Treatment  A discreet volume of wastewater is collected, treated, and discharged.

Centralized Waste Treater ( CWT)  A facility that recycles, reclaims, or treats any hazardous or nonhazardous industrial wastes received from off site and/ or wastes generated on site by the facility.

Clean Water Act ( CWA)  Federal legislation enacted by Congress to " restore and maintain the chemical, physical, and biological integrity of the Nation's waters" ( Federal Water Pollution Control Act of 1972, as amended, 33 U. S. C. 1251 et seq.).

Contract Haul  Collection of wastewater or sludge by a private disposal service, scavenger, or purveyor, in containers for subsequent transportation, treatment, and disposal off site.

Creek  A small, natural stream that is often a shallow or intermittent tributary to a river.

Discharge  The conveyance of wastewater to: ( 1) United States surface waters such as rivers, lakes, and oceans, or ( 2) a publicly owned, privately owned, federally owned, combined, or other treatment works.

Disposal  Intentional placement of waste into or on any land where the material will remain after closure. Waste placed into water is defined as discharge, not disposal.

Drinking Water Treatment Plant  Facility where water is filtered, disinfected, and/ or otherwise treated prior to its transmission into the distribution system ( or its conveyances to another purchasing water utility).

Evaporation  The process by which water or other liquid becomes a gas. Water from land areas, bodies of water, and all other moist surfaces is absorbed into the atmosphere as a vapor.

Facility  Physical location corresponding to the site where industrial and nonindustrial activities are conducted. The activities conducted include, but are not limited to: drinking water supply and treatment operations.

Fall  The dates for the fall season are September 22, 2004 to December 31, 2004.

Federally Owned Treatment Works ( FOTW)  Any device or system owned and/ or operated by a United States federal agency to recycle, reclaim, or treat liquid industrial wastes.

Groundwater  Water in a saturated zone or stratum beneath the surface of land or water.

Groundwater Intake  Point where untreated water from one or more wells is transmitted to a drinking water treatment plant.

Lake  A body of freshwater or saltwater surrounded by land.

Landfill  A natural or man made formation in the earth into which solid waste, sludges, or other process residuals are placed for permanent disposal.

Maximum Daily Flow  The maximum flow in a 24 hour period.

Mud Flat  A relatively level area of fine silt along a shore or around an island, alternately covered and uncovered by the tide, or covered by shallow water. Introduction Draft Detailed Drinking Water Treatment Survey vii NPDES ( National Pollutant Discharge Elimination System)  Program authorized by Sections 307, 318, 402, and 405 of the Clean Water Act that applies to facilities that discharge wastewater directly to United States surface waters.

Playa Lake  Round hollow in the ground in the Southern High Plains of the United States that fills with water and is only present at certain times of the year.

Pollutant  Under the Clean Water Act, a dredged spoil, solid waste, incinerator residue, filter backwash, sewage sludge, munitions, chemical waste, biological material, certain radioactive material, heat, wrecked or discarded equipment, rock sand, cellar dirt, and industrial, municipal, and agricultural waste ( 40 CFR 122.2).

Pollution Prevention  The use of materials, processes, or practices that reduce or eliminate the creation of pollutants or wastes. It includes practices that result in a reduction of residuals or wastewater generation. Pollution prevention consists of source reduction, in process recycle and reuse, and water conservation practices.

Pond  A small, shallow impoundment of fresh water.

Prairie Pothole  A shallow, bowl like depression of variable wetness found in the northern Great Plains of the United States.

Privately Owned Treatment Works ( PrOTW)  Any device or system owned and operated by a private company that is used to recycle, reclaim, or treat liquid industrial wastes not generated by that company.

Process Water  Water applied to the process, including any combination of service water, water recycled from the process, water reused from other processes, and any other water applied to the process.

Publicly Owned Treatment Works ( POTW)  Any device or system owned by a state or municipality that is used to recycle, reclaim, or treat liquid municipal sewage and/ or liquid industrial wastes.

Purchased Water  Water obtained from a third party vendor.

RCRA  Resource Conservation and Recovery Act of 1976 ( 42 U. S. C. Section 6901 et seq.), which regulates the generation, treatment, storage, disposal, or recycling of solid and hazardous waste.

Recycle/ Recovery  The process of recovering usable constituent fractions within a waste material or removal of contaminants from a waste material to allow it to be reused.

Residuals  The waste products generated during potable water treatment process, including organic and inorganic compounds in liquid and solid forms. Examples of residuals include sludges generated from presedimentation and coagulation, membrane reject water, spent backwash, and ion exchange resins.

River  Water which flows in a channel from high ground to low ground and ultimately to a lake or sea.

Safe Drinking Water Act ( SDWA)  Act passed by Congress in 1974 which establishes a cooperative program among local, state, and federal agencies to ensure safe drinking water for consumers ( 42 U. S. C. 300f et seq.).

SDWIS ( Safe Drinking Water Information System)  Database containing information about drinking water treatment plants that is maintained by EPA's Office of Ground Water and Drinking Water.

Sand Flat  A sandy area barren of vegetation that is alternately covered and uncovered by the tide. Introduction Draft Detailed Drinking Water Treatment Survey viii Semi volatile Organic Compound ( SVOC) Substances composed primarily of carbon and hydrogen atoms that have boiling points greater than 200 N C.

Slough  A stagnant swamp, marsh, bog, or pond, especially as part of a bayou, inlet, or backwater.

Sludge  The accumulated solids separated from liquids during processing.

Source Reduction  Any practice prior to recycling, treatment, or disposal that reduces the amount of any hazardous substance, pollutant, or contaminant entering any waste stream or otherwise released into the environment. Source reduction can include equipment or technology modifications, process or procedure modifications, substitution of raw materials, and improvements in housekeeping, maintenance, training, or inventory control.

SPDES ( State Pollutant Discharge Elimination System)  Program that applies to facilities that discharge wastewater directly to state surface waters.

Spring  The dates for the spring season are March 20, 2004 to June 20, 2004.

Storm Water  Any surface runoff related to storm events or snow melt; street wash waters related to street cleaning; or maintenance, infiltration, and drainage.

Summer  The dates for the summer season are June 21, 2004 to September 21, 2004.

Surface Impoundment  A natural topographic depression, man made excavation, or diked area framed primarily of earthen materials ( although it may be lined with man made materials), used to temporarily or permanently treat, store, or dispose of waste. Other common names for surface impoundments include ponds, pits, lagoons, finishing ponds, and settling ponds.

Surface Waters  Waters of the United States including, but not limited to, oceans and all interstate and intrastate lakes, rivers, streams, creeks, mudflats, sand flats, wetlands, sloughs, prairie potholes, wet meadows, playa lakes, and natural ponds.

Surface Water Intake  Point where untreated water from a surface water source is transmitted to a drinking water treatment plant.

Treatment  Any activity designed to change the character or composition of any waste so as to prepare it for transportation, storage, or disposal; render it amenable for recycling or recovery; or reduce it in volume.

Volatile Organic Compound ( VOC)  Any compound of carbon, excluding carbon monoxide, carbon dioxide, carbonic acid, metallic carbides or carbonates, and ammonium carbonate, which participates in atmospheric photochemical reactions. See 40 CFR Part 51.100 for additional detail and exclusions.

Wastewater  Any liquid that comes in direct contact with or results from the treatment of any raw material or waste.

Wastewater Treatment  The processing of wastewater by physical, chemical, biological, or other means to remove specific pollutants from the wastewater stream or to alter the physical or chemical state of specific pollutants in the wastewater stream. Treatment is performed for discharge of treated wastewater, recycle of treated wastewater to the same process which generated the wastewater, or for reuse of the treated wastewater in another process.

Wetland  A tidal or nontidal area characterized by saturated or nearly saturated soils the majority of the year that form an interface between terrestrial and aquatic environments. Examples include freshwater marshes, brackish marshes, and salt marshes.

Wet Meadow  A grassy wetland with saturated soil, but without standing water for most of the year.

Winter  The dates for the winter season are January 1, 2004 to March 19, 2004. Introduction Detailed Drinking Water Treatment Survey ix Zero Discharge or Alternative Disposal Methods  Disposal of process and/ or nonprocess wastewaters other than by direct discharge to a surface water or by indirect discharge to a POTW or PrOTW. Examples include reuse/ recycle and contract hauling. Introduction Detailed Drinking Water Treatment Survey x ABBREVIATIONS/ SYMBOLS avg Average BOD 5 Biochemical oxygen demand ( 5 day) btu British thermal unit CFR Code of Federal Regulations COD Chemical oxygen demand ft Foot ft2 Square foot ft3 Cubic foot GAC Granular activated carbon gal Gallon gpd Gallons per day gpm Gallons per minute in Inch kW Kilowatt kwh Kilowatt hour lb Pound max Maximum MGD Million gallons per day mg/ L Milligrams per liter min Minimum mmcf Million cubic feet NA Not applicable s Second SVOC Semi volatile organic compound TDS Total dissolved solids ton English ton, wet weight TOC Total organic carbon TSS Total suspended solids VOC Volatile organic compound yr Year

C Degrees Celsius

F Degrees Fahrenheit

g/ L Micrograms per liter  S/ cm Microsiemens per centimeter % Percent Facility SDWIS ID_______________________ Section 1: General Facility Information Draft Detailed Drinking Water Treatment Questionnaire 1 CBI?

Yes TECHNICAL INFORMATION SECTION 1: GENERAL FACILITY INFORMATION Attach Facility Address Label Here 1 1. Provide the following information for the primary contact for the technical information supplied in this questionnaire:

( ) Primary Contact Name Telephone Number ( ) Title Fax Number E mail Address Convenient time to call: between am/ pm and am/ pm Street Address or Post Office Box ( Eastern Time)

 City State Zip Code 1 2. Is the information contained in EPA's Safe Drinking Water Information System ( SDWIS) correct for your facility for calendar year 2004?

Yes

No This information can be checked via the Internet at < http:// www. epa. gov/ enviro/ html/ sdwis/ sdwis_ query. html> At the bottom of this page, enter the facility's Water System ID Number ( provided on your mailing label) and press " Enter." This query will provide the Water System Name, County Served, Population Served, Primary Water Source, and System Status for the facility.

1 3. What year did operations begin at the facility? Facility SDWIS ID_______________________ Section 2: Drinking Water Treatment Operations Draft Detailed Drinking Water Treatment Questionnaire 2 CBI?

Yes CBI?

Yes CBI?

Yes SECTION 2: DRINKING WATER TREATMENT OPERATIONS 2 1. Identify the name and location of the source water( s) intake( s) used at the facility in 2004.

Primary Intake name ( Specify):

Primary Intake location ( Specify):

Latitude Longitude 2nd Intake name ( Specify):

2nd Intake location ( Specify):

Latitude Longitude 2 2. What was the average daily water production at the facility in 2004? Select one category.

0.01 MGD or less

> 10  100 MGD

> 0.01  0.10 MGD

> 100  200 MGD

> 0.10  1.0 MGD

More than 200 MGD

> 1  10 MGD 2 3. What was the average daily amount of water treated at the facility in 2004? Select one category.

0.01 MGD or less

> 10  100 MGD

> 0.01  0.10 MGD

> 100  200 MGD

> 0.10  1.0 MGD

More than 200 MGD Facility SDWIS ID_______________________ Section 2: Drinking Water Treatment Operations Draft Detailed Drinking Water Treatment Questionnaire 3 CBI?

Yes 2 4. What were the water treatment objectives at the facility in 2004? Check (

) all that apply.

Algae control

Corrosion control

Disinfection

Dechlorination

Oxidation

Iron removal

Manganese removal

Fluoridation

Taste/ odor control

TOC removal

Particulate/ Turbidity removal

Softening ( hardness removal)

Recarbonation

Organic contaminant removal ( e. g., VOCs)

Inorganic contaminant removal ( e. g., arsenic)

Radionuclides contaminant removal

Other ( Specify): Facility SDWIS ID_______________________ Section 2: Drinking Water Treatment Operations Draft Detailed Drinking Water Treatment Questionnaire 4 CBI?

Yes 2 5. Provide seasonal raw water characteristics for the primary water intake identified in Question 2 1 above for 2004. Identify the minimum, maximum, and average characteristics for each parameter for each season. If seasonal data are unavailable, provide average annual characteristics for 2004. Characteristics data in another readily available form may be attached in lieu of filling out the table. ( See Definitions of Key Terms on page vi for specific dates that comprise each season.)

Parameter Raw Water Characteristics ( mg/ L) ( or specify unit)

Spring Summer Fall Winter Min Max Avg Min Max Avg Min Max Avg Min Max Avg Conventional Parameters Alkalinity Ammonia ( NH 3)

Biochemical oxygen demand ( BOD)

Fecal coliform ( total)

Hardness ( as CaCO 3)

Nitrogen ( total N)

Oil and grease pH Temperature (

C)

Total organic carbon ( TOC)

Total suspended solids ( TSS)

Turbidity ( NTU)

Metals Aluminum ( Al)

Arsenic ( As) (  g/ L)

Barium ( Ba)

Beryllium ( Be)

Boron ( B)

Cadmium ( Cd)

Chromium ( Cr)

Copper ( Cu)

Iron ( Fe)

Lead ( Pb)

Manganese ( Mn)

Mercury ( Hg)

Nickel ( Ni)

Silica ( Si)

Silver ( Ag) Facility SDWIS ID_______________________ Section 2: Drinking Water Treatment Operations Draft Detailed Drinking Water Treatment Questionnaire Parameter Raw Water Characteristics ( mg/ L) ( or specify unit)

Spring Summer Fall Winter Min Max Avg Min Max Avg Min Max Avg Min Max Avg 5 Metals ( Continued)

Thallium ( Tl)

Zinc ( Zn)

Organics Volatile organic compounds ( VOCs) (  g/ L) ( Specify) 1.________________ 2.________________ 3.________________ 4.________________

Semi volatile organic compounds ( SVOCs) (  g/ L) ( Specify) 1.________________ 2.________________ 3.________________ 4.________________

Other Parameters Bromide ( Br)

Calcium ( Ca)

Chemical oxygen demand ( COD)

Chloride ( Cl)

Chlorine ( Cl)

Conductivity (  S/ cm)

Fluoride ( Fl)

Nitrate ( NO 3)

Perchlorate ( ClO 4)

Phosphate ( PO 4)

Radionuclides ( Specify) 1.________________ 2.________________ 3.________________ 4.________________

Sodium ( Na)

Sulfate ( SO 4)

Total dissolved solids ( TDS) Facility SDWIS ID_______________________ Section 3: Schematics Draft Detailed Drinking Water Treatment Questionnaire 6 CBI?

Yes SECTION 3: SCHEMATICS 3 1. Drinking Water Treatment Schematic Flow Diagram for 2004 Attach a schematic flow diagram illustrating the treatment processes used at the facility in 2004. For each treatment process, identify the treatment chemicals used ( e. g., sulfuric acid for pH adjustment, scale inhibitor ahead of membrane treatment), frequency of chemical usage, flow rates for waste streams, and waste streams that generate residuals. You are not required to create a new diagram if an existing diagram will provide the requested information. Put the facility SDWIS ID number ( as shown on the mailing label on the questionnaire cover page) in the upper left corner, and number each diagram if you have multiple diagrams. Specific instructions and an example diagram are provided below. Review and check the following list to ensure that your schematic flow diagram is complete.

Drinking Water Treatment Schematic Flow Diagram Checklist Be sure to...

Identify and label all drinking water treatment processes/ areas ( see drinking water

treatment codes on page 10) used in 2004. If you have more than one of a certain type of unit, assign each unit a unique number on the diagram. For example, if you have two presedimentation basins, label the basins as PSB 1 and PSB 2 on the diagram.

Identify all treatment chemicals used in each step of the process. Identify whether

the chemicals are used routinely, seasonally, or in response to specific water quality situations.

Identify and label all treatment residuals streams and their destination.

Include average flow rates for waste streams. Provide estimates when actual data are not

available and provide the method of estimation ( e. g., meter, pipe size, best judgment). If flow is intermittent, provide amount and frequency; for example " 100 gal, twice/ day; 1000 gal, 4 months/ year."

Include and label recycle, recovery, or reuse ( e. g., filter backwash recycle) operations.

Number each schematic flow diagram ( e. g., Schematic Flow Diagram # 1) if multiple

diagrams are provided.

Review: If any of the statements above were not checked off, please revise the Schematic Flow Diagram( s) Facility SDWIS ID_______________________ Section 3: Schematics Draft Detailed Drinking Water Treatment Questionnaire 7 EXAMPLE DRINKING WATER TREATMENT SCHEMATIC FLOW DIAGRAM # 1 of 1 Facility SDWIS ID_______________________ Section 3: Schematics Draft Detailed Drinking Water Treatment Questionnaire 8 CBI?

Yes DRINKING WATER TREATMENT SCHEMATIC FLOW DIAGRAM # ____ of ___ Facility SDWIS ID_______________________ Section 3: Schematics Draft Detailed Drinking Water Treatment Questionnaire 9 DRINKING WATER TREATMENT UNIT CODES Code Treatment Unit/ Operation CH Chlorination only PSB Raw water storage/ presedimentation basin PDS Predisinfection/ oxidation prior to sedimentation PDO Predisinfection/ oxidation RM Rapid mix CF Coagulation/ flocculation CL Clarification FC Filter clearwell FR Finished water reservoir SF Softening STP Sedimentation tanks and ponds GMF Granular media filtration PDF Post disinfection after filters RO Reverse osmosis MF Microfiltration UF Ultrafiltration NF Nanofiltration IX Ion exchange CC Corrosion control OT1 Other ( Specify):

OT2 Other ( Specify):

OT3 Other ( Specify): Facility SDWIS ID_______________________ Section 3: Schematics Draft Detailed Drinking Water Treatment Questionnaire 10 CBI?

Yes 3 2. Drinking Water Treatment Residuals Schematic Flow Diagram for 2004 Attach a schematic flow diagram illustrating the processes used to treat and/ or dispose of all residuals generated at the facility. You are not required to create a new diagram if an existing diagram will provide the requested information. Put the facility SDWIS ID number ( as shown on the mailing label on the questionnaire cover page) in the upper left corner, and number each diagram if you have multiple diagrams. Specific instructions and an example diagram are provided below. Review and check the following list to ensure that the schematic flow diagram is complete. NOTE: You may combine this schematic with the drinking water treatment schematic requested in Question 3 1.

Drinking Water Treatment Residuals Schematic Flow Diagram Checklist Be sure to...

Identify and label all drinking water treatment residuals.

Include and label all units used to treat residuals in 2004 ( see residuals treatment unit codes on page 14). If you have more than one of a certain type of unit, assign each unit a unique number on the diagram. For example, if you have two evaporation ponds, label the ponds as EP 1 and EP 2 on the diagram. These unit labels will be used to complete Question 4 10.

Identify and label all sources entering the residuals treatment system. Sources include, but are not limited to: filter backwash water, sludge, filter material, reuse and backwash water from ion exchange operations, regeneration liquid, resin, reject water from reverse osmosis, greensand media, and sorbent media.

Identify and label all residuals destinations using destination codes provided on page 14.

Include all chemical additions to residuals treatment units.

Include all residuals recycle/ reuse streams.

Include flow rates/ discharge quantities for all streams, indicating the basis ( e. g., daily, monthly, annually).

Indicate all significant losses of water ( e. g., evaporation losses). If exact numbers are not available, please estimate.

Indicate all locations at which residuals samples are routinely collected for analysis with the letters " SP" and a unique sample point number ( i. e., SP1, SP2).

Number each schematic flow diagram ( e. g., Schematic Residuals Flow Diagram # 1) if multiple diagrams are provided.

Review: If any of the statements above were not checked off, please revise the Schematic Flow Diagram( s) Facility SDWIS ID_______________________ Section 3: Schematics Draft Detailed Drinking Water Treatment Questionnaire 11 EXAMPLE DRINKING WATER TREATMENT RESIDUALS SCHEMATIC FLOW DIAGRAM # 1 of 1 Facility SDWIS ID_______________________ Section 3: Schematics Draft Detailed Drinking Water Treatment Questionnaire 12 CBI?

Yes DRINKING WATER TREATMENT RESIDUALS SCHEMATIC FLOW DIAGRAM # ____ of ____ Facility SDWIS ID_______________________ Section 3: Schematics Draft Detailed Drinking Water Treatment Questionnaire 13 RESIDUALS TREATMENT UNIT CODES Code Treatment Unit/ Operation DW Dewatering DR Drying TH Thickener CR Coagulant recovery LR Lime recovery ECB Evaporation and cystallization of brine AR Aeration HSR Hydrogen sulfide removal PH pH adjustment STP Sedimentation tanks and ponds EP Evaporation ponds OTR1 Other ( specify):

OTR2 Other ( specify):

OTR3 Other ( specify):

RESIDUALS DESTINATION CODES Code Residuals Destination PO POTW SW Surface waters EV Evaporated from unit on site SS Storm water sewer RE Recycled/ reused in drinking water treatment operations UI Underground injection LR Licensed low level radioactive waste disposal site CH FO Contract hauled to a federally owned treatment works CH PR Contract hauled to a privately owned treatment works CH CW Contract hauled to a centralized waste treater LF Landfill disposal SI Spray irrigation CP Composting OD On site disposal LA Land application OTD1 Other disposal ( specify on Residuals Diagram) Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 14 CBI?

Yes CBI?

Yes CBI?

Yes CBI?

Yes CBI?

Yes SECTION 4: RESIDUALS MANAGEMENT, COST, AND ANALYTICAL DATA 4 1. During 2004, did the facility discharge drinking water treatment residuals to a publicly owned treatment works ( POTW)?

Yes

No ( Skip to Question 4 5)

4 2. Please provide the name, contact name, address, and telephone number of the POTW.

Name of POTW POTW Contact Name ( ) Street Address Telephone Number  City State Zip Code 4 3. Please provide the number and date of the facility's indirect discharge permit/ agreement with the POTW identified above in Question 4 2.

Indirect Discharge Permit/ Agreement Number Date of Permit/ Agreement 4 4. Indicate (

) ALL types of water regulated by this POTW discharge permit/ agreement in 2004.

Sludges/ wastewater from drinking water treatment operations including presedimentation, coagulation, filter backwashing operations, lime softening, iron and manganese removal, and slow sand and diatomaceous earth filtration

Discharges from residuals treatment including thickener decant, centrate, and filtrate from belt presses or plate and frame and dewatering lagoons

Concentrate ( brines) from ion exchange regeneration and salt water conversion, membrane reject water and spent backwash, activated alumina waste regenerant, and membrane cleaning fluid

Storm water collected from areas associated with drinking water treatment operations

Storm water collected from areas not associated with drinking water treatment operations.

Ion exchange resins, spent GAC, and spent filter media

Other ( specify):

Other ( specify):

Other ( specify):

4 5. During 2004, did the facility discharge drinking water treatment residuals/ wastewater to surface waters?

Yes

No ( Skip to Question 4 9) Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 15 CBI?

Yes CBI?

Yes 4 6. Please provide the facility's NPDES/ SPDES permit number( s), the name of the receiving water or the coordinates ( latitude/ longitude) for your discharge outfall , and (

) the type of receiving water. ( See Definitions of Key Terms on page vi for explanation of receiving water types.)

Also, please ATTACH a copy of the facility's NPDES/ SPDES permit and fact sheet ( if available) to this survey.

Name of receiving water NPDES/ SPDES Permit Number or coordinates of outfall discharge Latitude Longitude Type of Receiving Water

River

Creek

Wetland

Wet meadow

Other ( Specify):

Lake

Pond

Slough

Playa Lake

Ocean

Sand flat

Mudflat

Prairie pothole 4 7. Has your facility conducted monitoring or other studies to assess the potential impact of discharges to receiving waters?

Yes ( please provide an appropriate point of contact for additional information below)

No ( ) Contact Name Telephone Number ( ) Title Fax Number E mail Address Convenient time to call: between am/ pm and am/ pm Street Address or Post Office Box ( Eastern Time)

 City State Zip Code Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 16 CBI?

Yes CBI?

Yes

Yes CBI? 4 8. Indicate (

) ALL types of water regulated by this NPDES/ SPDES discharge permit in 2004.

Sludges/ wastewater from drinking water treatment operations including presedimentation, coagulation, filter backwashing operations, lime softening, iron and manganese removal, and slow sand and diatomaceous earth filtration

Discharges from residuals treatment including thickener decant, centrate, and filtrate from belt presses or plate and frame and dewatering lagoons

Concentrate ( brines) from ion exchange regeneration and salt water conversion, membrane reject water and spent backwash, activated alumina waste regenerant, and membrane cleaning fluid

Storm water collected from areas associated with drinking water treatment operations

Storm water collected from areas not associated with drinking water treatment operations

Ion exchange resins, spent GAC, and spent filter media

Other ( specify):

Other ( specify):

Other ( specify):

4 9. Is there land available on site to construct any or additional residuals treatment units?

Yes

No 4 10. Did the facility treat any residuals generated at the facility in 2004?

Yes

No ( Skip to Question 4 13 on page 37) Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 17 CBI?

Yes 4 11. Provide the requested information for each unit operation used to manage drinking water treatment residuals in 2004. This question is divided into 12 tables listed below:

A. Thickening B. Mechanical dewatering ( vacuum filter, continuous belt filter press, plate pressure filter, centrifuge) C. Drying ( sand drying beds, freeze assisted sand beds, solar drying beds, vacuum  assisted drying beds, wedgewire beds, lagoons, evaporation ponds) D. pH adjustment E. Evaporation and crystallization of brine F. Other treatment unit/ operation ( specify) G. On site disposal H. Off site land application I. Off site landfill disposal J. Haul to POTW/ PrOTW/ FOTW/ CWT K. Underground injection L. Other off site disposal ( specify)

For each residual management operation that the facility uses, please complete the table that best describes the practice. Complete Table 4 11F ( Other Treatment Unit/ Operation) and Table 4 11L ( Other Off Site Disposal) to describe any treatment unit operations and disposal operations indicated on the Residuals Treatment Diagram that do not fit into Tables 4 11A through 4 11K.

Instructions for completing this table are provided below.

Answer the first question in each table. If the answer is yes, complete the remainder of the table.

Complete the appropriate tables for each residuals management operation at the facility.

Write the treatment unit code or residuals destination code ( from the Residuals Treatment Diagram) in the box provided at the top of the table on each page.

Be sure to provide the type of unit or operation, if applicable, and provide values for all parameters that apply.

Provide average daily and daily maximum flows for all influent and effluent streams associated with this unit or operation.

Check the Residuals Diagram to ensure that questions have been completed for each residuals treatment unit/ operation indicated on the diagram.

If exact data are not available, please provide estimates. Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 18 TABLE 4 11A. THICKENING a. Does your facility use thickening? . . . . . . . . .

Yes

No ( Skip to Table 4 11B)

b. Facility terminology for this unit . . . . . . . . . . .

c. Type of unit . . . . . . . . . . . . . . . . . . . . . . . . . .

Gravity

Flotation

Centrifuge

Rotating Drum d. Is the unit operated in batch or continuous mode? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Batch

Continuous e. Design capacity flow . . . . . . . . . . . . . . . . . . . gal/ day f. Average number of hours per day operated in 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . hours/ day g. Number of days per year operated in 2004 . . days/ year h. Residence time . . . . . . . . . . . . . . . . . . . . . . . hours or days i. Does mechanical mixing occur in this unit? . .

Yes

No j. Percent solids of sludge entering unit . . . . . . % solids k. Provide thickening agent information:

Thickening Agent Consumption Rate _____ gal/ day _____ lbs/ day _____ gal/ day _____ lbs/ day _____ gal/ day _____ lbs/ day l. Amount of thickened sludge generated daily in 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lb/ day OR gal/ day m. Percent solids of the sludge leaving the unit % solids Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 19 TABLE 4 11A. THICKENING ( Continued)

n. Provide cost information for the unit:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Chemical costs:

Energy costs ( electricity, gas, fuel oil, etc.): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 20 TABLE 4 11B. MECHANICAL DEWATERING a. Does your facility use mechanical dewatering? . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No ( Skip to Table 4 11C)

b. Facility terminology for this unit . . . . . . . . . . .

c. Type of unit . . . . . . . . . . . . . . . . . . . . . . . . . .

Vacuum Filter

Plate Pressure Filter

Continuous Belt Filter Press

Centrifuge d. Is the unit operated in batch or continuous mode? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Batch

Continuous e. Design capacity flow . . . . . . . . . . . . . . . . . . . gal/ day f. Average number of hours per day operated in 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . hours/ day g. Number of days per year operated in 2004 . . days/ year h. Percent solids of sludge entering unit . . . . . . % solids i. Are any chemicals added to this unit? . . . . . .

Yes

No ( Skip to Question k)

j. Provide the chemical name:

Chemical Purpose Consumption Rate _____ gal/ day _____ lbs/ day _____ gal/ day _____ lbs/ day _____ gal/ day _____ lbs/ day k. Amount of solids generated daily in 2004 . . . lb/ day OR gal/ day l. Percent solids of the dewatered sludge . . . . . % solids m. Frequency of solids removal . . . . . . . . . . . . .

Daily

Weekly

Monthly

Other ( specify): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 21 TABLE 4 11B. MECHANICAL DEWATERING ( Continued)

n. Solids disposal method . . . . . . . . . . . . . . . . .

Landfill

Residuals Reuse

Land Application

Other ( specify):

o. Is the water generated during the dewatering process recycled? . . . . . . . . . . . . . . . . . . . . .

Yes

No p. Provide cost information for the unit:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Chemical costs:

Energy costs ( electricity, gas, fuel oil, etc.): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 22 TABLE 4 11C. DRYING a. Does your facility use drying? . . . . . . . . . . . .

Yes

No ( Skip to Table 4 11D)

b. Facility terminology for this unit . . . . . . . . . . .

c. Type of unit . . . . . . . . . . . . . . . . . . . . . . . . . .

Sand Drying Bed

Solar Drying Bed

Wedgewire Bed

Lagoon

Freeze Assisted Sand Bed

Vacuum Assisted Drying Bed

Other ( Specify):

d. Is the unit operated in batch or continuous mode? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Batch

Continuous e. Average number of hours per day operated in 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . hours/ day f. Number of days per year operated in 2004 . . days/ year g. Percent solids of sludge entering unit . . . . . . % solids h. Design capacity flow . . . . . . . . . . . . . . . . . . . gal/ day i. Bed or pond capacity . . . . . . . . . . . . . . . . . . . gallons j. Depth of bed or pond . . . . . . . . . . . . . . . . . . . feet k. Surface area of bed or pond . . . . . . . . . . . . . ft2 l. Is the unit drained? . . . . . . . . . . . . . . . . . . . .

Yes

No ( Skip to Question n)

m. Designed drainage rate . . . . . . . . . . . . . . . . . in/ day n. Designed evaporation rate . . . . . . . . . . . . . . in/ day o. Are any chemicals added to this unit?

Yes

No ( Skip to Question q) Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 23 TABLE 4 11C. DRYING ( Continued)

p. Provide the chemical name:

Chemical Purpose Consumption Rate _____ gal/ day _____ lbs/ day _____ gal/ day _____ lbs/ day q. How much sludge was generated daily in 2004? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lb/ day OR gal/ day r. Percent solids of the sludge leaving the unit % solids s. Frequency of solids removal . . . . . . . . . . . . .

Daily

Weekly

Monthly

Other ( specify):

t. How is the sludge disposed of? . . . . . . . . . . .

Landfill

Residuals Reuse

Land Application

Other ( specify):

u. Provide cost information for the unit:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Chemical costs:

Energy costs ( electricity, gas, fuel oil, etc.): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 24 TABLE 4 11D. pH ADJUSTMENT a. Does your facility use pH adjustment? . . . . . .

Yes

No ( Skip to Table 4 11E)

b. Facility terminology for this unit . . . . . . . . . . .

c. Is the unit operated in batch or continuous mode? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Batch

Continuous d. Design capacity flow . . . . . . . . . . . . . . . . . . . gal/ day e. Average number of hours per day operated in 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . hours/ day f. Number of days per year operated in 2004 . . days/ year g. Residence time . . . . . . . . . . . . . . . . . . . . . . . hours or days h. Does mechanical mixing occur in this unit? . .

Yes

No i. Percent solids of sludge entering unit . . . . . . % solids j. Are any chemicals added to this unit? . . . . . .

Yes

No ( Skip to Question l)

k. Provide the chemical name:

Chemical Purpose Consumption Rate _____ gal/ day _____ lbs/ day _____ gal/ day _____ lbs/ day l. Is sludge collected from this unit? . . . . . . . . .

Yes

No ( Skip to Question p)

m. How much sludge was collected daily in 2004? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lb/ day OR gal/ day n. How often was sludge collected from this unit in 2004? . . . . . . . . . . . . . . . . . . . . . . . . . . . . times per year Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 25 TABLE 4 11D. pH ADJUSTMENT ( Continued)

o. What was the percent solids of the sludge leaving the unit? . . . . . . . . . . . . . . . . . . . . . . % solids p. Provide cost information for the unit:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Chemical costs:

Energy costs ( electricity, gas, fuel oil, etc.): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 26 TABLE 4 11E. EVAPORATION AND CRYSTALLIZATION OF BRINES a. Does your facility use evaporation and crystallization of brines?

Yes

No ( Skip to Table 4 11F)

b. Facility terminology for this unit . . . . . . . . . . .

c. Is the unit operated in batch or continuous mode? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Batch

Continuous d. Design capacity flow . . . . . . . . . . . . . . . . . . . gal/ day e. Average number of hours per day operated in 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . hours/ day f. Number of days per year operated in 2004 . . days/ year g. Residence time . . . . . . . . . . . . . . . . . . . . . . . hours or days h. Feed TDS concentration . . . . . . . . . . . . . . . . ppm i. Feed temperature . . . . . . . . . . . . . . . . . . . . . N F j. Feed slurry concentration . . . . . . . . . . . . . . . % solids k. Energy requirements/ 1,000 gal . . . . . . . . . . . kwh l. Are any chemicals added to this unit? . . . . . .

Yes

No ( Skip to Question n)

m. Provide the chemical name:

Chemical Purpose Consumption Rate _____ gal/ day _____ lbs/ day _____ gal/ day _____ lbs/ day n. TDS of waste brine . . . . . . . . . . . . . . . . . . . . ppm o. Total solids waste brine . . . . . . . . . . . . . . . . . % solids p. Distillate TDS . . . . . . . . . . . . . . . . . . . . . . . . ppm Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 27 TABLE 4 11E. EVAPORATION AND CRYSTALLIZATION OF BRINES ( Continued)

q. Disposal method of waste brine . . . . . . . . . . .

Deep Well Injection

Surface Water Discharge

Spray Irrigation

Sanitary Sewer

Other ( specify):

r. Provide cost information for the unit:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Chemical costs:

Energy costs ( electricity, gas, fuel oil, etc.): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 28 TABLE 4 11F. OTHER TREATMENT UNIT/ OPERATION a. Does your facility use another type of treatment unit not previously specified? . . . .

Yes

No ( Skip to Table 4 11G)

b. Facility terminology for this unit . . . . . . . . . . .

c. Source of Influent Streams to Treatment Unit Average Daily Flow in 2004 Daily Maximum Flow in 2004 ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year d.

Destination of Residuals Flow from Treatment Unit Average Daily Discharge Rate in 2004 Daily Maximum Discharge Rate in 2004 ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year ____ gallons per day ____ days per year e. Is the unit operated in batch or continuous mode? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Batch

Continuous f. Which parameters/ pollutants are targeted for removal by this unit?

g. Design capacity flow . . . . . . . . . . . . . . . . . . . gal/ day h. Tank or pond capacity . . . . . . . . . . . . . . . . . . gallons i. Average number of hours per day operated in 2004 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . hours/ day j. Number of days per year operated in 2004 . . days/ year Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 29 TABLE 4 11F. OTHER TREATMENT UNIT/ OPERATION ( Continued)

k. Does mechanical mixing occur in this unit?

Yes

No l. Are any chemicals added to this unit?

Yes

No ( Skip to Question n)

m. Provide the chemical name:

Chemical Purpose Consumption Rate _____ gal/ day _____ lbs/ day _____ gal/ day _____ lbs/ day n. Is sludge collected from this unit? . . . . . . . . .

Yes

No ( Skip to Question r)

o. How much sludge was collected daily in 2004? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lb/ day OR gal/ day p. How often was sludge collected from this unit in 2004? . . . . . . . . . . . . . . . . . . . . . . . . . . . . times per year q. What was the percent solids of the sludge? . . % solids r. Provide cost information for the unit:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Chemical costs: Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 30 TABLE 4 11G. ON SITE DISPOSAL a. Does your facility dispose of residuals on site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No ( Skip to Table 4 11H)

b. Facility terminology for this operation . . . . . .

c. How often do you dispose of residuals on site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d. Quantity of residuals disposed of on site annually . . . . . . . . . . . . . . . . . . . . . . . . . . . . lbs/ year e. How many trucks are required to haul residuals that are disposed of on site per disposal event? . . . . . . . . . . . . . . . . . . . . . . . trucks f. What is the quantity of residuals hauled in each truck load? . . . . . . . . . . . . . . . . . . . . . . lbs/ truck g. What is the distance the trucks travel to the disposal location? . . . . . . . . . . . . . . . . . . . . . miles/ one way h. Do you perform waste characterization of the residuals before you dispose of them on site? ( e. g., sample or test the residuals for certain components) . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No i. Percent solids of sludge disposed of on site % solids j. Provide cost information for the operation:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Energy costs ( electricity, gas, fuel, etc.):

Other ( specify): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 31 TABLE 4 11H. OFF SITE LAND APPLICATION a. Does your facility dispose of residuals through off site land application? . . . . . . . . . .

Yes

No ( Skip to Table 4 11I)

b. Facility terminology for this operation . . . . . .

c. How often do you dispose of residuals through off site land application? . . . . . . . . . .

d. Quantity of residuals disposed of through offsite land application annually . . . . . . . . . . . . . lbs/ year e. How many trucks are required to haul residuals that are disposed of through off site land application per disposal event? . . . . . . . trucks f. What is the quantity of residuals hauled in each truck load? . . . . . . . . . . . . . . . . . . . . . . lbs/ truck g. What is the distance the trucks travel to the disposal location? . . . . . . . . . . . . . . . . . . . . . miles/ one way h. Do you perform waste characterization of the residuals before you dispose of them through off site land application? ( e. g., sample or test the residuals for certain components) . . . . . .

Yes

No i. Percent solids of sludge disposed of off site % solids j. Provide cost information for the operation:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Energy costs ( electricity, gas, fuel, etc.):

Other ( specify): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 32 TABLE 4 11I. OFF SITE LANDFILL DISPOSAL a. Does your facility dispose of residuals in an off site landfill? . . . . . . . . . . . . . . . . . . . . . . .

Yes

No ( Skip to Table 4 11J)

b. Facility terminology for this operation . . . . . .

c. How often do you dispose of residuals at the off site landfill? . . . . . . . . . . . . . . . . . . . . . . .

d. Quantity of residuals disposed of at the offsite landfill annually . . . . . . . . . . . . . . . . . . . . lbs/ year e. How many trucks are required to haul residuals that are disposed of at the off site landfill per disposal event? . . . . . . . . . . . . . . trucks f. What is the quantity of residuals hauled in each truck load? . . . . . . . . . . . . . . . . . . . . . . lbs/ truck g. What is the distance the trucks travel to the disposal location? . . . . . . . . . . . . . . . . . . . . . miles/ one way h. Do you perform waste characterization of the residuals before you dispose of them at the off site landfill? ( e. g., sample or test the residuals for certain components) . . . . . . . . .

Yes

No i. Percent solids of sludge disposed of in the off site landfill . . . . . . . . . . . . . . . . . . . . . . . . % solids j. Provide cost information for the operation:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Energy costs ( electricity, gas, fuel, etc.):

Other ( specify): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 33 TABLE 4 11J. HAUL TO POTW/ PrOTW/ FOTW/ CWT a. Does your facility dispose of residuals by hauling them to a POTW, PrOTW, FOTW, or CWT? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No ( Skip to Table 4 11K)

b. Facility terminology for this operation . . . . . .

c. How often do you dispose of residuals by this method? . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d. Quantity of residuals disposed of by this method annually . . . . . . . . . . . . . . . . . . . . . . lbs/ year e. How many trucks are required to haul residuals that are disposed of at a POTW, PrOTW, FOTW, or CWT per disposal event? trucks f. What is the quantity of residuals hauled in each truck load? . . . . . . . . . . . . . . . . . . . . . . lbs/ truck g. What is the distance the trucks travel to the disposal location? . . . . . . . . . . . . . . . . . . . . . miles/ one way h. Do you perform waste characterization of the residuals before you dispose of them by this method? ( e. g., sample or test the residuals for certain components) . . . . . . . . . . . . . . . . .

Yes

No i. Percent solids of sludge hauled to facility . . . % solids j. Provide cost information for the operation:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Energy costs ( electricity, gas, fuel oil, etc.):

Other ( specify): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 34 TABLE 4 11K. UNDERGROUND INJECTION a. Does your facility dispose of residuals by underground injection? . . . . . . . . . . . . . . . .

Yes

No ( Skip to Table 4 11L)

b. Facility terminology for this operation . . . . . .

c. How often do you dispose of residuals on site? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d. Quantity of residuals disposed of by underground injection annually . . . . . . . . . . . gal/ year e. Are trucks used to transport residuals to the injection site? . . . . . . . . . . . . . . . . . . . . . . . .

Yes

No ( Skip to Question i)

f. How many trucks are required to haul residuals to the injection site per disposal event? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . trucks g. What is the quantity of residuals hauled in each truck load? . . . . . . . . . . . . . . . . . . . . . . gal/ truck h. What is the distance the trucks travel to the disposal location? . . . . . . . . . . . . . . . . . . . . . miles/ one way i. Do you perform waste characterization of the residuals before you dispose of them by underground injection? ( e. g., sample or test the residuals for certain components) . . . . . .

Yes

No j. Percent solids of residuals disposed of via underground injection . . . . . . . . . . . . . . . . . . % solids k. Provide cost information for the operation:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Energy costs ( electricity, gas, fuel oil, etc.):

Other ( specify): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 35 TABLE 4 11L. OTHER OFF SITE DISPOSAL a. Does your facility dispose of residuals through another off site disposal method not previously specified? . . . . . . . . . . . . . . . . . . .

Yes

No ( Skip to Question 4 12)

b. Facility terminology for this operation . . . . . .

c. How often do you dispose of residuals by this method? . . . . . . . . . . . . . . . . . . . . . . . . . . . .

d. Quantity of residuals disposed of by this method annually . . . . . . . . . . . . . . . . . . . . . . lbs/ year e. How many trucks are required to haul residuals that are disposed of by this method per disposal event? . . . . . . . . . . . . . . . . . . . . trucks f. What is the quantity of residuals hauled in each truck load? . . . . . . . . . . . . . . . . . . . . . . lbs/ truck g. What is the distance the trucks travel to the disposal location? . . . . . . . . . . . . . . . . . . . . . miles/ one way h. Do you perform waste characterization of the residuals before you dispose of them by this method? ( e. g., sample or test the residuals for certain components) . . . . . . . . . . . . . . . . .

Yes

No i. Percent solids of residuals disposed of off site . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . % solids j. Provide cost information for the operation:

O& M Category Cost ($)

Labor ( operating and maintenance):

Maintenance ( materials and vendors):

Sampling/ monitoring costs:

Energy costs ( electricity, gas, fuel oil, etc.):

Other ( specify): Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 36 4 12. Provide actual operating and maintenance ( O& M) costs paid and rates for the facility's residuals management system during 2004. If actual costs and rates are not available, provide best estimates. Include operating labor, maintenance, sampling/ monitoring costs, chemical costs, energy costs, steam costs, and sludge, oil, or other residuals disposal fees. Also include rates of labor, energy, steam, and sludge, oil, and other residuals disposal fees.

O& M Category Cost Rate Labor ( operating and maintenance) $ $________ per hour ( average rate of labor)

Maintenance ( materials and vendors) $

Sampling/ monitoring costs $

Chemical costs $

Energy costs  electricity $ $________ per kwh Energy costs  gas $ $________ per

mmcf

million btu Energy costs  fuel oil $ $________ per

gallon

barrel Energy costs  other ( specify): $ $________ per ( specify unit of measurement):

RCRA hazardous waste disposal $ $________ per

gallon

ton Nonhazardous waste disposal $ $________ per

gallon

ton Contract Hauling $ $________ per

gallon

ton Other disposal, if other classifications apply to the area ( specify type): $ $________ per

gallon

ton Other ( specify): $

Other ( specify): $

Other ( specify): $

RCRA = Resource Conservation and Recovery Act mmcf = million cubic feet kwh = kilowatt hour btu = British thermal unit barrel = 42 gallons ton = English ton, wet weight Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 37 CBI?

Yes CBI?

Yes Analytical Data 4 13. Were samples collected and analyzed to characterize/ monitor any drinking water treatment residuals generated at the facility in 2004?

Yes

No ( Skip to Section 5, Question 5 1)

4 14. In the following table, please provide the requested information for each sampling point reported in Question 3 2 ( Residuals Diagram). Instructions for completing the table are provided below.

Complete the questions for each sampling point at the facility. Photocopy Question 4 14 for each sampling point before writing on it, and number each copy in the space provided in the top right corner.

Provide a description of the waste stream and its corresponding average flow rate. Include units for flow rate ( e. g., gallons per minute).

Identify (

) the pollutants that were monitored.

Identify how many times during 2004 these pollutants were monitored.

Indicate whether the samples were grab or composite.

Identify the analytical method used to analyze the sample for each pollutant.

Identify the detection limit for the pollutant using the specified analytical method.

Provide the range of pollutant concentrations, including an average, that were obtained during monitoring.

NOTES:

Electronic or hard copies of monitoring reports can be submitted in lieu of filling out the table in Question 4 14.

EPA reserves the right to contact the facility for additional data. Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data 38 CBI?

Yes Copy ___ of ___ 4 14. Residuals Sampling and Analysis Data Sampling Point: ( from Residuals Diagram # ) Waste Stream Name/ Description: Average Flow Rate ( specify units):

Monitored Pollutants/ Parameters Frequency of monitoring events ( e. g., daily, weekly, monthly) Type of Sample ( grab, composite) Analytical Method Detection Limit ( mg/ L) Range ( Min, Max, Avg) of pollutant concentrations for 2004 ( Specify unit of concentration)

Conventional Parameters

Alkalinity

Ammonia ( NH 3)

Biochemical oxygen demand ( BOD)

Fecal coliform ( total)

Hardness ( as CaCO 3)

Nitrogen ( total N)

Oil and Grease

pH

Temperature (

C)

Total organic carbon ( TOC)

Total suspended solids ( TSS)

Turbidity ( NTU)

Metals

Aluminum ( Al)

Arsenic ( As) (  g/ L)

Barium ( Ba)

Beryllium ( Be)

Boron ( B)

Cadmium ( Cd)

Chromium ( Cr)

Copper ( Cu)

Iron ( Fe) Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data Monitored Pollutants/ Parameters Frequency of monitoring events ( e. g., daily, weekly, monthly) Type of Sample ( grab, composite) Analytical Method Detection Limit ( mg/ L) Range ( Min, Max, Avg) of pollutant concentrations for 2004 ( Specify unit of concentration)

39 Metals ( Continued)

Lead ( Pb)

Manganese ( Mn)

Mercury ( Hg)

Nickel ( Ni)

Silica ( Si)

Silver ( Ag)

Thallium ( Tl)

Zinc ( Zn)

Others Organics

Volatile organic compounds ( VOCs) ( Specify) 1. 2. 3. 4.

Semi volatile organic compounds ( SVOCs) ( Specify) 1. 2. 3. 4.

Other Parameters

Bromide ( Br)

Calcium ( Ca)

Chemical oxygen demand ( COD)

Chloride ( Cl)

Chlorine ( Cl)

Conductivity (  S/ cm)

Fluoride ( Fl) Facility SDWIS ID_______________________ Draft Detailed Drinking Water Treatment Questionnaire Section 4: Residuals Management, Cost, and Analytical Data Monitored Pollutants/ Parameters Frequency of monitoring events ( e. g., daily, weekly, monthly) Type of Sample ( grab, composite) Analytical Method Detection Limit ( mg/ L) Range ( Min, Max, Avg) of pollutant concentrations for 2004 ( Specify unit of concentration)

40 Other Parameters ( Continued)

Nitrate ( NO 3)

Perchlorate ( ClO 4)

Phosphate ( PO 4)

Radionuclides 1. 2. 3. 4.

Sodium ( Na)

Sulfate ( SO 4)

Total Dissolved Solids ( TDS)

Others Facility SDWIS ID_______________________ Section 5: Practices That Reduce Residuals Generation Draft Detailed Drinking Water Treatment Questionnaire 41 CBI?

Yes SECTION 5: PRACTICES THAT REDUCE RESIDUALS GENERATION 5 1. Below is a list of practices that reduce the quantity of residuals or chemicals discharged/ disposed. For each practice performed at the facility, please complete the associated table that best describes the practice. Complete Table 5 1F ( Other Practice) to describe any residuals reduction practices that do not fit into Tables 5 1A to 5 1E. Only complete the tables that are applicable to the practices at the facility in 2004.

A. Adjust source water and intake locations to maximize raw water quality B. Chemical recovery ( e. g., lime or coagulant recovery) C. Beneficial reuse ( e. g., development of co products, such as bricks or cement, or blending residuals with compost material) D. Best management practices ( BMPs) E. Recycling of all wastewater from residuals treatment to plant headworks F. Other practice ( specify) Facility SDWIS ID_______________________ Section 5: Practices That Reduce Residuals Generation Draft Detailed Drinking Water Treatment Questionnaire 42 Type of Solid Total Decrease in Annual Quantity Discharged ( lb/ yr) Total Increase in Annual Quantity Discharged ( lb/ yr)

Chemical/ Pollutant Total Decrease in Annual Quantity Discharged Total Increase in Annual Quantity Discharged

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr TABLE 5 1A. Adjust source water and intake locations to maximize raw water quality a. Describe practice:

b. List affected drinking water treatment residuals streams:

c. Cost and/ or savings of implementing practice in 2004: Cost of installation/ implementation . . . . . . . . . . . . . Net change in operating costs as a result of the practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

d. What was the reduction in the quantity of residuals generated in 2004 as a result of this activity? . . . . . . . . gal/ day ( lb/ day)

e. What was the change in the quantity of solids generated in 2004?

f. Did the practice result in a change in chemicals/ pollutants discharged in residuals in 2004? . .

Yes

No ( Skip to next table)

g. What was the change in chemicals/ pollutants discharged in the residuals in 2004? Facility SDWIS ID_______________________ Section 5: Practices That Reduce Residuals Generation Draft Detailed Drinking Water Treatment Questionnaire 43 Type of Solid Total Decrease in Annual Quantity Discharged ( lb/ yr) Total Increase in Annual Quantity Discharged ( lb/ yr)

Chemical/ Pollutant Total Decrease in Annual Quantity Discharged Total Increase in Annual Quantity Discharged

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr TABLE 5 1B. Chemical recovery ( e. g., lime or coagulant recovery)

a. Describe practice:

b. List affected drinking water treatment residuals streams:

c. Cost and/ or savings of implementing practice in 2004: Cost of installation/ implementation . . . . . . . . . . . . . Net change in operating costs as a result of the practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

d. What was the reduction in the quantity of residuals generated in 2004 as a result of this activity? . . . . . . . . gal/ day ( lb/ day)

e. What was the change in the quantity of solids generated in 2004?

f. Did the practice result in a change in chemicals/ pollutants discharged in residuals in 2004? . .

Yes

No ( Skip to next table)

g. What was the change in chemicals/ pollutants discharged in the residuals in 2004? Facility SDWIS ID_______________________ Section 5: Practices That Reduce Residuals Generation Draft Detailed Drinking Water Treatment Questionnaire 44 Type of Solid Total Decrease in Annual Quantity Discharged ( lb/ yr) Total Increase in Annual Quantity Discharged ( lb/ yr)

Chemical/ Pollutant Total Decrease in Annual Quantity Discharged Total Increase in Annual Quantity Discharged

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr TABLE 5 1C. Beneficial reuse ( e. g., development of co products, such as bricks or cement, or blending residuals with compost material)

a. Describe practice:

b. List affected drinking water treatment residuals streams:

c. Cost and/ or savings of implementing practice in 2004: Cost of installation/ implementation . . . . . . . . . . . . . Net change in operating costs as a result of the practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

d. What was the reduction in the quantity of residuals generated in 2004 as a result of this activity? . . . . . . . . gal/ day ( lb/ day)

e. What was the change in the quantity of solids generated in 2004?

f. Did the practice result in a change in chemicals/ pollutants discharged in residuals in 2004? . .

Yes

No ( Skip to next table)

g. What was the change in chemicals/ pollutants discharged in the residuals in 2004? Facility SDWIS ID_______________________ Section 5: Practices That Reduce Residuals Generation Draft Detailed Drinking Water Treatment Questionnaire 45 Type of Solid Total Decrease in Annual Quantity Discharged ( lb/ yr) Total Increase in Annual Quantity Discharged ( lb/ yr)

Chemical/ Pollutant Total Decrease in Annual Quantity Discharged Total Increase in Annual Quantity Discharged

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr TABLE 5 1D. Best management practices ( BMPs)

a. Describe practice:

b. List affected drinking water treatment residuals streams:

c. Cost and/ or savings of implementing practice in 2004: Cost of installation/ implementation . . . . . . . . . . . . . Net change in operating costs as a result of the practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

d. What was the reduction in the quantity of residuals generated in 2004 as a result of this activity? . . . . . . . . gal/ day ( lb/ day)

e. What was the change in the quantity of solids generated in 2004?

f. Did the practice result in a change in chemicals/ pollutants discharged in residuals in 2004? . .

Yes

No ( Skip to next table)

g. What was the change in chemicals/ pollutants discharged in the residuals in 2004? Facility SDWIS ID_______________________ Section 5: Practices That Reduce Residuals Generation Draft Detailed Drinking Water Treatment Questionnaire 46 Type of Solid Total Decrease in Annual Quantity Discharged ( lb/ yr) Total Increase in Annual Quantity Discharged ( lb/ yr)

Chemical/ Pollutant Total Decrease in Annual Quantity Discharged Total Increase in Annual Quantity Discharged

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr TABLE 5 1E. Recycling of all wastewater from residuals treatment to plant headworks a. Describe practice:

b. List affected drinking water treatment residuals streams:

c. Cost and/ or savings of implementing practice in 2004: Cost of installation/ implementation . . . . . . . . . . . . . Net change in operating costs as a result of the practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

d. What was the reduction in the quantity of residuals generated in 2004 as a result of this activity? . . . . . . . . gal/ day ( lb/ day)

e. What was the change in the quantity of solids generated in 2004?

f. Did the practice result in a change in chemicals/ pollutants discharged in residuals in 2004? . .

Yes

No ( Skip to next table)

g. What was the change in chemicals/ pollutants discharged in the residuals in 2004? Facility SDWIS ID_______________________ Section 5: Practices That Reduce Residuals Generation Draft Detailed Drinking Water Treatment Questionnaire 47 Type of Solid Total Decrease in Annual Quantity Discharged ( lb/ yr) Total Increase in Annual Quantity Discharged ( lb/ yr)

Chemical/ Pollutant Total Decrease in Annual Quantity Discharged Total Increase in Annual Quantity Discharged

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr

lb/ yr

gal/ yr TABLE 5 1F. Other practice ( specify)

a. Describe practice:

b. List affected drinking water treatment residuals streams:

c. Cost and/ or savings of implementing practice in 2004: Cost of installation/ implementation . . . . . . . . . . . . . Net change in operating costs as a result of the practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $

$

d. What was the reduction in the quantity of residuals generated in 2004 as a result of this activity? . . . . . . . . gal/ day ( lb/ day)

e. What was the change in the quantity of solids generated in 2004?

f. Did the practice result in a change in chemicals/ pollutants discharged in residuals in 2004? . .

Yes

No ( Skip to Question 5 2)

g. What was the change in chemicals/ pollutants discharged in the residuals in 2004? Facility SDWIS ID_______________________ Section 5: Practices That Reduce Residuals Generation Draft Detailed Drinking Water Treatment Questionnaire 48 CBI?

Yes 5 2. Do you plan on implementing any practices for reducing the generation of residuals and/ or chemicals discharged with the residuals in the future? If so, please list below.

Practice Scheduled Implementation ( Date) Facility SDWIS ID_______________________ Section 6: Comments on Survey Questions Draft Detailed Drinking Water Treatment Questionnaire 49 CBI?

Yes SECTION 6: COMMENTS ON SURVEY QUESTIONS Copy ___ of ___

6 1. Please cross reference your comments by question number. If you need additional space, please photocopy this page before writing on it, and number each copy in the space provided.

Section Number Question Number Comment


[Federal Register: April 22, 2008 (Volume 73, Number 78)]
[Notices]
[Page 21628-21629]
[DOCID:fr22ap08-48]

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DEPARTMENT OF ENERGY

Federal Energy Regulatory Commission

[Docket No. CP08-100-000]

Texas Eastern Transmission, LP; Notice of Application

April 15, 2008.
    Take notice that on April 1, 2008, Texas Eastern Transmission, LP
(Texas Eastern), 5400 Westheimer Court, Houston, Texas 77056, filed in
Docket No. CP08-100-000, an application, pursuant to sections 7(b) and
7(c) of the Natural Gas Act (NGA), for an order authorizing Texas
Eastern's Northern Bridge Project which will provide up to 150,000 Dth
per day of firm natural gas transportation capacity from the
Clarington, Ohio area to the Delmont, Pennsylvania area, all as more
fully set forth in the application which is on file with the Commission
and open to public inspection. This filing is accessible on-line at
http://www.ferc.gov, using the ``eLibrary'' link and is available for
review in the Commission's Public Reference Room in Washington, DC.
There is an ``eSubscription'' link on the Web site that enables
subscribers to receive e-mail notification when a document is added to
a subscribed docket(s). For assistance with any FERC Online service,
please e-mail<EMAIL_ADDRESS>or call<PHONE_NUMBER> (toll
free). For TTY, call<PHONE_NUMBER>.
    Specifically, Texas Eastern seeks authorization to construct,
install, own, operate, and maintain 14,416 horsepower of additional
compression at its Holbrook Compressor Station located in Greene
County, Pennsylvania through the addition of a new 13,333 horsepower
compressor unit and the uprate of an existing compressor unit by 1,083
horsepower. Texas Eastern also seeks authority to abandon four
reciprocating compressor units totaling 5,400 horsepower at the
Holbrook Compressor Station. The net increase in compression at the
Holbrook Compressor Station will be 9,016 horsepower. Finally, Texas
Eastern seeks authority to uprate an existing compressor unit at its
Uniontown Compressor Station in Fayette County, Pennsylvania by 1,650
horsepower.
    Any questions regarding this application should be directed to
Garth Johnson, General Manager, Certificates & Reporting, Texas Eastern
Transmission, LP, P.O. Box 1642, Houston, Texas 77251-1642, at (713)
627-5415 (phone) or<PHONE_NUMBER> (Fax).
    Pursuant to section 157.9 of the Commission's rules, 18 CFR 157.9,
within 90 days of this Notice the Commission staff will either:
complete its environmental assessment (EA) and place it into the
Commission's public record (eLibrary) for this proceeding; or issue a
Notice of Schedule for Environmental Review. If a Notice of Schedule
for Environmental Review is issued, it will indicate, among other
milestones, the anticipated date for the Commission staff's issuance of
the final environmental impact statement (FEIS) or EA for this
proposal. The filing of the EA in the Commission's public record for
this proceeding or the issuance of a Notice of Schedule for
Environmental Review will serve to notify federal and state agencies of
the timing for the completion of all necessary reviews, and the
subsequent need to complete all federal authorizations within 90 days
of the date of issuance of the Commission staff's FEIS or EA.
    There are two ways to become involved in the Commission's review of
this project. First, any person wishing to obtain legal status by
becoming a party to the proceedings for this project should, on or
before the comment date stated below, file with the Federal Energy
Regulatory Commission, 888 First Street, NE., Washington, DC 20426, a
motion to intervene in accordance with the requirements of the
Commission's Rules of Practice and Procedure (18 CFR 385.214 or
385.211) and the Regulations under the NGA (18 CFR 157.10). A person
obtaining party status will be placed on the service list maintained by
the Secretary of the Commission and will receive copies of all
documents filed by the applicant and by all other parties. A party must
submit 14 copies of filings made with the Commission and must mail a
copy to the applicant and to every other party in the proceeding. Only
parties to the proceeding can ask for court review of Commission orders
in the proceeding.
    However, a person does not have to intervene in order to have
comments considered. The second way to participate is by filing with
the Secretary of the Commission, as soon as possible, an original and
two copies of comments in support of or in opposition to this project.
The Commission will consider these comments in determining the
appropriate action to be taken, but the filing of a comment alone will
not serve to make the filer a party to the proceeding. The Commission's
rules require that persons filing comments in opposition to the project
provide copies of their protests only to the party or parties directly
involved in the protest.
    The Commission strongly encourages electronic filings of comments,
protests and interventions in lieu of paper using the ``eFiling'' link
at http://www.ferc.gov. Persons unable to file electronically should
submit an original and 14 copies of the protest or intervention to the
Federal Energy regulatory Commission, 888 First Street, NE.,
Washington, DC 20426.
    This filing is accessible on-line at http://www.ferc.gov, using the
``eLibrary'' link and is available for review in the Commission's
Public

Reference Room in Washington, DC. There is an ``eSubscription'' link on
the Web site that enables subscribers to receive e-mail notification
when a document is added to a subscribed docket(s). For assistance with
any FERC Online service, please e-mail<EMAIL_ADDRESS>or
call<PHONE_NUMBER> (toll free). For TTY, call<PHONE_NUMBER>.
    Comment Date: April 30, 2008.

Kimberly D. Bose,
Secretary.
[FR Doc. E8-8637 Filed 4-21-08; 8:45 am]

BILLING CODE 6717-01-P


[Federal Register: April 21, 2010 (Volume 75, Number 76)]
[Notices]
[Page 20881-20883]
[DOCID:fr21ap10-115]

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DEPARTMENT OF TRANSPORTATION

Federal Motor Carrier Safety Administration

[Docket No. FMCSA-1999-6480; FMCSA-2001-11426; FMCSA-2003-16241; FMCSA-
2003-16564; FMCSA-2005-21711; FMCSA-2005-22194; MCSA-2005-22727; FMCSA-
2005-23099; FMCSA-2007-0017; FMCSA-2007-0071]

Qualification of Drivers; Exemption Applications; Vision

AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT.

ACTION: Notice of renewal of exemptions; request for comments.

-----------------------------------------------------------------------

SUMMARY: FMCSA announces its decision to renew 17 individuals. FMCSA
has statutory authority to exempt individuals from the vision
requirement if the exemptions granted will not compromise safety. The
Agency has concluded that granting these exemption renewals will
provide a level of safety that is equivalent to, or greater than, the
level of safety maintained without the exemptions for these commercial
motor vehicle (CMV) drivers.

DATES: This decision is effective April 23, 2010. Comments must be
received on or before May 21, 2010.

ADDRESSES: You may submit comments bearing the Federal Docket
Management System (FDMS) Docket ID FMCSA-1999-6480; FMCSA-2001-11426;
FMCSA-2003-16241; FMCSA-2003-16564; FMCSA-2005-21711; FMCSA-2005-22194;
FMCSA-2005-22727; FMCSA-2005-23099; FMCSA-2007-0017; FMCSA-2007-0071,
using any of the following methods.
     Federal eRulemaking Portal: Go to http://
www.regulations.gov. Follow the online instructions for submitting
comments.
     Mail: Docket Management Facility; U.S. Department of
Transportation, 1200 New Jersey Avenue, SE., West Building Ground
Floor, Room W12-140, Washington, DC 20590-0001.
     Hand Delivery or Courier: West Building Ground Floor, Room
W12-140, 1200 New Jersey Avenue, SE., Washington, DC, between 9 a.m.
and 5 p.m., Monday through Friday, except Federal Holidays.
     Fax: 1-202-493-2251.

    Each submission must include the Agency name and the docket number
for this Notice. Note that DOT posts all comments received without
change to http://www.regulations.gov, including any personal
information included in a comment. Please see the Privacy Act heading
below.
    Docket: For access to the docket to read background documents or
comments, go to http://www.regulations.gov at any time or Room W12-140
on the ground level of the West Building, 1200 New Jersey Avenue, SE.,
Washington, DC, between 9 a.m. and 5 p.m., Monday through Friday,
except Federal holidays. The FDMS is available 24 hours each day, 365
days each year. If you want acknowledgment that we received your
comments, please include a self-addressed, stamped envelope or postcard
or print the acknowledgement page that appears after submitting
comments online.
    Privacy Act: Anyone may search the electronic form of all comments
received into any of our dockets by the name of the individual
submitting the comment (or of the person signing the comment, if
submitted on behalf of an association, business, labor union, etc.).
You may review the DOT's complete Privacy Act Statement in the Federal
Register published on April 11, 2000 (65 FR 19476). This information is
also available at http://www.regulations.gov.

FOR FURTHER INFORMATION CONTACT: Dr. Mary D. Gunnels, Director, Medical
Programs,<PHONE_NUMBER><EMAIL_ADDRESS>FMCSA, Department of
Transportation, 1200 New Jersey Avenue, SE., Room W64-224, Washington,
DC 20590-0001. Office hours are from 8:30 a.m. to 5 p.m. Monday through
Friday, except Federal holidays.

SUPPLEMENTARY INFORMATION:

Background

    Under 49 U.S.C. 31136(e) and 31315, FMCSA may renew an exemption
from the vision requirements in 49 CFR 391.41(b)(10), which applies to
drivers of CMVs in interstate commerce, for a two-year period if it
finds ``such exemption would likely achieve a level of safety that is
equivalent to, or greater than, the level that would be achieved absent
such exemption.'' The procedures for requesting an exemption (including
renewals) are set out in 49 CFR part 381.

Exemption Decision

    This notice addresses 17 individuals who have requested renewal of
their exemptions in accordance with FMCSA procedures. FMCSA has
evaluated these 17 applications for renewal on their merits and decided
to extend each exemption for a renewable two-year period. They are:

Roy L. Allen
Lyle H. Banser
Lloyd J. Botsford
Walter M. Brown
Charley J. Davis
Derek T. Ford
Paul D. Gaither
Taras G. Hamilton
Thomas R. Hedden
Laurent G. Jacques
Lucio Leal
Earl R. Mark
Douglas A. Mendoza
Michael R. Moore
Richard W. Neyens
John P. Rodrigues
Charles W. Towner, Jr.

    The exemptions are extended subject to the following conditions:
(1) That each individual has a physical examination every year (a) by
an ophthalmologist or optometrist who attests that the vision in the
better eye continues to meet the standard in 49 CFR 391.41(b)(10), and
(b) by a medical examiner who attests that the individual is otherwise
physically qualified under 49 CFR 391.41; (2) that each individual
provides a copy of the ophthalmologist's or optometrist's report to the
medical examiner at the time of the annual medical examination; and (3)
that each individual provides a copy of the annual medical
certification to the employer for retention in the driver's
qualification file and retains a copy of the certification on his/her
person while driving for presentation to a duly authorized Federal,
State, or local enforcement official. Each exemption will be valid for
two years unless rescinded earlier by FMCSA. The exemption will be
rescinded if: (1) The person fails to comply with the terms and
conditions of the exemption; (2) the exemption has resulted in a lower
level of safety than was maintained before it was granted; or (3)
continuation of the exemption would not be consistent with the goals
and objectives of 49 U.S.C. 31136(e) and 31315.

Basis for Renewing Exemptions

    Under 49 U.S.C. 31315(b)(1), an exemption may be granted for no
longer than two years from its approval date and may be renewed upon
application for additional two year periods. In accordance with 49
U.S.C. 31136(e) and 31315, each of the 17 applicants has satisfied the
entry conditions for obtaining an exemption from the vision
requirements (64 FR 68195; 65 FR 20251; 67 FR 17102; 69 FR 17267; 71 FR
16410; 67 FR 10471; 67 FR 19798; 69 FR 19611; 71 FR 19604; 73 FR 15254;
68 FR 61857; 68 FR 75715; 71 FR 646; 72 FR 71998; 68 FR 74699; 69 FR
10503; 71 FR 6829; 70 FR 48797; 70 FR 61493; 70 FR 57353; 70 FR 72689;
70 FR 71884; 71 FR 4632; 73 FR 9158; 71 FR 4194; 71 FR 13450; 72 FR
67340; 73 FR 1395; 73 FR 6242; 73 FR 16950). Each of these 17
applicants has requested renewal of the exemption and has submitted
evidence showing that the vision in the better eye continues to meet
the standard specified at 49 CFR 391.41(b)(10) and that the vision
impairment is stable. In addition, a review of each record of safety
while driving with the respective vision deficiencies over the past two
years indicates each applicant continues to meet the vision exemption
standards. These factors provide an adequate basis for predicting each
driver's ability to continue to drive safely in interstate commerce.
Therefore, FMCSA concludes that extending the exemption for each
renewal applicant for a period of two years is likely to achieve a
level of safety equal to that existing without the exemption.

Request for Comments

    FMCSA will review comments received at any time concerning a
particular driver's safety record and determine if the continuation of
the exemption is consistent with the requirements at 49 U.S.C. 31136(e)
and 31315. However, FMCSA requests that interested parties with
specific data concerning the safety records of these drivers submit
comments by May 21, 2010.
    FMCSA believes that the requirements for a renewal of an exemption
under 49 U.S.C. 31136(e) and 31315 can be satisfied by initially
granting the renewal and then requesting and evaluating, if needed,
subsequent comments submitted by interested parties. As indicated
above, the Agency previously published notices of final disposition
announcing its decision to exempt these 17 individuals from the vision
requirement in 49 CFR 391.41(b)(10). The final decision to grant an
exemption to each of these individuals was based on the merits of each
case and made only after careful consideration of the comments received
to its Notices of applications. The Notices of applications stated in
detail the qualifications, experience, and medical condition of each
applicant for an exemption from the vision requirements. That
information is available by consulting the above cited Federal Register
publications.
    Interested parties or organizations possessing information that
would

otherwise show that any, or all of these drivers, are not currently
achieving the statutory level of safety should immediately notify
FMCSA. The Agency will evaluate any adverse evidence submitted and, if
safety is being compromised or if continuation of the exemption would
not be consistent with the goals and objectives of 49 U.S.C. 31136(e)
and 31315, FMCSA will take immediate steps to revoke the exemption of a
driver.

    Issued on: April 15, 2010.
Larry W. Minor,
Associate Administrator for Policy and Program Development.
[FR Doc. 2010-9117 Filed 4-20-10; 8:45 am]
BILLING CODE 4910-EX-P