Monthly Report Of Operation Vertical Loop Reactor Wastewater Treatment Plant {53341}

Name of Facility Permit Number MONTHLY REPORT OF OPERATION VERTICAL LOOP REACTOR WASTEWATER TREATMENT PLANT State Form 53341 (R2 / 3-14) Month Year Plant Design Flow Telephone Number mgd E-mail address: Certified Operator: Name Class Certificate Number Expiration Date 3/1/ CHEMICALS USED Lbs or Gal Lbs or Gal Man-Hours at Plant (Plants less than 1 MGD only) Precipitation - Inches Bypass At Plant Site ("x" If Occurred) Collection System Overflow ("x" If Occurred) Total= RAW SEWAGE Air Temperature (optional) Susp. Solids - mg/l Phosphorus - mg/l Influent Flow Rate (if metered) MGD Susp. Solids - lbs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Average Maximum Minimum No. of Data I certify under penalty of law that this document and all attachments were Prepared by or under the direction of (Certified Operator): prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the persons who manage the system, or those persons directly responsible for gathering the information, Signature of principal executive officer or authorized agent the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for (or attested by NetDMR subscriber agreement) submitting false information, including the possibility of fine and imprisonment for knowing violations. Page 1 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Date (month, day, year) Date (month, day, year) Ammonia - mg/l CBOD5 - mg/l Chlorine - Lbs Day Of Month Day of Week CBOD5 - lbs pH Name of Facility Avg. Max. Min. Data Day Of Month 1 2 3 4 5 Temperature in Reactors Settleable Solids % in 30 minutes State Form 53341 (R2 / 3-14) MONTHLY REPORT OF OPERATION VERTICAL LOOP REACTOR WASTEWATER TREATMENT PLANT 26 27 28 29 30 31 Susp. Solids - mg/l 21 22 23 24 25 16 17 18 19 20 11 12 13 14 15 6 7 8 9 10 REACTOR # 1 Permit Number Sludge Vol. Index - ml/gm Dissolved Oxygen mg/l Settleable Solids % in 30 minutes For Month Of: Susp. Solids - mg/l Year REACTOR # 2 Sludge Vol. Index - ml/gm Dissolved Oxygen mg/l Settleable Solids % in 30 minutes Comments for the Month (major repairs, breakdowns, process upsets and their causes, inplant treatment process bypass, etc.): Page 2 of 4 Susp. Solids - mg/l REACTOR # 3 Sludge Vol. Index - ml/gm Dissolved Oxygen mg/l Volume - MG Susp. Solids - mg/l Residual Chlorine Contact Tank Residual Chlorine Final E. Coli - colony/100 ml pH - daily low (or single sample) pH - daily high (if multiple samples) RETURN SLUDGE FINAL EFFLUENT American LegalNet, Inc. www.FormsWorkFlow.com MONTHLY REPORT OF OPERATION VERTICAL LOOP REACTOR WASTEWATER TREATMENT PLANT State Form 53341 (R2 / 3-14) Name of Facility Permit Number For Month Of: Year Flow Dissolved Oxygen mg/l Effluent Flow Rate (MGD) Phosphorus - mg/l FINAL EFFLUENT BOD Total Suspended Solids Susp. Solids - lbs/day Weekly Average Susp. Solids - mg/l Susp. Solids - mg/l Weekly Average Ammonia Ammonia - lbs/day Weekly Average Susp. Solids - lbs CBOD5 - lbs/day Weekly Average Effluent Flow Weekly Average CBOD5 - mg/l Weekly Average Ammonia - mg/l Weekly Average Ammonia - mg/l 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Avg Max Min Data 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 MONTHLY REMOVAL SUMMARY BOD5 S.S. Ammonia Percent Removal Total Monthly Flow: Phosphorus (million gallons) Percent Capacity (actual flow/design) Page 3 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Ammonia - lbs CBOD5 - mg/l Day Of Month Day of Week CBOD5 - lbs MONTHLY REPORT OF OPERATION VERTICAL LOOP REACTOR WASTEWATER TREATMENT PLANT State Form 53341 (R2 / 3-14) Name of Facility Permit Number For Month Of: Year Waste Act. Sludge Gal. x 1000 Gas Production Cubic Ft. x 1000 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Avg. Max. Min. Data Send completed forms by the 28th of the month to: Indiana Department of Environmental Management Office of Water Quality, Mail Code 65-42 100 North Senate Avenue Indianapolis, Indiana 46204-2251 Temperature - F Day Of Month pH Page 4 of 4 American LegalNet, Inc. www.FormsWorkFlow.com Digested Sludge Withdrawn hrs. or Gal. x 1000 Supernatant BOD5 mg/l or NH3-N mg/l Total Solids in Incoming Sludge - % Volatile Solids in Incoming Sludge - % Volatile Solids in Digested Sludge - % Total Solids in Digested Sludge - % SLUDGE TO DIGESTER DIGESTER OPERATION Anaerobic Only Supernatant Withdrawn hrs. or Gal. x 1000