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
