Mwra Submittal Form
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1
2MWRA Submittal Form
Date:
Company Name:
Facility Address:
Permit Number:
Type of Submittal
Due Date
Sampling Location#
Month
Day
Year
0 1
0 1
9 9
0 1 0 1
REPORTS
(a)
Self Monitoring Report
_____ / _____ / _____
___ ___ ___ ___
(b)
Pretreatment Report
_____ / _____ / _____
___ ___ ___ ___
(c)
Servicing Invoice/Report Type:
_____ / _____ / _____
___ ___ ___ ___
(d)
Plans/Schematics
_____ / _____ / _____
___ ___ ___ ___
(e)
Filter Backwash/RO Reject Report
_____ / _____ / _____
___ ___ ___ ___
(f)
Spill/Slug Control Plan
_____ / _____ / _____
___ ___ ___ ___
(g)
Photo Processing/Printing Report
_____ / _____ / _____
___ ___ ___ ___
SCHEDULES
(h)
SRU Maintenance
_____ / _____ / _____
___ ___ ___ ___
(i)
Trap/Separator Maintenance
_____ / _____ / _____
___ ___ ___ ___
(j)
Non-Contact Cooling Water Removal
_____ / _____ / _____
___ ___ ___ ___
LOGS
(k)
Flow Logs
_____ / _____ / _____
___ ___ ___ ___
(l)
pH Logs
_____ / _____ / _____
___ ___ ___ ___
(m)
Pretreatment System Log
_____ / _____ / _____
___ ___
___ ___
CERTIFICATIONS
(n)
Category 4 Certification
_____ / _____ / _____
___ ___ ___ ___
(o)
TOMP Certification
_____ / _____ / _____
___ ___ ___ ___
(p)
Lab Certification
_____ / _____ / _____
___ ___ ___ ___
a. Notice of Location not Discharging During
Sampling Period
_____ / _____ / _____
___ ___ ___ ___
b. Other
_____ / _____ / _____
___ ___ ___ ___
(please specify)
Comments:_____________________________________________________________________
______________________________________________________________________
PLEASE FOLLOW INSTRUCTIONS ON THE REVERSE
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Parent category: Business