816R02008B
Arsenic Rule Planning and
Monitoring Worksheets
(To be used with USEPA's Complying With
the Revised Drinking Water Standard for
Arsenic: Small Entity Compliance Guide
[EPA 816-R-02-008A])
-------
Office of Ground Water and Drinking Water
(4606M)
EPA816-R-02-008B
www.epa.gov/safewater
August 2002
Please Note...
The worksheets provided in this document are intended for use with
USEPA's Complying With the Revised Drinking Water Standard for
Arsenic: Small Entity Compliance Guide. Copies of that document can
be obtained by calling the Safe Drinking Water Hotline at 1-800-426-
4791 and requesting publication number EPA 816-R-02-008A.
Printed on recycled paper
-------
Arsenic Rule Planning Worksheet
Date Sample
Collected
EPTDS/Sampling Point
Result
Was the Result
^0.010mg/L?
Was an
Approved
Analytical
Method
Used?3
Was Every
EPTDS
Sampled?6
"Certain analytical methods are no longer approved See the laboratory testing section on page 25 for more information
bSystems must have results from each entry point to the distribution system (EPTDS) (40 CFR 141 23(a))
-------
Arsenic Rule Planning Worksheet
Date Sample
Collected
EPTDS/Sampling Point
Result
Was the Result
<> 0.010 mg/L?
Was an
Approved
Analytical
Method
Used?3
Was Every
EPTDS
Sampled?11
"Certain analytical methods are no longer approved See the laboratory testing secdon on page 25 for more Information
bSystems must have resJts from each entry point to the distribution system (EPTDS) (40 CFR 141 23(a)).
-------
Arsenic Rule Planning Worksheet
Date Sample
Collected
EPTDS/Sampling Point
Result
Was the Result
50.010mg/L?
Was an
Approved
Analytical
Method
Used?3
Was Every
EPTDS
Sampled?6
"Certain analytical methods are no longer approved See the laboratory testing section on page 25 for more information.
bSystems must have results from each entry point to the distribution system (EPTDS) (40 CFR 141.23(a)).
-------
Date Sample
Collected
Arsenic Rule Planning Worksheet
EPTDS/Sampling Point
Result
Was the Result
50.010rng/L?
Was an
Approved
Analytical
Method
Used?3
Was Every
EPTDS
Sampled?6
"Certain analytical methods are no longer approved See the laboratory testing section on page 25 for more Information.
''Systems must have results from each entry point to the distribution system (EPTDS) (40 CFR 141.23(a)).
-------
Arsenic Monitoring Worksheet for Routine and Reduced Monitoring3
EPTDS/Sampling
Point13
1.
2.
3.
4.
Date
Sample
Collected
Arsenic
Result0
(CIRCLE
result if
>0.010 mg/L)
Date Result
Reported to
Stated
Date
Confirmation
Sample
Collected (if
required)0
Confirmation
Sample
Result (if
required)0
Average of Initial and
Confirmation Results (if
required)0 (CIRCLE average
tfX).010mg/L)
Date
Confirmation
Sample Result
Reported to
State (if
required)0-6
"Unless told otherwise by their State, surface water and GWUDl systems must take annual samples at each sampling point, and ground water systems must take samples once every 3 years at
each sampling point (40 CFR 141 .23(c)(1 )).
bYou must take one sample at each EPTDS (40 CFR 141 ,23(a)). tf your State has allowed you to composite samples, the samples will be composited in the laboratory.
c If the results at all of the sampling points are equal to or less than 0.010 mg/L, continue sampling at each sampling point in accordance with the State-prescribed schedule. If any result is
greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter (40 CFR 141 .23(c)(7)). HOWEVER, your State may require confirmation samples at that
sampling point. The confirmation samples must be taken within 2 weeks (40 CFR 141 .23(f)(1 )). The average of the initial and confirmation samples will be used to calculate compliance (40 CFR
141.23(f)). If the average is greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter unless directed otherwise by your State (40 CFR 141.23(c)(7)).
dYour State must receive your results within 10 days after the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141.31(a)).
You do not need to report the result if your laboratory does so automatically, although you should confirm that the State received the results.
°Your State will determine when your confirmation samples must be reported to your State.
-------
Arsenic Monitoring Worksheet for Routine and Reduced Monitoring3
EPTDS/Sampling
Pointb
1.
2.
3.
4.
Date
Sample
Collected
Arsenic
Result0
(CIRCLE
result if
>0.010 mg/L)
Date Result
Reported to
Stated
Date
Confirmation
Sample
Collected (if
required)0
Confirmation
Sample
Result (if
required)0
Average of Initial and
Confirmation Results (if
required)0 (CIRCLE average
if>0.010mg/L)
Date
Confirmation
Sample Result
Reported to
State (If
required)0*
aUnless told otherwise by their State, surface water and GWUDI systems must take annual samples at each sampling point, and ground water systems must take samples once every 3 years at
each sampling point (40 CFR 141 .23(c)(1 )}.
bYou must take one sample at each EPTDS (40 CFR 141 .23(a)). If your State has allowed you to composite samples, the samples will be composited in the laboratory.
c If the results at all of the sampling points are equal to or less than 0.010 mg/L, continue sampling at each sampling point in accordance with the State-prescribed schedule. If any result is
greater than 0.010 mq/L, you must begin quarterly monitoring at that samcling point in the next quarter (40 CFR 141 .23(c}(7)). HOWEVER, your State may require confirmation samples at that
sampling point. The confirmation samples must be taken within 2 weeks (40 CFR 141 .23(f)(1 }) The average of the initial and confirmation s'amples will be used to calculate compliance (40 CFR
141,23(f)). If the average is greater than 0.0 10 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter unless directed otherwise by your State (40 CFR 141.23(c)(7)).
d Your State must receive your results within 10 days after the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141. 31 (a)).
You do not need to report the result if your laboratory does so automatically, although you should confirm that the State received the results.
"Your State will determine when your confirmation samples must be reported to your State.
-------
Arsenic Monitoring Worksheet for Routine and Reduced Monitoring3
EPTDS/Sampling
Point13
1.
2.
3.
4.
Date
Sample
Collected
Arsenic
Result0
(CIRCLE
result if
>0.010 mg/L)
Date Result
Reported to
Stated
Date
Confirmation
Sample
Collected (if
required)0
Confirmation
Sample
Result (if
required)0
Average of Initial and
Confirmation Results (if
required)0 (CIRCLE average
lfX).010mg/L)
Date
Confirmation
Sample Result
Reported to
State (If
required)0*
3Unless told otherwise by their State, surface water and GWUDI systems must take annual samples at each sampling point, and ground water systems must take samples once every 3 years at
each sampling point (40 CFR 141 .23(c)(1 )).
bYou must take one sample at each EPTDS (40 CFR 141 ,23(a)). If your State has allowed you to composite samples, the samples will be composited in the laboratory.
clfthe results at all of the sampling points are equal to or less than 0.010 mg/L, continue sampling at each sampling point in accordance with the State-prescribed schedule. If any result is
greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter (40 CFR 141 .23(c)(7)). HOWEVER, your State may require confirmation samples at that
sampling point. The confirmation samples must be taken within 2 weeks (40 CFR 141 .23(f)(1 )). The average of the initial and confirmation samples will be used to calculate compliance (40 CFR
141.23(f)). If the average is greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter unless directed otherwise by your State (40 CFR 141.23(c)(7)).
dYour State must receive your results within 1 0 days after the month in which the sample was taken or within 1 0 days of the end of the sampling period, whichever is shorter (40 CFR 141 .31 (a)).
You do not need to report the result if your laboratory does so automatically, although you should confirm that the State received the results.
"Your State will determine when your confirmation samples must be reported to your State.
-------
Arsenic Monitoring Worksheet for Routine and Reduced Monitoring9
EPTDS/Sampling
Pointb
1.
2.
3.
4.
Date
Sample
Collected
Arsenic
Result0
(CIRCLE
result if
>0.010 mg/L)
Date Result
Reported to
Stated
Date
Confirmation
Sample
Collected (if
required)0
Confirmation
Sample
Result (if
required)0
Average of Initial and
Confirmation Results (if
required)0 (CIRCLE average
if >0.010 mg/L)
Date
Confirmation
Sample Result
Reported to
State (If
required)*'8
"Unless told otherwise by their State, surface water and GWUDI systems must take annual samples at each sampling point, and ground water systems must take samples once every 3 years at
each sampling point (40 CFR 141.23(c)(1)).
bYou must take one sample at each EPTDS (40 CFR 141 .23(a)). If your State has allowed you to composite samples, the samples will be composited in the laboratory.
c If the results at all of the sampling points are equal to or less than 0.0 10 mg/L, continue sampling at each sampling point in accordance with the State-prescribed schedule. If any result is
greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter (40 CFR 141 23(c}(7}}. HOWEVER, your State may require confirmation samples at that
sampling point. The confirmation samples must be taken within 2 weeks (40 CFR 141 .23(f)(1 )). The average of the initial and confirmation samples will be used to calculate compliance (40 CFR
141.23(f)). If the average is greater than 0.0 10 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter unless directed otherwise by your State (40 CFR 141.23(c)(7)).
d Your State must receive your results within 10 days after the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141. 31 (a)).
You do not need to report the result if your laboratory does so automatically, although you should confirm that the State received the results.
BYour State will determine when your confirmation samples must be reported to your State.
-------
Arsenic Monitoring Worksheet for Routine and Reduced Monitoring3
EPTDS/Sampling
Pointb
1.
2.
3.
4.
Date
Sample
Collected
Arsenic
Result0
(CIRCLE
result if
>0.010 mg/L)
Date Result
Reported to
State"
Date
Confirmation
Sample
Collected (if
required)6
Confirmation
Sample
Result (if
required)0
Average of Initial and
Confirmation Results (if
required)0 (CIRCLE average
lf>0.010mg/L)
Date
Confirmation
Sample Result
Reported to
State (If
required)0*
3Unless told otherwise by their State, surface water and GWUDI systems must take annual samples at each sampling point, and ground water systems must take samples once every 3 years at
each sampling point (40 CFR 141.23(c)(1)).
bYou must take one sample at each EPTDS (40 CFR 141 .23(a)). tf your State has allowed you to composite samples, the samples will be composited in the laboratory.
clfthe results at all of the sampling points are equal to or less than 0.010 mg/L, continue sampling at each sampling point in accordance with the State-prescribed schedule. If any result is
greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter (40 CFR 141 .23(c)(7)). HOWEVER, your State may require confirmation samples at that
sampling point. The confirmation samples must be taken within 2 weeks (40 CFR 141 .23(f)(1 )). The average of the initial and confirmation samples will be used to calculate compliance (40 CFR
141.23(f)). If the average is greater than 0.010 mgA., you must begin quarterly monitoring at that sampling point in the next quarter unless directed otherwise by your State (40 CFR 141.23(c)(7)).
dYour State must receive your results within 1 0 days after the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141 .31 (a)).
You do not need to report the result if your laboratory does so automatically, although you should confirm that the State received the results.
"Your State will determine when your confirmation samples must be reported to your State.
-------
Arsenic Monitoring Worksheet for Routine and Reduced Monitoring3
EPTDS/Sampling
Pointb
1.
2.
3.
4.
Date
Sample
Collected
Arsenic
Result0
(CIRCLE
result if
>0.010 mg/L)
Date Result
Reported to
Stated
Date
Confirmation
Sample
Collected (if
required)0
Confirmation
Sample
Result (if
required)0
Average of Initial and
Confirmation Results (if
required)0 (CIRCLE average
if >0. 010 mg/L)
Date
Confirmation
Sample Result
Reported to
State (If
required)0^
aUntess told otherwise by their State, surface water and GWUDI systems must take annual samples at each sampling point, and ground water systems must take samples once every 3 years at
each sampling point (40 CFR 141 .23(c)(1 )).
bYou must take one sample at each EPTDS (40 CFR 141 .23(a)). If your State has allowed you to composite samples, the samples will be composited in the laboratory.
c If the results at all of the sampling points are equal to or less than 0.01 Omg/L, continue sampling at each sampling point in accordance with the State-prescribed schedule. If any result is
greater than 0.010 mg/L. you must begin quarterly monitoring at that sampling point in the next quarter (40 CFR 141 .23(c)(7)). HOWEVER, your State may require confirmation samples at that
sampling point. The confirmation samples must be taken within 2 weeks (40 CFR 141 .23(f)(1 ))• The average of the initial and confirmation samples will be used to calculate compliance (40 CFR
141.23(f)). If the average is greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter unless directed otherwise by your State (40 CFR 141.23(c)(7)).
dYour State must receive your results within 1 0 days after the month in which the sample was taken or within 1 0 days of the end of the sampling period, whichever is shorter (40 CFR 141 .31 (a)).
You do not need to report the result if your laboratory does so automatically, although you should confirm that the State received the results.
BYour State will determine when your confirmation samples must be reported to your State.
-------
Arsenic Monitoring Worksheet for Routine and Reduced Monitoring3
EPTDS/Sampling
Pointb
1.
2.
3.
4.
Date
Sample
Collected
Arsenic
Result0
(CIRCLE
result if
>0.010 mg/L)
Date Result
Reported to
Stated
Date
Confirmation
Sample
Collected (if
required)0
Confirmation
Sample
Result (if
required)0
Average of Initial and
Confirmation Results (if
required)0 (CIRCLE average
if >0. 010 mg/L)
Date
Confirmation
Sample Result
Reported to
State (if
required)016
3 Unless told otherwise by their State, surface water and GWUDl systems must take annual samples at each sampling point, and ground water systems must take samples once every 3 years at
each sampling point (40 CFR 141 .23(c)(1)).
bYou must take one sample at each EPTDS (40 CFR 141 .23(a)). If your State has allowed you to composite samples, the samples will be composited in the laboratory.
c If the results at all of the sampling points are equal to or less than 0.01 0 mg/L, continue sampling at each sampling point in accordance with the State-prescribed schedule. If any result is
greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter (40 CFR 141 .23(c)(7)). HOWEVER, your State may require confirmation samples at that
sampling point. The confirmation samples must be taken within 2 weeks (40 CFR 141.23(f)(1)). The average of the initial and confirmation samples will be used to calculate compliance (40 CFR
141.23(f)). If the average is greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter unless directed otherwise by your State (40 CFR 141.23(c)(7)).
dYour State must receive your results within 10 days after the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141.31(a)).
You do not need to report the result if your laboratory does so automatically, although you should confirm that the State received the results.
BYour State will determine when your confirmation samples must be reported to your State.
-------
Arsenic Monitoring Worksheet for Routine and Reduced Monitoring3
EPTDS/Sampling
Pointb
1.
2.
3.
4.
Date
Sample
Collected
Arsenic
Result0
(CIRCLE
result if
>0.010 mg/L)
Date Result
Reported to
Stated
Date
Confirmation
Sample
Collected (if
required)0
Confirmation
Sample
Result (if
required)0
Average of Initial and
Confirmation Results (if
required)0 (CIRCLE average
if >0.010 mg/L)
Date
Confirmation
Sample Result
Reported to
State (If
required)0"6
aUnless told otherwise by their State, surface water and GWUDI systems must take annual samples at each sampling point, and ground water systems must take samples once every 3 years at
each sampling point (40 CFR 141.23(c)(1)).
bYou must take one sample at each EPTDS (40 CFR 141 .23(a)). If your State has allowed you to composite samples, the samples will be composited in the laboratory.
c If the results at all of the sampling points are equal to or less than 0.010 mg/L, continue sampling at each sampling point in accordance with the State-prescribed schedule. If any result is
greater than 0.010 mg/L. you must begin quarterly monitoring at that sampling point in the next quarter (40 CFR 141 .23(c)(7)). HOWEVER, your State may require confirmation samples at that
sampling point. The confirmation samples must be taken within 2 weeks (40 CFR 141 .23(f)(1 )). The average of the initial and confirmation samples will be used to calculate compliance (40 CFR
141.23(f)). If the average is greater than 0.010 mg/L, you must begin quarterly monitoring at that sampling point in the next quarter unless directed otherwise by your State (40 CFR 141.23(c)(7)).
d Your State must receive your results within 10 days after the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141. 31 (a)).
You do not need to report the result if your laboratory does so automatically, although you should confirm that the State received the results.
BYour State will determine when your confirmation samples must be reported to your State.
-------
Arsenic Monitoring Worksheet for Quarterly Monitoring
EPTDS/Sampling Point:
Quarter
Date Sample
Collected
Arsenic Result
Running Annual Average Calculation3
(CIRCLE if>0.010mg/L)
Date Result Reported
to State1* c
Date Violation(s)
Reported to
Customers0
(if necessary)
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
a When calculating the running annual average, add up the quarterly samples taken during the last four quarters and divide by the number of quarterly samples you took (40 CFR
141 .23(i)(1 )). Insert 0.0 mg/L for all future quarterly samples during the first year of quarterly sampling. Do not insert 0.0 mg/L if you failed to take a sample; instead, divide by the
number of samples you took. Assume that ail results below the method detection limit have 0.0 mg/L of arsenic (40 CFR 141 .23(i)(1 )).
b If you have an MCL violation, your State must receive your results within 48 hours (40 CFR 141.203(a)). If there is no violation, your State must receive your results within 10 days after
the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141. 31 (a)). You do not need to report the result if your
laboratory does so automatically, although you should confirm that the State received it.
0 If the running annual average at any EPTDS is greater than 0.010 mg/L, then your system has violated the MCL (40 CFR 141.23(1)). YJU must notify the State within 48 hours and your
customers within 30 days (40 CFR 141.31(b)and 40 CFR 141.203), continue quarterly monitoring, and take other corrective action as required by your State.
-------
Arsenic Monitoring Worksheet for Quarterly Monitoring
EPTDS/Sampling Point:
Quarter
Date Sample
Collected
Arsenic Result
Running Annual Average Calculation3
(CIRCLE if >0.010 mg/L)
Date Result Reported
to State1* c
Date Violation(s)
Reported to
Customers0
(if necessary)
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
a When calculating the running annual average, add up the quarterly samples taken during the last four quarters and divide by the number of quarterly samples you took (40 CFR
141 .23(i)(1 )). Insert 0.0 mg/L for all future quarterly samples during the first year of quarterly sampling. Do not insert 0.0 mg/L if you failed to take a sample; instead, divide by the
number of samples you took. Assume that all results below the method detection limit have 0.0 mg/L of arsenic (40 CFR 141 .23(i)(1 )).
blf you have an MCL violation, your State must receive your results within 48 hours (40 CFR 141.203(a)). If there is no violation, your State must receive your results within 10 days after
the month in wNch the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141. 31 (a)). You do not need to report the result if your
laboratory does so automatically, although you should confirm that the State received it.
0 If the running annual average at any EPTDS is greater than 0.010 mg/L, then your system has violated the MCL (40 CFR 141.23(i)). You must notify the State within 48 hours and your
customers within 30 days (40 CFR 141 .31(b) and 40 CFR 141 .203), continue quarterly monitoring, and take other corrective action as required by your State.
-------
Arsenic Monitoring Worksheet for Quarterly Monitoring
EPTDS/Sampling Point:
Quarter
Date Sample
Collected
Arsenic Result
Running Annual Average Calculation3
(CIRCLE if >0.010 mg/L)
Date Result Reported
to State*5- c
Date Violation(s)
Reported to
Customers0
(if necessary)
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
3 When calculating the running annual average, add up the quarterly samples taken during the last four quarters and divide by the number of quarterly samples you took (40 CFR
1 41 .23(i)(1 )). Insert 0.0 mg/L for all future quarterly samples during the first year of quarterly sampling. Do not insert 0.0 mg/L f you failed to take a sample; instead, divide by the
number of samples you took. Assume that all results below the method detection limit have 0.0 mg/L of arsenic (40 CFR 141 .23(i)(1 )).
b If you have an MCL violation, your State must receive your results within 48 hours (40 CFR 141 .203(a)). If there is no violation, your State must receive your results within 10 days after
the month in wNch the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141 .31 (a)). You do not need to report the result if your
laboratory does so automatically, although you should confirm that the State received it.
c If the running annual average at any EPTDS is greater than 0.010 mg/L, then your system has violated the MCL (40 CFR 141.23(i)). >bu must notify the State within 48 hours and your
customers within 30 days (40 CFR 141 ,31(b) and 40 CFR 141 .203), continue quarterly monitoring, and take other corrective action as required by your State.
-------
Arsenic Monitoring Worksheet for Quarterly Monitoring
EPTDS/Sampling Point:
Quarter
Date Sample
Collected
Arsenic Result
Running Annual Average Calculation3
(CIRCLE if>0.010mg/L)
Date Result Reported
to State1* c
Date Violation(s)
Reported to
Customers0
(if necessary)
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
a When calculating the running annual average, add up the quarterly samples taken during the last four quarters and divide by the number of quarterly samples you took (40 CFR
141 .23(1X1 ))• Insert 0.0 mg/L for all future quarterly samples during the first year of quarterly sampling. Do not insert 0.0 mg/L if you failed to take a sample; instead, divide by the
number of samples you took. Assume that all results below the method detection limit have 0.0 mg/L of arsenic (40 CFR 141 .23(i)(1 )).
blf you have an MCL violation, your State must receive your results within 48 hours (40 CFR 141 .203(a)). If there is no violation, your State must receive your results within 10 days after
the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141. 31 (a)}. You do not need to report the result if your
laboratory does so automatically, although you should confirm that the State received it.
°lfthe running annual average at any EPTDS is greater than 0.010 mg/L, then your system has violated the MCL (40 CFR 141.23(i)). You must notify the State within 48 hours and your
customers within 30 days (40 CFR 141 .31(b) and 40 CFR 141 .203), continue quarterly monitoring, and take other corrective action as required by your State.
-------
Arsenic Monitoring Worksheet for Quarterly Monitoring
EPTDS/Sampling Point:
Quarter
Date Sample
Collected
Arsenic Result
Running Annual Average Calculation3
(CIRCLE if>0.010mg/L)
Date Result Reported
to State"-0
Date Violation(s)
Reported to
Customers0
(if necessary)
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
a When calculating the running annual average, add up the quarterly samples taken during the last four quarters and divide by the number of quarterly samples you took (40 CFR
141,23(i)(1)). Insert 0.0 mg/L for all future quarterly samples during the first year of quarterly sampling. Do not insert 0.0 mg/L if you failed to take a sample; instead, divide by the
number of samples you took. Assume that all results below the method detection limit have 0.0 mg/L of arsenic (40 CFR 141 .23(i)(1 )).
blf you have an MCL violation, your State must receive your results within 48 hours (40 CFR 141 .203(a)). If there is no violation, your State must receive your results within 10 days after
he month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141. 31 (a)). You do not need to report the result if your
laboratory does so automatically, although you should confirm that the State received it.
c If the running annual average atany EPTDS is greater than 0.010 mg/L, then your system has violated the MCL (40 CFR 141.23(i)). Vtou must notify the State within 48 hours and your
customers within 30 days (40 CFR 141 .31(b) and 40 CFR 141 .203), continue quarterly monitoring, and take other corrective action as required by your State.
-------
Arsenic Monitoring Worksheet for Quarterly Monitoring
EPTDS/Sampling Point:
Quarter
Date Sample
Collected
Arsenic Result
Running Annual Average Calculation3
(CIRCLE if>0.010mg/L)
Date Result Reported
to State13- c
Date Violation (s)
Reported to
Customers0
(if necessary)
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
aWhen calculating the running annual average, add up the quarterly samples taken during the last four quarters and divide by the number of quarterly samples you took (40 CFR
141 .23(i)(1 )). Insert 0.0 mg/L for all future quarterly samples during the first year of quarterly sampling. Do not insert 0.0 mg/L if you failed to take a sample; instead, divide by the
number of samples you took. Assume that all results below the method detection limit have 0.0 mg/L of arsenic (40 CFR 141 .23(l)(1 )).
blf you have an MCL violation, your State must receive your results within 48 hours (40 CFR 141.203(a)). If there is no violation, your State must receive your results within 10 days after
the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141. 31 (a)). You do not need to report the result if your
laboratory does so automatically, although you should confirm that the State received it.
c If the running annual average at any EPTDS is greater than 0.01 0 mg/L, then your system has violated the MCL (40 CFR 141.23(i)). MHJ must notify the State within 48 hours and your
customers within 30 days (40 CFR 141.31(b)and 40 CFR 141.203), continue quarterly monitoring, and take other corrective action as required by your State.
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Arsenic Monitoring Worksheet for Quarterly Monitoring
EPTDS/SamplIng Point:
Quarter
Date Sample
Collected
Arsenic Result
Running Annual Average Calculation3
(CIRCLE if>0.010mg/L)
Date Result Reported
to State13'0
Date Violation (s)
Reported to
Customers0
(if necessary)
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
"When calculating the running annual average, add up the quarterly samples taken during the last four quarters and divide by the number of quarterly samples you took (40 CFR
141 .23(i)(1 ))• Insert 0.0 mg/L for all future quarterly samples during the first year of quarterly sampling. Do not insert 0.0 mg/L if you failed to take a sample; instead, divide by the
number of samples you took. Assume that all results below the method detection limit have 0.0 mg/L of arsenic (40 CFR 141 .23(i)(1 )).
blf you have an MCL violation, your State must receive your results within 48 hours (40 CFR 141 .203(a)). If there is no violation, your State must receive your results within 10 days after
the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141.31(a)). You do not need to report the result if your
laboratory does so automatically, although you should confirm that the State received it.
c If the running annual average at any EPTDS is greater than 0.010 mg/L, then your system has violated the MCL (40 CFR 141.23(i)). \t>u must notify the State within 48 hours and your
customers within 30 days (40 CFR 141 .31(b) and 40 CFR 141 .203), continue quarterly monitonng, and take other corrective action as required by your State.
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Arsenic Monitoring Worksheet for Quarterly Monitoring
EPTDS/Sampling Point:
Quarter
Date Sample
Collected
Arsenic Result
Running Annual Average Calculation3
(CIRCLE if >0.010 mg/L)
Date Result Reported
to State1* c
Date Violation(s)
Reported to
Customers0
(if necessary)
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
MCL:
M&R:
a When calculating the running annual average, add up the quarterly samples taken during the last four quarters and divide by the number of quarterly samples you took (40 CFR
141 .23(i)(1 ))• Insert 0.0 mg/L for all future quarterly samples during the first year of quarterly sampling. Do not insert 0.0 mg/L if you failed to take a sample; instead, divide by the
number of samples you took. Assume that all results below the method detection limit have 0.0 mg/L of arsenic (40 CFR 141 .23(i)(1 )).
blf you have an MCL violation, your State must receive your results within 48 hours (40 CFR 141 ,203(a)). If there is no violation, your State must receive your results within 10 days after
the month in which the sample was taken or within 10 days of the end of the sampling period, whichever is shorter (40 CFR 141 .31 (a)). You do not need to report the result if your
laboratory does so automatically, although you should confirm that the State received it.
clfthe running annual average at any EPTDS is greater than 0.010 mg/L, then your system has violated the MCL (40 CFR 141.23(i)). Vbu must notify the State within 48 hours and your
customers within 30 days (40 CFR 141.31(b)and 40 CFR 141.203), continue quarterly monitoring, and take other corrective action as required by your State.
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