v>EPA Complying With the Stage 1
          Disinfectants and Disinfection
          Byproducts Rule: Supplement A

          One of the Simple Tools for Effective
          Performance (STEP) Guide Series

          For Small Systems Adding Chlorine Dioxide or Ozone
          In addition to this guide, small systems adding a chemical disinfectant should obtain the Basic Guide to
          learn about other requirements of the Stage 1 Disinfectants and Disinfection Byproducts Rule (Stage 1
          DBPR) that will apply to their system. Owners and operators of Subpart H systems using conventional
          filtration should obtain Supplement B of this guide or contact their state for more information on how the
          Stage 1 DBPR applies to them.

-------
Office of Water (4606M)
EPA 816-B-05-005
www.epa.gov/safewater
March 2006
Printed on Recycled Paper

-------
NOTICE: This guide is intended to aid you in complying with the Stage 1 Disinfectants and Disinfection Byproducts Rule (Stage 1
DBPR) published on December 16, 1998, under the Safe Drinking Water Act (SDWA). The SDWA provisions, the Stage 1 DBPR,
  and other EPA regulations described in this guide contain legally binding requirements.  This document does not substitute for
those provisions or regulations, nor is it a regulation itself. It does not impose legally-binding requirements on EPA, states, or the
  regulated community, and may not apply to a particular situation based on the circumstances. EPA and state decision-makers
retain the discretion to adopt approaches on a case-by-case basis that differ from this guidance where appropriate. Any decisions
    regarding a particular community water system or non-transient non-community water system will be made based on the
      applicable statutes and regulations.  Therefore, interested parties  are free to raise questions and objections about the
        appropriateness of the application of this guide to a particular situation, and EPA will consider whether or not the
  recommendations or interpretations in this guide are appropriate in that situation based on the law and regulations. EPA may
  change this guidance in the future.  To determine whether EPA has revised this guide and/or to obtain copies, contact the Safe
                                       Drinking Water Hotline at 1-800-426-4791.

 Please note that the term "state" is used in this guide to refer to your Primacy Agency. The Primacy Agency for most systems is
  your state Drinking Water Agency.  However, the Primacy Agency for systems located in the Navajo Nation is your tribal office,
and the Primacy Agency for systems  located on other tribal lands, in Wyoming, or in the District of Columbia is your EPA Regional
                                                        office.

-------
Contents

Acronyms and Definitions	Supplement A -1

Is This Guide for Me?	Supplement A - 3

What Will I  Learn?  	Supplement A - 4

Chlorine Dioxide and Chlorite	Supplement A - 5
      Monitoring Requirements for Chlorine Dioxide and Chlorite	Supplement A - 6
             Do I Have to Monitor for Chlorine Dioxide and Chlorite?  	Supplement A - 6
             How Do I Determine Compliance? 	Supplement A - 9

Bromate 	Supplement A -11
      Monitoring Requirements for Bromate 	Supplement A -12
             Do I Have to Monitor for Bromate?	Supplement A -12
             Where Do I Take the Samples? 	Supplement A -12
             How Do I Determine Compliance? 	Supplement A -13

Analysis and Reporting	Supplement A -14
      Who Must Analyze My Samples?	Supplement A -15
      What Do I Report to the State?	Supplement A -16
      What Do I Report to My Customers?  	Supplement A -17
             Public Notification in the Case of a Violation 	Supplement A -17

Appendices
Appendix A: Compliance Determination Examples 	Supplement A - A-1
Appendix B: Sample Monitoring Worksheets	Supplement A - B-1
Appendix C: Monitoring Plan Worksheets and Examples  	Supplement A - C-1
Appendix E: Contact Information for Safe Drinking Water Act Primacy Agencies	Supplement A - E-1
Appendix F: Tribal Contacts	Supplement A - F-1
Appendix G: Other STEP Documents  	Supplement A - G-1

-------
     Additional copies of this Supplement A, the Basic Guide, and Supplement B can be
      downloaded from EPA's Safe Drinking Water Web site atwww.epa.gov/safewater.

You can also call the Safe Drinking Water Hotline at 800-426-4791 to request these documents.

-------
Acronyms and  Definitions
ART - Average residence time
CCR - Consumer Confidence Report
CFR - Code of Federal Regulations
Compliance Samples - Required samples your system takes
to comply with regulations.  Compliance samples are identified
in your monitoring plan. All compliance samples identified in
your monitoring plan must be included in your compliance
calculations, even if you take more than the minimum number
of samples.
Conventional Filtration - A series of processes including
coagulation, flocculation, sedimentation, and filtration that
results in substantial particulate removal.
CWS - Community water system
DBP - Disinfection  byproduct
DBP Precursor - Disinfection byproduct precursor
Enhanced Coagulation - Refers to the process of achieving
improved disinfection byproduct precursor removal by using
conventional treatment.
Enhanced Softening - Refers to the process of achieving
improved disinfection byproduct precursor removal by using
precipitative softening.
EPA - Environmental Protection Agency
EPTDS - Entry point to the distribution system
GWUDI - Ground water under the direct influence of surface
water
LT1ESWTR - Long-Term 1 Enhanced Surface Water
Treatment Rule
MCL - Maximum contaminant levels are the maximum
permissible levels of a contaminant in water delivered to a
consumer. MCLs are enforceable standards.
MRDL - Maximum residual disinfectant levels are the
maximum permissible levels of disinfectant residuals in water
delivered to a consumer. MRDLs are enforceable standards.
MRT - Maximum residence time is an active point in the
distribution system where the water has been in the system
the longest. This may not necessarily be the same as the
most distant point from your treatment plant.
NTNCWS - Non-transient non-community water system
Operational Samples - Samples your system takes not for
compliance purposes, but to gain a better understanding of
water quality. These samples should not be included in your
compliance calculations.
Oxidant - Oxidants are most often used for the oxidation of
reduced iron and manganese, destruction of taste and odor
causing organic contaminants, and the destruction of synthetic
organic contaminants.  Many oxidants act as coagulant aids
and are used as part of an overall program for the control of
potentially harmful disinfection by-products.
PN - Public notification
Primacy Agency - The state agency that has been  granted
primary enforcement responsibility for administration and
enforcement of primary drinking water regulations and related
requirements applicable to public water systems within a state
(40 CFR 142.2).
PWS - Public water system
RAA - Running annual average
                                                  Supplement A -1

-------
SDWA - Safe Drinking Water Act
Stage 1 DBPR - Stage 1 Disinfectants and Disinfection
Byproducts Rule
State - Used in this guide to refer to your Primacy Agency.
The Primacy Agency for most systems is your state Drinking
Water Agency.  The Primacy Agency for systems located in
the Navajo Nation is your tribal office, and the Primacy Agency
for systems located on other tribal lands, in Wyoming, or in the
District of Columbia is your EPA Regional office.
Subpart H - PWSs using surface water or ground water under
the direct influence of surface water as a source.
SUVA - Specific ultraviolet absorption
TCR - Total Coliform Rule
TOC - Total organic carbon
TNCWS - Transient non-community water system
WTP - Water treatment plant
                                                   Supplement A - 2

-------
Is This Guide for Me?
The Stage 1 Disinfectants and Disinfection Byproducts Rule (Stage 1 DBPR) applies to water systems that add a chemical
disinfectant such as chlorine, chloramine, chlorine dioxide, or ozone to their drinking water during any part of the treatment process.
In addition to the basic requirements for all systems that add a chemical disinfectant (covered in the Complying With the Stage 1
Disinfectants and Disinfection Byproducts Rule: Basic Guide EPA Doc. No. 816-B-05-004), this guide covers the additional
requirements for:
             Community water systems (CWSs) and non-transient non-community
             water systems (NTNCWSs) adding chlorine dioxide during any part of
             the treatment process;
             Transient non-community water systems (TNCWSs) adding chlorine
             dioxide during any part of the treatment process; and
             CWSs and NTNCWSs adding ozone during any part of the treatment
             process.
                Stop!
If you do not add a chemical disinfectant
to your water, the Stage 1 DBPR does not
 apply to your system. If you do not use
     chlorine dioxide or ozone, the
requirements covered in this supplement
      do not apply to your system.
Systems that will typically find this guide useful (if they use chlorine dioxide or ozone) include:
       •      Small towns                                            •     Home owners' associations
       •      Rural water districts                                     •     Small private systems
       •      Tribal systems                                          •     Factories, religious institutions, and schools
       •      Manufactured housing communities                              with their own water supplies

Subpart H systems that use conventional filtration should obtain Supplement B of this guide or contact their state.  Contact
information for Safe Drinking Water Act (SDWA) Primacy Agencies is provided in Appendix E.  Tribal contact information is provided
in Appendix F.  If your system is a new system or if you are just starting to use a disinfectant, you should work with your state to
determine which requirements apply to you. Your state can also help you figure out how to calculate compliance with the Rule.
                                                   Supplement A - 3

-------
What Will I Learn?
As a drinking water system operator, your most important job is to
protect the health of your customers.  This guide serves as a
companion to the Basic Guide, which offers information on basic
requirements that apply to all systems that add a chemical
disinfectant.  This guide contains:

      •      The monitoring required for chlorine dioxide, chlorite,
             and bromate under the Stage 1 DBPR;

      •      How to determine if you are in compliance; and

      •      What to report to the state and to your customers.

Table 1 outlines the requirements  of the regulations and the systems
to which they apply. It also indicates where you can find information
on each disinfectant residual, byproduct, or precursor in the Basic
Guide and its supplements.  The appendices contain examples of
compliance calculations, sample monitoring worksheets, and sample
monitoring plans.
Table 1: Requirements of the Stage 1 DBPR
Disinfectant
Residual,
Byproduct, or
Precursor
Chlorine &
Chloramine
Residuals
Chlorine Dioxide
Residuals
Total
trihalomethanes
(TTHM) & five
haloacetic acids
(HAAS)
Chlorite
Bromate
Disinfection
Byproduct (DBP)
Precursors
Systems Required to
Monitor
CWSs and NTNCWSs
using chlorine or
chloramines for any
purpose
All systems using
chlorine dioxide for
disinfection or oxidation
CWSs and NTNCWSs
adding any chemical
disinfectant for any
purpose
CWSs and NTNCWs
adding chlorine dioxide
for disinfection or
oxidation
CWSs and NTNCWSs
using ozone
CWSs and NTNCWSs
using surface water or
ground water under the
direct influence of
surface water (GWUDI)
and conventional
filtration
Where to Find
Information
Basic Guide
Supplement A
Page 5
Basic Guide
Supplement A
Page 5
Supplement A
Page 1 1
Supplement B
       This guide describes the minimum federal requirements under the Stage 1 DBPR. Some states may have additional
  requirements and monitoring forms.  Be sure to check your state's specific requirements.  For state and tribal contact information,
                                             refer to Appendices E and F.
                                                  Supplement A- 4

-------
Chlorine Dioxide and Chlorite
           Supplement A - 5

-------
Monitoring  Requirements  for Chlorine  Dioxide and  Chlorite
DO I HAVE TO MONITOR FOR CHLORINE DIOXIDE AND CHLORITE?
All systems (including TNCWSs) that add chlorine  dioxide for disinfection or oxidation must monitor for chlorine dioxide and comply with
the maximum residual disinfectant level (MRDL) listed in Table 2 (40 CFR 141.65).  In addition, all CWSs and NTNCWSs using chlorine
dioxide to disinfect or oxidize their water must monitor for chlorite and comply with the maximum contaminant level (MCL) listed in Table 3
(40 CFR 141.64). If you use chlorine dioxide intermittently, you only have to monitor on days or in months when you use it. If you do not
use chlorine dioxide to oxidize or disinfect, this section does not apply to you. Unlike chlorite, excessive levels of chlorine dioxide
can cause acute (i.e., immediate) health effects. Because of this, TNCWSs are required to comply with the chlorine dioxide MRDL even
though they serve transient customers.
                                                                                Table 2: Chlorine Dioxide MRDL
Disinfectant
Chlorine Dioxide*
MRDL (mg/L)
0.8
                                                                                *As CIO,
                                                                                Table 3: Chlorite MCL
HOW OFTEN DO I HAVE TO SAMPLE AND WHERE DO I TAKE THE SAMPLES?
Routine and Additional Monitoring
Chlorine Dioxide. Routine monitoring for chlorine dioxide requires one sample per day
taken at the entry point to the distribution system (EPTDS). If a sample exceeds the
MRDL, you must take three additional samples in the distribution system the following
day. Table 4 will help you determine how often you have to sample and how your
system characteristics determine where you must take these samples (40 CFR
141.132(c)(2)(i)). These requirements apply to TNCWSs as well as CWSs and
NTNCWSs.
Chlorite.  Routine monitoring for chlorite requires one daily sample at the EPTDS as well as three monthly distribution system samples.
Table 4 explains where to take these samples. If any daily sample exceeds the MCL, you must take additional samples in the
distribution system the following day (40 CFR 141.132(b)(2)(i)).  These requirements apply only to CWSs and NTNCWSs. TNCWSs are
not required to monitor for chlorite because it usually causes negative health effects only after long-term exposure.
DBF
Chlorite
MCL (mg/L)
1.0
                                                  Supplement A - 6

-------
Reduced Monitoring
There is no reduced monitoring for chlorine dioxide (40 CFR 141.132(c)(2)(iii)) or for daily chlorite monitoring (40 CFR
Monthly chlorite monitoring can be reduced to quarterly monitoring after one year of sampling (with prior written permission from the
state) if:

       •     No individual sample taken in the distribution system exceeded the chlorite MCL; and

       •     No individual daily sample taken at the EPTDS exceeded the chlorite MCL.

You must return to routine monitoring if any of your samples (quarterly or daily) exceed the MCL (40 CFR 141.132(b)(2)(iii)(B)).
                                                      Supplement A - 7

-------
Table 4: Monitoring Frequency and Locations for Chlorine Dioxide and Chlorite
Disinfectant




Chlorine Dioxide
(measured as
CI02)





DBF






Chlorite





MRDL
(mg/L)




0.8





MCL
(mg/L)






1.0





System
Type



All
systems
using
chlorine
dioxide




System
Type



All
systems
using
chlorine
dioxide
except
TNCWSs


Routine
Monitoring
Frequency




Daily**




Routine
Monitoring
Frequency



Daily**





Monthly**


Routine
Monitoring
Location




At the
EPTDS




Increased
Monitoring
Frequency*



3 samples the
day after a
daily sample
exceeds the
MRDL




Routine Monitoring Location



At the EPTDS



3 samples:
1 . As close as possible to
the first customer;
2. Location representative of
ART; and
3. Location of MRT.
Increased Monitoring Locations
Systems not operating a booster chlorination station
after the first customer must take three samples as
close to the first customer as possible with at least 6
hours between samples (e.g., 6am, 12pm, 6pm).
Systems operating a booster chlorination station after
the first customer must take 3 samples:
1 . As close as possible to the first customer
2. At the location representative of average
residence time (ART);*** and,
3. At the location of maximum residence time
(MRT).***
Increased
Monitoring
Frequency*
3 samples the
day after a
daily sampling
exceeds the
MCL


\ /
\ /
x
/ \
/ \

Increased Monitoring Locations
At the same locations as the routine
monthly samples
1 . As close as possible to the first
customer;
2. Location representative of
ART; and
3. Location of MRT
^^ ^^
^\ .^^
x
^^^ ^^^
^ ^^
* You must still take the routine daily sample at the EPTDS the day after you exceed the MRDL.
** If you use chlorine dioxide intermittently, you are only required to monitor on days or months when you use chlorine dioxide.
*** States may use different criteria to determine locations of average and MRT in the distribution system. Consult with your state for assistance in determining the
points of average and MRT in your distribution system.
                                                               Supplement A - 8

-------
HOW DO I DETERMINE COMPLIANCE?
Chlorine Dioxide. There are two types of chlorine dioxide violations: acute and non-acute.

•   Acute violations occur when any routine daily sample taken at the EPTDS exceeds the MRDL and one or more of the samples taken
    in the distribution system the following day also exceeds the MRDL (i.e., exceedance of chlorine dioxide in the distribution system).
    Failure to take any one of the required additional samples in the distribution system on the day following an exceedance of
    the chlorine dioxide (MRDL) at the entry point is also an acute MRDL violation (40 CFR 141.133(c)(2)(i)). For example:

                System A's routine EPTDS sample was 0.90 mg/L (> MRDL).
                System A's additional distribution system samples the following day were 0.80 mg/L, 0.70 mg/L, and 0.90 mg/L.
                System A has committed an acute MRDL violation because one of its additional distribution system samples exceeded
                the MRDL.

•   Non-acute violations occur when two consecutive routine daily entry point samples exceed the MRDL, but none of the additional
    samples taken in the distribution system are above the MRDL (i.e., exceedance of chlorine dioxide at the EPTDS, but not in the
    distribution system.). Failure to collect the routine entry point sample on the day following  an exceedance of the chlorine
    dioxide MRDL at the entry point is also a non-acute MRDL violation (40 CFR 141.133(c)(2)(ii)). For example:

                System A's routine EPTDS sample was 0.90 mg/L (> MRDL).
                System A's routine EPTDS sample on the following day was also 0.90 mg/L, and  System A's additional distribution
                system samples taken the same day (because of the initial exceedance) were 0.80 mg/L, 0.70 mg/L, and 0.60 mg/L.
                System A's routine EPTDS sample on the third day was 0.10 mg/L.
                System A has committed a non-acute MRDL violation because two consecutive routine EPTDS samples exceeded the
                MRDL, but none of the additional distribution system samples exceeded the MRDL.
                                                    Supplement A - 9

-------
Chlorite. Compliance for chlorite monitoring is based exclusively on the average of the 3-sample set taken in the distribution system.
Daily samples must also be taken. If the average of any 3-sample set (either your routine monthly sample set or an additional set taken
due to a daily exceedance) exceeds the MCL, your system has violated the MCL. Even if your routine daily entry point monitoring
result exceeds the MCL and one or more of your additional distribution system samples exceeds the MCL. you are not in
violation unless the average of your three additional distribution system sample exceeds the MCL (40 CFR 141.133(b)(3)).

Table 5 presents information on determining compliance and identifies MCL and MRDL violations.

Table 5: Determining Compliance for Chlorine Dioxide and Chlorite
Disinfectant
Chlorine
Dioxide
DBF
Chlorite
Monitoring
Frequency
Daily
Monitoring
Frequency
Daily and
monthly
Compliance is based on:
Consecutive daily sampling results
Compliance is based on:
An average of each 3-sample set taken in the
distribution system (both routine monthly and
all additional sets). Add the results from each
3-sample set and divide the sum by 3.
You have an MCL or MRDL violation if:
Acute violation:
Your routine daily entrance point result is > 0.8 mg/L, and either:
1 . Any additional distribution system sample is > 0.8 mg/L; or,
2. You fail to take any of the additional samples in the distribution
system.
Non-acute violation:
1 . Two consecutive routine daily entry point samples are > 0.8
mg/L, but distribution system samples are < 0.8 mg/L.
2. Your daily sample is > 0.8 mg/L, and you fail to take your
required routine entry point daily sample the next day.
You have an MCL or MRDL violation if:
The average of any 3-sample set is > 1 .0 mg/L.
Note: If your daily entry point sample is above the MCL, you are not
in violation unless the average of your 3 additional distribution
system samples is above the MCL.
                                                   Supplement A-10

-------
Bromate
Supplement A -11

-------
Monitoring  Requirements for Bromate
DO I HAVE TO MONITOR FOR BROMATE?
                                                                                        Table 6: Bromate MCL
If your system uses ozone for disinfection or oxidation, you must monitor for bromate, a byproduct of
ozonation, and comply with the MCL listed in Table 6 (40 CFR 141.64).  A system may choose to monitor
for bromide in order to reduce bromate monitoring and thereby reduce their overall monitoring costs.
                                                                                            DBF
Bromate
           MCL (mg/L)
0.010
HOW OFTEN DO I HAVE TO SAMPLE?
Routine and Increased Monitoring
You must take one sample per month for each treatment plant using ozone while the ozonation system is operating under normal
conditions (40 CFR 141.132(b)(3)(i)).  There is no increased monitoring for bromate.

Reduced Monitoring
Systems using ozone may reduce their bromate monitoring (with prior written state permission), and thereby reduce overall monitoring
costs, to once per quarter by monitoring for bromide in source water for twelve consecutive months. Because bromate is formed from
bromide, low levels of bromide in your source water indicate low levels of bromate in you treated water. If your running annual average
(RAA) for bromide is < 0.05 mg/L, you may be eligible for reduced bromate monitoring.  Contact your state for more information.

If you qualify for reduced monitoring, you must continue to monitor for bromide every month. If your RAA of bromide is ever > 0.05 mg/L,
you must return to routine (monthly) bromate monitoring. NOTE: Monitoring the source water for bromide is optional and is only
necessary if you choose to try to qualify for and remain on reduced bromate monitoring (40 CFR 141.132(b)(3)(ii).

WHERE DO I TAKE THE SAMPLES?
You must take your routine or reduced bromate samples at the EPTDS (see Table 7 for locations) (40 CFR 141.132(b)(3)(i)). If you
choose to sample for bromide to obtain reduced monitoring status, you must sample your source water (40 CFR 141.132(b)(3)(ii)).
                                                  Supplement A -12

-------
Table 7: Bromate and Optional Bromide Monitoring Requirements and Locations
DBF
Bromate
Precursor
Bromide
MCL (mg/L)
0.010
Trigger Level
(mg/L)
0.05
System Type
Systems using ozone
System Type
Systems using ozone
attempting to qualify for
reduced monitoring
Routine Monitoring
Frequency
Monthly
Monitoring
Frequency
Monthly
Reduced Monitoring
Frequency
Quarterly
Reduced Monitoring
Frequency
X
Increased Monitoring
Frequency
^>^^
Increased Monitoring
Frequency
X
Monitoring
Location
EPTDS
Monitoring
Location
Source water
HOW DO I DETERMINE COMPLIANCE?
Compliance with the bromate monitoring requirements is determined by an RAA of your monthly samples (or monthly averages if you
take more than one sample per month), calculated at the end of each quarter. If your RAA exceeds the MCL, your system is in violation.

For example, if System A's monthly results for the last 12 months were 0.015 mg/L, 0.010 mg/L, 0.010 mg/L, 0.012 mg/L, 0.014 mg/L,
0.016 mg/L, 0.010 mg/L, 0.012 mg/L, 0.010 mg/L, 0.012 mg/L, 0.015 mg/L, and 0.013 mg/L, the sum of System A's 12 monthly results
(0.149 mg/L) divided by the number of samples collected (12) equals 0.012 (> MCL).  System A has committed an MCL violation.

If you are on reduced monitoring and your RAA for bromate exceeds the MCL, your system is in violation.  You must notify the public and
report to the state (40 CFR 141.134) whenever you commit a violation. Table 8 presents compliance criteria and identifies MCL violations
(40 CFR 141.133(b)(2)). The next section of this guide provides information on reporting requirements.
Table 8: Determining Compliance for Bromate
   DBF
Monitoring Frequency
          Compliance is based on:
       You have an MCL violation if:
  Bromate
      Monthly
An RAA of the last 12 monthly samples (or monthly
averages if > 1 sample each month) computed each
                 quarter.
1.   The RAA is > 0.010 mg/L;
                  OR,
2.   Any one sample result will cause the RAA to
    violate the MCL.
                                                    Supplement A-13

-------
Analysis and Reporting
       Supplement A -14

-------
Who  Must Analyze  My Samples?
The Stage 1 DBPR specifies analytical methods for measuring each relevant water quality parameter covered by the Rule. You must use
analytical methods specified in the Rule or otherwise approved by EPA to monitor and show compliance under the Stage 1 DBPR. For
more information on analytical methods, see 40 CFR 141.131 or refer to the Stage 1 Disinfectants and Disinfection Byproducts Rule:
Laboratory Quick Reference Guide (EPA 16-F-02-021), available online at
www.epa.gov/safewater/publicoutreach/quickreferenceguides.html.

Monthly chlorite sample analysis must be done by a certified laboratory. Your system operator, however, may be able to qualify for state
approval to analyze chlorine dioxide and daily chlorite samples. Bromate sample analysis must be done by a certified laboratory.  If you
choose to sample for bromide to attempt to qualify for reduced bromate monitoring, your system operator may be able to qualify for state
approval to collect and analyze bromide samples. Contact your state for more information. Contact information is provided in Appendix
E. Tribal contact information is provided in Appendix F.
                                                   Supplement A -15

-------
What Do  I  Report to the  State?
All public water systems (PWSs) required to comply with the Stage 1 DBPR must report routine sampling results to their state within 10
days of the end of each quarter in which they collect samples (40 CFR 141.134(a)). Table 9 shows what information must be included in
your chlorine dioxide and chlorite routine report.  Table 10 shows what information must be included in your bromate routine report.  You
must also report all MCL, MRDL, and monitoring violations. You must notify the state within 48 hours  of a non-acute chlorine dioxide
MRDL violation, a bromate MCL violation, or a chlorite MCL violation. Due to the acute health effects  of chlorine dioxide, you must report
acute chlorine dioxide violations to your state as soon as possible, but within 24 hours (40 CFR 141.202(b)(2)).

Table 9: Reporting Information for Chlorine Dioxide and Chlorite
Disinfectant
Chlorine Dioxide*
DBF
Chlorite**
Monitoring Frequency
Daily
Monitoring Frequency
Daily and Monthly
Report Information
1.
2.
3.
Dates, results, and locations of all samples taken during the last
quarter.
Whether the MRDL was violated.
Whether the MRDL was exceeded in any two consecutive daily
samples and if so, whether the violation was acute or non-acute.
Report Information
1.
2.
3.
4.
Number of entry point samples taken each month for last 3 months.
Location, date, and result of each sample (both entry point and
distribution) taken during the last quarter.
For each month in the reporting period, the average of each 3-
sample set taken in the distribution system.
Whether the MCL was violated, in which month, and how many times
it was violated each month.
*40CFR141.134(c)
**40CFR141.134(b)

Table 10: Reporting Information for Bromate
           DBF
Monitoring Frequency
                     Report Information
          Bromate
      Monthly
1.   Number of samples taken during the last quarter.
2.   Location, date, and result of each sample taken during the quarter.
3.   Average of the monthly averages of all samples taken during the
    previous 12 months.*
4.   Whether the MCL was violated.
* If you only collect one sample per month, your monthly average should be the same as your monthly result.
                                                    Supplement A-16

-------
What Do I Report to My  Customers?
Letting your customers know what is happening with their water system is part of your legal responsibility. In addition, informed
customers are more likely to understand the need for new treatment systems, infrastructure changes, and rate increases. While you
should try to communicate with your customers on a regular basis, you must provide public notification (PN) in the following situations:
                                                                                             Remember!

                                                                                   You must send your state copies
                                                                                         of all PNs sent to your
                                                                                     customers for Stage 1 DBPR
                                                                                     monitoring, MCL, and MRDL
                                                                                    violations.  The copies must be
                                                                                   sent with a letter stating that you
                                                                                   have met all the requirements of
                                                                                     the Public Notification Rule.
                                                                                     This must be done within 10
                                                                                       days of sending out a PN.
PUBLIC NOTIFICATION IN THE CASE OF A VIOLATION
The method and timing of your PN report varies based on the type of violation.  If you have a
non-acute chlorine dioxide MRDL violation, a bromate MCL violation, or a chlorite MCL
violation, you must provide Tier 2 PN: that is, you must notify the public as soon as
practicable, but no later than 30 days after you learn of the violation (40 CFR 141.203(b)(1)).
Within 10 days of notifying your customers, you must also submit to the state both a
certification that you have fully complied with the PN regulations and a copy of the PN.

Unless otherwise directed by your state, you must provide notice to each customer receiving
a bill, to other service connections to which your system delivers water, and to other people
regularly served  by your system who would not otherwise receive notice (e.g., house renters,
students, nursing home patients, prison inmates). You must use at least one of a variety of
PN methods. You can deliver the notice door-to-door or send it via mail.  If you operate a non-community water system, you can also
post the notice in a public place. If any of your customers will not receive the notice through mail, door-to-door delivery, or postings, you
must also use other methods, like a newspaper or radio announcement, to reach these customers (40 CFR 141.203(c)).

Due to the acute health effects caused by chlorine dioxide, the requirements for an acute violation are more stringent. In the case of an
acute chlorine dioxide MRDL or monitoring violation, you must provide Tier 1 PN: that is, you must notify the public as soon as possible,
but within 24 hours using television, radio, posted notices, or hand delivery. Whatever method you choose to use must be designed to
reach residential, transient, and non-transient users (40 CFR 141.202(c)).  Your state may establish other or additional methods to help
ensure that your notice reaches all users. Within 10 days of notifying your customers, you must also submit to the state both a
certification that you have fully complied with the PN regulations and a copy of the PN.

All monitoring violations (e.g., failure to take the required number of samples) must be reported to the state and to your customers.
                                                    Supplement A -17

-------
Generally, monitoring violations require Tier 3 PN, that is, you must notify your customers within 12 months of the violation. You may
include the notification in your Consumer Confidence Report (CCR) if it is published in time to satisfy the 12-month deadline.  Chlorine
dioxide monitoring violations require you to issue a Tier 1 PN and notify the public as soon as possible, but within 24 hours (40 CFR
141.202(c)).  Your state has the discretion to impose more stringent PN requirements.  Check with your state for more information.

All PNs must include the following specific health effects language (40 CFR Subpart Q, Appendix B):

    •   Acute chlorine dioxide: "Some infants and young children who drink water containing chlorine dioxide in excess of the MRDL
        could experience nervous system effects.  Similar effects may occur in fetuses of pregnant women who drink water containing
        chlorine dioxide in excess of the MRDL.  Some people may experience anemia.

        The chlorine dioxide violations reported today include exceedances of the EPA standard within the distribution system which
        delivers water to consumers.  Violations of the chlorine dioxide standard within the distribution system may harm human health
        based on short-term exposures.  Certain groups, including fetuses, infants, and young children, may be especially susceptible to
        nervous system effects from excessive chlorine dioxide exposure."

    •   Non-acute chlorine dioxide: "Some infants and young children who drink water containing chlorine dioxide in excess of the
        MRDL could experience nervous system effects.  Similar effects may occur in fetuses of pregnant women who drink water
        containing chlorine dioxide in excess of the MRDL.  Some people may  experience anemia.

        The chlorine dioxide violations reported today are the result of exceedances at the treatment facility only, not within the
        distribution system which delivers water to consumers.  Continued compliance with chlorine dioxide levels within the distribution
        system minimizes the potential risk of these violations to consumers."

    •   Chlorite: "Some infants and young children who drink water containing chlorite in excess of the MCL could experience nervous
        system effects.  Similar effects may occur in fetuses of pregnant women who drink water containing chlorite in excess of the
        MCL. Some people may experience anemia."

    •   Bromate: "Some people who drink water containing bromate in excess of the MCL over many years may have an increased risk
        of getting cancer."

                                                      Supplement A -18

-------
ROUTINE CONSUMER CONFIDENCE REPORTS
By July 1 of every year, you must make a CCR available to your customers (40 CFR 141.152(b)).  This report is designed to provide a
"snapshot" of the quality of the water supplied by your system over the past year.  In your CCR, you must tell your customers about any
violations, the actions you took to fix the violations, and any potential health effects resulting from the violations. You can find more
information on CCRs on EPA's CCR Web site, www.epa.gov/safewater/drinkingwaterquality/index.html.
                                                   Supplement A -19

-------
Appendix  A:  Compliance  Determination  Examples

The following examples are designed to help you understand the requirements of the Stage 1 DBPR. The chlorite and chlorine dioxide compliance
determination examples are each preceded by a flowchart outlining monitoring requirements and situations in which systems are considered to have
committed a violation.  Monitoring examples, including a detailed narrative of monitoring activities for each disinfectant or byproduct, are provided,
followed by portions of completed monitoring worksheets showing sampling results and compliance calculations. Blank copies of the monitoring
worksheets are provided in Appendix B for your use. Please note that the completed worksheets that accompany the examples are abbreviated
versions of the blank copies provided.
                Note: The monitoring requirements listed in these examples correspond to the type of system
                  described in each example, and may be different than the requirements for your system.
                                               Supplement A-A-1

-------
CHLORITE
                              Daily Chlorite Monitoring
                Continue to
               take routine
               daily samples
                atEPTDS
No
                                      System takes routine daily
                                      chlorite sample at EPTDS
          Result is > MCL
                                                  Yes
                                      System takes 3 additional
                                         samples day after
                                         exceedance at first
                                      customer, ART, and MRT
                                       Average of 3-sample
                                           set is > MCL
                                        Yes
                        No
                                        MCL
                                      violation
                     No
                  violation
                                         Monthly Chlorite Monitoring
                                             System takes routine monthly
                                                chlorite samples at first
                                               customer, ART, and MRT
c
o
                                  VI
                                  TO
                                  c
                                  03
                                  O
              Average of 3-sample set
                     is > MCL
                               No
                                                          Continue routine
                                                              monthly
                                                            monitoring*
              *After 1 year system can reduce monthly monitoring to quarterly, with state approval, if no individual monthly samples and no
              routine daily samples exceed the MCL.
                                                  Supplement A - Page A-2

-------
Example #1: A Small Surface Water CWS Monitors for Chlorite (Daily)

This example shows how a small surface water system using chlorine dioxide would conduct routine monitoring for chlorite and calculate compliance on a
daily basis. Although it will not be discussed in this example, the system must also monitor and calculate compliance with the chlorine dioxide MRDL.

This surface water system serves 700 persons and is required to perform daily chlorite monitoring at the EPTDS because it uses chlorine dioxide for
oxidation and disinfection.  It is also required to perform monthly distribution system chlorite monitoring. Monthly monitoring for chlorite will be covered in
example #3. The system will also have to perform daily chlorine dioxide monitoring.  Daily chlorine dioxide monitoring will be  covered in examples #4 and
#5.

On April 18, 2005 the daily chlorite sample at the EPTDS is below the MCL.  The system's daily EPTDS sample on April 17 (not shown) was also below the
MCL, so no additional monitoring in the distribution system was required.  In addition, the system will not be required to take distribution system samples on
April 19, 2005.
Example #1 Worksheet
Daily Chlorite Monitoring Worksheet
MCL for Chlorite: 1 .0 mg/L
Routine Daily Monitoring
Date
Samples
Collected
Day,
month, and
year
4/18/05
Location
Must be
taken at
EPTDS
EPTDS
Result
Circle if
above
MCL
0.8 mg/L
Date Report
Sent to State
Routine or
violation report

Additional Distribution System Monitoring
Additional Sample
and Date
Must be taken day
after entry point
exceedance
1
2
3

Location
1st customer,
ART, MRT



Result




Compliance
Calculation
Average of3-sample set
(circle if above MCL)

Follow-up Action
Taken
Check appropriate
box
a Notify the State
n Notify the Public

-------
Example #2: A Small Surface Water CWS Monitors for Chlorite (Daily)
This example shows what would happen if a routine daily entry point sample taken by the surface water system in example #1 exceeded the chlorite MCL,
but the average of the three distribution system follow-up samples did not exceed the MCL.

The system collects its routine daily entry point sample on April 19, 2005. No additional distribution system monitoring is required on April 19 because the
daily entry point sample collected on April 18, 2005 did not exceed the MCL (see example #1). The routine daily sample result collected on April 19 (1.2
mg/L) exceeds the MCL (1.0 mg/L). The system must take additional distribution system samples the next day (April 20) at each of the following three
locations: the first customer, the location of ART, and the MRT. The system must take the three sample set in addition to the  routine daily entry point
sample required on April 20, 2005.

On April 20, the system takes its routine daily entry point sample (0.7 mg/L), which is below the MCL. The system will not have to take additional samples
in the distribution system on April 21, 2005. The system also takes the three additional samples required by the exceedance of the MCL at the EPTDS on
the previous day (April 19). The average of the three April  20 additional samples is below the MCL, so the system remains in  compliance, even though the
sample at the first customer (1.1 mg/L) is above the MCL:
                                           1.1 +0.9+ 0.5 mg/L
                                      	      =0.8 mg/L < MCL
                                                         Supplement A - Page A-5

-------
Example #2 Worksheet
Daily Chlorite Monitoring Worksheet
MCL for Chlorite: 1 .0 mg/L
Routine Daily Monitoring
Date Sample
Collected
Day, month,
and year
4/19/05
4/20/05
Location
Must be
taken at
EPTDS
EPTDS{
EPTDS
Result
Circle if
above
^AĞM^^K^
Ğ->"/WUL1~Ğ..
1.2 mg/L
fc- -^
0.7 mg/L
Date Report
Sent to State
Routine or
violation report
x
)

Additional Distribution System Monitoring
Additional Sample
and Date
Must be taken day
after entry point
exceedance
1
2
3
1
2
3

4/20/05
Location
1st
customer,
ART, MRT



First Customer
Average RT
Maximum RT
Result




1.1 mg/L
0.9 mg/L
0.5 mg/L
Compliance
Calculation
Average of3-sample set
(circle if above MCL)

1.1 +0.9 + 0.5 =0.8mq/L
3
Follow-up Action
Taken
Check appropriate
box
a Notify the State
n Notify the Public
a Notify the State
n Notify the Public
                                                   Supplement A - Page A-6

-------
Example #3: A Small Surface Water CWS Monitors for Chlorite (MCL Violation)

This example shows how the surface water system in examples #1 and #2 violates the MCL with its routine monthly distribution system samples.


On June 20, 2005 the system takes its three routine distribution system samples for the month. The average of the three samples exceeds the MCL:

                                          1.2 mg/L + 1.1  mg/L + 1.0 mg/L
                                      	   =1.1 mg/L > MCL
                                                       3

The system has committed an MCL violation and must report to the state within 48 hours and to its customers within 30 days.


The average of monthly distribution system samples taken for July 2005 does not exceed the MCL.  The system is in compliance for the month of July.



Example #3 Worksheet
Monthly and Quarterly Distribution System Chlorite Monitoring Worksheet
MCL for Chlorite: 1 .0 mg/L
Monitoring
Frequency
Check box
/ Monthly
n Quarterly
/" Monthly
n Quarterly
Date Sample
Collected
Day, month,
and year
June 20, 2005
July 20, 2005
Location
Must be taken at first customer,
ART, and MRT
1
2
3
1
2
3
First Customer ,
Average Residence Time >
Maximum Residence Time
First Customer
Average Residence Time
Maximum Residence Time
Results
Circle if above
MCL
	 	 ~~ 1.2 mg/L ~~ \
^ 1.1 mg/L JP
lUmg/T ^
1.0 mg/L
0.9 mg/L
0.8 mg/L
Compliance Calculation
Average of 3-sample set; circle
if above MCL
— — ^
*1 o +11 + 10-11 mn/l ^^N
. 3 V
iTT^Try + u o — 1\_ —
3
Follow-up Action
Taken
Check appropriate
box
X Notify the State
X Notify the Public
n Notify the State
n Notify the Public
Date Report Sent to
State
Routine or violation
report
6/30/05

                                                        Supplement A - Page A-7

-------
CHLORINE DIOXIDE
                                        System takes routine daily CHLORINE
                                             DIOXIDE sample at EPTDS
                                  No
            Continue to take
          routine daily samples
               at EPTDS
               No
                                 Yes
           EPTDS Result is > MRDL
                                                  Result is > MRDL
Additional samples at
 first customer and at
 least 6 hours apart
    One or more
 additional samples
    are > MRDL
                                           No
                                                             Yes
              Acute
             violation
                                    Yes
                                                                     No
                                             Continue daily monitoring*
                                                                                  System takes 3
                                                                               additional samples day
                                                                                 after exceedance*
Booster chlorination
after first customer?
                                                                                            Yes
Additional samples
   taken at first
customer, ART, and
       MRT
       *Failuretotake additional samples in the distribution system the day after your routine daily sample exceeded the MRL is an acute violation.

       **Failuretotake your routine EPTDS daily sample the day after a routine daily sample exceeds the MRDL is a non-acute violation.
                                                Supplement A - Page A-8

-------
Example #4: A Surface Water CWS Monitors for Chlorine Dioxide (Non-acute Violation)
This example shows how a surface water system using chlorine dioxide collects routine daily entry point samples and commits a non-acute chlorine dioxide
MRDL violation based on consecutive daily entry point samples. Although it will not be discussed in this example, the system would also be required to
monitor and calculate compliance with the chlorite MCL.

This surface water system serves 1,000 persons and is required to perform daily chlorine dioxide monitoring at the entrance to the distribution system
because it uses chlorine dioxide as a disinfectant.  On March 29, 2004 the system takes its required sample at the EPTDS. The sample (0.7 mg/L) is below
the MRDL (0.8 mg/L), and no additional monitoring is required.

On March 30, the system takes its required daily sample at the EPTDS.  The sample (0.9 mg/L) exceeds the MRDL, and the system must perform
additional distribution system monitoring on March 31.  Since two samples collected on consecutive days have not yet exceeded the MRDL (the routine
entry point sample for March 29 was below the MRDL), the system has not yet committed a violation.

On March 31, the system takes its required sample at the EPTDS and its three additional distribution system samples required by the  March 30 entry point
sample result. Since the entry point sample (0.9 mg/L) exceeds the MRDL, the system must perform additional monitoring on April 1.  Now, because two
routine daily entry point samples in  a row exceed the MRDL (March 30 and 31), the system has committed a non-acute MRDL violation and must report to
the state within 48 hours and to its customers within 30 days.  Because the system does not operate booster chlorination stations after the first customer,
the additional distribution system three sample set taken on March 31 (due to the MRDL exceedance on March 30) is taken as close as possible to the first
customer. The samples are taken at least 6 hours apart from one another. None of the additional distribution  system samples exceed the  MRDL. Based
on the entry point sample result for March  30 and the distribution system monitoring for March 31, the system has not committed an acute MRDL violation
(but does have a  non-acute violation).

On April 1, the system collects its routine daily entrance point sample. The sample  (0.7 mg/L) does not exceed the MRDL.  No additional monitoring  in the
distribution system will be required on April 2. Still on April 1, the system collects the additional distribution system samples required because of the
exceedance at the entry point on March 31. None of the additional distribution system samples exceed the MRDL.  The system has not committed an
acute violation.
                                                         Supplement A - Page A-9

-------
Example #4 Worksheet
Chlorine Dioxide Monitoring Worksheet
MRDL for Chlorine Dioxide: 0.8 mg/L (as CIO2)
Routine Monitoring
Date Sample
Collected
Day, month,
and year
3/29/04
3/30/04
3/31/04
4/1/04
Location
Must be taken at
EPTDS
EPTDS
EPTDS /
EPTDS /
EPTDS
Result
Circle if
above
MRDL
0.7 mg/L
^O.Qmg/L^
0.9 mg/L
0.7 mg/L
Date Report Sent
to State
Routine or violation
report



t
)

Vion-acute
//iolation 4/2/04




Additional Monitoring
Additional Sample and Date
Must be taken day after
exceedance



1
2
3
1
2
3
1
2
3


6:00 am
3/31/04 12:00 pm
6:00 pm
6:00 am
4/1/04 12:00 pm
6:00 pm
Location or Time
Varies by system
type






First customer
First customer
First customer
First customer
First customer
First customer
Result
Circle if
above
MRDL






0.7 mg/L
0.5 mg/L
0.6 mg/L
0.8 mg/L
0.8 mg/L
0.7 mg/L
Violation Type
Check
appropriate box
n Acute
n Non-acute
n Acute
n Non-acute
n Acute
X Non-acute
n Acute
n Non-acute
Follow-up Action
Taken
Check appropriate box
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
X Notify the State
X Notify the Public
n Notify the State
n Notify the Public
                                                  Supplement A - Page A-10

-------
Example #5: A Surface Water CWS Monitors for Chlorine Dioxide (Acute Violation)
This example shows how the surface water system in example #4 commits an acute MRDL violation based on additional distribution system samples.
Although it will not be discussed in this example, the system will also be required to monitor and calculate compliance with the chlorite MCL.

On April 2, the  system continues to collect its routine daily chlorine dioxide entry point sample.  The sample (1.1 mg/L) exceeds the MRDL (0.8 mg/L). The
system must conduct additional distribution system monitoring the following day (April 3) to determine whether it has committed an acute MRDL
violation.

On April 3, the  system collects its  routine daily entry point sample. The sample (0.8 mg/L) does not exceed the MRDL (0.8 mg/L). No additional distribution
system samples are required on April 4.  Still on April 3, the system conducts follow-up sampling because of the routine daily exceedance on April 2. Two
of the samples taken at the first customer in the distribution system (1.1 mg/L, 0.9 mg/L) violate the MRDL.  The system has now committed an acute
violation since, in combination with the previous day's entry point  exceedance, any single violation of the MRDL during follow-up distribution system
sampling constitutes an acute violation. The system must report to the state as soon as possible (but no later than 24 hours after learning of the violation)
and issue  a PN within 24 hours (starting at 6 a.m., the time the first sample violated the MRDL). The system reports the violation to the state and the public
on April 3.

The routine daily entry point sample for April 4 (0.6 mg/L) does not exceed the MRDL. The system has not committed a non-acute violation. No additional
follow-up distribution system samples are required on April 5.  The additional distribution system samples taken on April 4 because of the routine daily entry
point exceedance on April 3 do not exceed  the MRDL. The system has not committed another acute MRDL violation on April 4.
                                                         Supplement A - Page A-11

-------
Example #5 Worksheet
Chlorine Dioxide Monitoring Worksheet
MRDL for Chlorine Dioxide: 0.8 mg/L (as CIO2)
Routine Monitoring
Date
Samples
Collected
Day, month,
and year
4/2/04
4/3/04
Location
Must be taken at
EPTDS
EPTDS /
EPTDS
Result
Circle if
above
fl/fpp/
'l1 mg/L^
^ 	 ^
0.8 mg/L
Date Monitoring
Report Sent to
State
Routine or violation
report



acute violation
4/3/04


Additional Monitoring
Additional Sample and
Date
Must be taken day after
exceedance



1 6:00 am
2 AmnA 12:00pm
3 6:00 pm
Location
Vanes by
system type



First customer (
First customer i
First customer
Result
Circle if
above
MRDL


^f i.
^11 mg/L
^0.9 mg/L
0.8 mg/L
Violation Type
Check
appropriate box
o Acute
o Non-acute
*^C Acute
^3 Non-acute

Follow-up Action
Taken
Check appropriate box
a Notify the State
a Notify the Public
X Notify the State
X Notify the Public
                                                  Supplement A - Page A-12

-------
BROMATE
Example #6: A GWUDI System Monitors for Bromate
This example discusses bromate monitoring, reporting, and compliance issues for a system using ozone.

This GWUDI system uses ozone for disinfection, so it must monitor for bromate each month. On April 18, 2005 the system takes its monthly sample at the
EPTDS. Since compliance is calculated at the end of each quarter, no further action is required. The system continues to collect one bromate sample
each month.

June 2005 marks the end of the second quarter of 2005. After collecting its sample for the month, the system must calculate its running annual average to
determine compliance using monthly results for the last 12 months. The monthly results for July of 2004 through June of 2005 are as follows: 0.012 mg/L,
0.006 mg/L, 0.009 mg/L, 0.008 mg/L, 0.009 mg/L, 0.012 mg/L, 0.009 mg/L, 0.009, 0.015 mg/L, 0.009 mg/L, 0.010 mg/L, and 0.011 mg/L. Since the system
did not collect a sample in May, it only has  11 samples available to calculate its running annual average. To determine whether the system has violated the
MCL, the system sums all available monthly samples for the last 12 months (12 samples) and divides it by the total number of samples taken  (12):

                0.012+0.006+0.009+0.008+0.009+0.012+0.009+0.009+0.015+0.009+0.010+0.011 mg/L
             	     = 0.010 mg/L < MCL
                                                     12

Four of the individual monthly results in the last four quarters exceed the MCL.  However, the system is in compliance because none of these results cause
the RAAto violate the MCL (0.010  mg/L).  No further action is required except to report to the state on or before the 10th day after the end of the quarter.
For this example, the routine monitoring report is due on July 10, 2005. The system reports to the state on July 1, 2005, the same day it issues its CCR.
                                                        Supplement A - Page A-13

-------
^JBromate/Br^nide Monitoring Worksheet
MCL for Bromate: 0.010 mg/L RAA for Reduced Monitoring (Bromide): 0.05 mg/L
Date Sample
Collected
Day, month,
and year
4/18/05
5/18/05
6/18/05
Location
Must be taken at
EPTDS (bromate)
or source (bromide)
EPTDS
EPTDS
EPTDS
Result
Use for avg.
0.009 mg/L
0.010 mg/L
0.011 mg/L
Compliance Calculation
Running annual average computed quarterly


(0.012+0.006+0.009+0.008+0.009+0.012+0.009+0.009+
0.015+0.009+0.010+0.011)/12 = 0.010 mg/L
Follow-up
Action Taken
Check appropriate
box
a Notify the State
a Notify the Public
n Notify the State
a Notify the Public
X Notify the State
a Notify the Public
Date Report Sent to
State
Routine or violation
report


routine - 7/01/05
Supplement A - Page A-14

-------
Appendix  B:  Sample Monitoring  Worksheets

The following worksheets are designed to help you keep track of your Stage 1 DBPR sampling and results. These worksheets are designed
to allow you to record both the results from your routine monitoring and the results from additional monitoring (where applicable). While
these worksheets may be a useful management tool, system operators should also keep the original laboratory results on file.

The worksheets can help you ensure that you collect the right number of routine samples in each monitoring period and that you calculate
compliance correctly. The worksheets will also remind you of corrective actions you will have to take if you violate the MCL or MRDL.

Each worksheet includes an explanation of how to complete it and how to use it to calculate compliance.  Review the examples in Appendix
A to help you understand how the worksheets would be used in real-world situations.
  Note: Some states may have their own monitoring worksheets that small drinking water systems are required to complete. The
  worksheets contained in this section are presented as learning tools and should not replace monitoring forms required by the
                                                    state.
                                               Supplement A - B-1

-------
                                        Daily Chlorite Monitoring Worksheet Instructions
                                                                   J
Step #1 Note when you took the routine daily entry point sample.
In the column labeled 'Date Sample Collected,' record the day, month, and year
you took the sample.

Step #2 Record where you took the sample.
In the column labeled 'Location,' record where you collected the sample.  Your
daily chlorite samples must be taken at the entrance to the distribution system.

Step #3 Record result.
In the column labeled 'Result,' record the sample analytical result, including units
of measure.

•  If your result is below the MCL, no further action is required.
•  If your result exceeds the MCL, you must take 3 additional samples on the next
  day and complete the 'Additional  Monitoring' portion of the worksheet using the
  results from these samples.

Step #4  Monitoring report.
All systems must report to their state both routinely and after committing a
violation.  Enter the date you  send your report to  the state in the column labeled
'Date Report Sent to State.'

•  Systems monitoring for chlorite daily must report within 10 days of the end of
  the quarter.
•  Systems that have committed a violation must report within 48 hours.

Step #5A Record date and result of additional distribution system samples.
In the column labeled 'Additional Sample and Date/record the day, month, and
year that each of the 3  additional samples were taken.  In addition, record the
location and result for each of the samples in their respective columns.

•  You must take one sample as close as possible to the first customer, one at the
  point of ART, and one at the point of MRT.
Step #5B  Calculate average of additional samples.
Add the results of the 3-sample set you have taken and divide that number by
3.  You will use this average to determine if you are in compliance.  In the
column labeled 'Compliance Calculation,' enter the calculated average.

•  If your result is < MCL, no further action is required.
•  If your result is > MCL, you  have violated the MCL and must notify your
   state and your customers. Circle the result if it is greater than the MCL.

Step #6 Follow-up action taken.
Specific follow-up actions need to be taken if a sampling result is > MCL or if
you fail to take a sample (a monitoring violation). In the column labeled
'Follow-up Action Taken:'

•  Check 'Notify the State' AND 'Notify the Public' if you fail to take a required
   sample.
•  Check'Notify the State' AND 'Notify the Public' if the average of your 3-
   sample set is > MCL. Notify the state within 48 hours and your customers
   within 30 days.
                                                              Supplement A - B-2

-------
Daily Chlorite Monitoring Worksheet
MCL for Chlorite: 1.0 mg/L
Routine Daily Monitoring
Date Sample
Collected
Day, month, and
year










Location
Must be taken at
EPTDS










Result
(a)(b)
Circle if
above
MCL










Date Report Sent to
State
Routine or violation
report






























Additional Distribution System Monitoring
Additional Sample
and Date
Must be taken day after
entry point exceedance
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3










Location (c)
7sf customer,
ART, MRT






























Result































Compliance
Calculation (d)
Average of 3-sample set
(circle if above the MCL)










Follow-up Action
Taken
Check appropriate
box
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
(a) If you fail to take a required sample, you have committed a monitoring violation and must notify the state and your customers.
(b) If your daily entry point sample exceeds the MCL, you must conduct follow-up monitoring in the distribution system on the day after the exceedance.
(c) You must take your additional samples in the distribution system at the first customer, the location of ART, and the location of MRT.
(d) If the average of your 3-sample set in the distribution system exceeds the MCL, you have committed an MCL violation and must notify the state within 48 hours and your customers within 30
days.
Supplement A- B-3

-------
                                       Monthly Chlorite Monitoring Worksheet Instructions
                                                                    J
Step #1 Check monitoring frequency.
In the column labeled 'Monitoring Frequency,' check the box corresponding to
the monitoring frequency of the sample.  If you have qualified for reduced
monitoring, you will monitor each quarter. Otherwise, you will monitor each
month.

Step #2 Note when you took the samples.
In the column labeled 'Date Samples Collected,' record the day, month, and
year you collected the sample.

Step #3 Enter the location where you took the sample.
In the column labeled 'Location,' enter the location where you took the sample.
Monthly chlorite samples must be collected at the first customer, the location of
ART, and the location of MRT.

Step #4 Record result.
In the column labeled 'Results,' record the sample analytical results, including
units of measure.  Record each sample on the line corresponding with the
appropriate sample location.

Step #5 Calculate average of monthly samples.
Add the results of the 3-sample set  you have taken and divide the sum by 3.
You will use this average to determine if you are in compliance. Enter this
average in the column labeled 'Compliance Calculation.'

•  If your result is < MCL, no further action is required.
•  If your result is > MCL, you have violated the MCL and must notify your
   state and your customers. Circle all averages that are above the MCL.
Step #6 Follow-up action taken.
Specific follow-up actions need to be taken if a sampling result is > MCL or if
you fail to take a sample (a monitoring violation). In the column labeled
'Follow-up Action Taken:'

• Check 'Notify the State' AND 'Notify the Public' if you fail to take a required
  sample.
• Check 'Notify the State' AND 'Notify the Public' if your monthly average is >
  MCL. Notify the state within 48 hours and your customers within 30 days.

Step #7 Monitoring report.
All systems must report to their state both routinely and after committing a
violation.  Enter the date you send your report to the state  in the column
labeled 'Date Monitoring Report Sent to State.'

• Systems monitoring for chlorite monthly or quarterly must report within 10
  days of the end of the quarter.
• Systems that have committed a violation must report within 48 hours.
                                                              Supplement A - B-4

-------
Monthly and Quarterly Distribution System Chlorite Monitoring Worksheet
MCL for Chlorite: 1.0mg/L
Monitoring
Frequency
Check box
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
DMonthly
QQuarterly
Date
Sample
Collected
Day, month,
and year











Location
Must be taken at first customer,
ART, and MRT
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3

































Results (a)
Circle if above
MCL

































Compliance Calculation (b)
Average of 3-sample set; circle if above
MCL











Follow-up Action
Taken
Check appropriate box
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
n Notify the State
n Notify the Public
Date Report
Sent to State
Routine or violation
report











(a) If you fail to take a required sample, you have committed a monitoring violation and must notify the state and your customers.
(b) If the average of your 3-sample set exceeds the MCL, you have committed an MCL violation and must notify the state within 48 hours and your customers within 30 days.
Supplement A- B-5

-------
                                          Chlorine Dioxide Monitoring Worksheet Instructions
Step #1 Note when you took the entry point sample.
In the column labeled 'Date Sample Collected,' record the day, month, and year you
took the sample.

Step #2 Record where you took the samples.
In the column labeled 'Location,' record where you collected the sample. Your routine
chlorine dioxide samples must be taken at the EPTDS.

Step #3 Record result.
In the column labeled 'Result,' record the sample analytical result, including units of
measure.

•  If your result is < MRDL, no further action is required.
•  If your result is > MRDL, you must take 3 additional samples the next day and
  complete the 'Additional Monitoring' portion of the worksheet (circle the result).
•  If two consecutive daily samples exceed the MRDL, you have committed a non-acute
  violation. Check the box labeled 'Non-acute.' You must notify your state and your
  customers.

Step #4 Monitoring report.
All systems must report to their state after each quarter in which they collected samples.
Systems that commit a violation must also report to the state.  Enter the date you send
your report to the state in the column labeled  'Date Report Sent to State.'  Also note the
type of report and violation and the submission date.

•  Systems monitoring for chlorine  dioxide must submit a report within 10 days of the
  end of each quarter.

Step #5A  Record date, location, and result of additional samples.
If your daily sample exceeds the MRDL,  you must take 3 additional distribution system
samples the following day.  Record the day, month, and year you took the samples in
the  column labeled 'Additional Sample and Date.'  Where you take the samples depends
on what type of system you operate. Record  the location of each sample in the column
labeled 'Location or Time.'

•  Systems not operating a booster chlorination station after the first customer must take
  3 samples in the distribution system as close to the first customer as possible with at
  least 6 hours between samples.  Enter one sample on each available line (marked  1,
  2, and 3).
•  Systems operating booster chlorination stations after the first customer must take one
  sample  at the EPTDS, one at the point of ART in the distribution system, and

  one at the point of MRT  in the distribution system.  Enter one sample on each
  available line (marked 1, 2,  and  3).
In the column marked 'Result,' enter the analytical result of each additional
distribution system sample on the line corresponding to the appropriate sample
location.  Circle any results above the MRDL.

Step #5B Determine compliance for additional samples.
Compare all three results to the MRDL. In the column labeled 'Violation Type:'

•  If all your results are < MRDL, no further action is required.
•  If any of your results are > MRDL, you have committed an acute MRDL
  violation. Check the box labeled 'Acute.'  You must notify your state and your
  customers.

If none of your results are > MRDL, but your routine sample has exceeded the
MRDL on successive days, you have committed a non-acute violation. Check the
box labeled 'Non-acute.' You must notify your state and your customers.

Step #6  Follow-up action taken.
Specific follow-up actions need to be taken if a sampling result is > MRDL or if you
fail to take a sample (a monitoring violation).  In the column labeled 'Follow-up
Action Taken:'

•  Check 'Notify the State' AND 'Notify the Public' if you fail to take a required
  sample.
•  If you have committed a non-acute violation, check 'Notify the State' AND
  'Notify the Public.' Notify the state within 48 hours and your customers within
  30 days.
•  If you have committed an acute violation,  check 'Notify the State' AND 'Notify
  the Public.' Notify the state and customers as soon as possible but within 24
  hours.
                                                                  Supplement A- B-6

-------
Chlorine Dioxide Monitoring Worksheet
MRDL for Chlorine Dioxide: 0.8 mg/L
as CIO2)
Routine Monitoring
Date Sample
Collected
Day, month,
and year









Location
Must be taken at
EPTDS









Result
(a)(b)
Circle if
above
MRDL









Date Report Sent
to State
Routine or violation
report



























Additional Monitoring
Additional Sample and
Date (c)(d)
Must be taken day after
exceedance
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3
1
2
3









Location or
Time (e)
Vanes by system
type



























Result (f)
Circle if
above
MRDL



























Violation Type
Check appropriate box
o Acute
o Non-acute
o Acute
o Non-acute
o Acute
o Non-acute
o Acute
o Non-acute
o Acute
o Non-acute
o Acute
o Non-acute
o Acute
o Non-acute
o Acute
o Non-acute
o Acute
o Non-acute
Follow-up Action
Taken
Check appropriate box
a Notify the State
a Notify the Public
a Notify the State
o Notify the Public
a Notify the State
o Notify the Public
a Notify the State
a Notify the Public
a Notify the State
o Notify the Public
a Notify the State
o Notify the Public
a Notify the State
a Notify the Public
a Notify the State
o Notify the Public
a Notify the State
o Notify the Public
(a) If you fail to take a required entry point sample, you have committed a monitoring violation and must notify the state and your customers.
(b) If your daily entry point sample exceeds the MRDL, you must conduct additional distribution system monitoring on the day after the exceedance.
(c) If you do not operate a booster chlorination station after the first customer, indicate the time when you took the samples.
(d) If you fail to take follow-up distribution system samples, you have committed an acute MRDL violation.
(e) If you do not operate a booster chlorination station after the first customer, take samples at the EPTDS with at least 6 hours between samples. If you operate booster chlorination stations after the first
customer, take distribution system samples at the first customer, ART, and MRT locations.
(f) If any of your three additional samples exceeds the MRDL, you have committed an acute MRDL violation and must notify the state and your customers within 24 hours.
Supplement A- B-7

-------
                                          Bromate/Bromide Monitoring Worksheet Instructions
Step #1 Circle whether you are monitoring for bromate or bromide.
In the worksheet title, circle whether you are using this worksheet for bromate
monitoring or for additional bromide monitoring in order to qualify for reduced
bromate monitoring. Track each analyte on a separate worksheet.

Step #2 Note when you took the sample.
In the column labeled 'Date Sample Collected,' record the day, month, and year you
took the sample.

Step #3 Record where you took the sample.
In the column labeled 'Location,' record where you collected the sample. Your
bromate sample must be taken at the entrance to the distribution system and your
bromide sample must be taken from your source water.

Step #4A  Record result.
In the column labeled 'Result,' record the sample analytical result, including units of
measure.

Step #4B  Determine compliance/reduced monitoring eligibility.
In the column labeled 'Compliance Calculation,' record the RAA,  calculated at the
end of each quarter. Use your monthly bromate/bromide samples for the last 12
months to calculate your running annual average.

Step #4C  Determine if further action is required (bromate).
If you are monitoring for bromate, compare your  RAA to the MCL.
•  If the result is <  MCL, no further action is required.
•  If the result is >  MCL, you  have committed an  MCL violation and must notify the
  state and your customers.

Step #4D  Determine if you  are eligible for reduced monitoring (bromide).
If you are monitoring for bromide, compare your RAA to the RAA required to qualify
for reduced monitoring (0.05  mg/L).

•  If the result is <  qualifying  level and your average is based on 1 year (12
  months) of monitoring, contact your state to see if you are eligible for reduced
  bromate monitoring.
•  If the result is >  qualifying  level, you are not eligible for reduced monitoring.  You
  will have to wait for another quarter of results to see if you qualify.
Step #5A   Follow-up action taken (bromate).
Specific follow-up actions need to be taken if a bromate RAA is > MCL or if you fail
to take a sample (a monitoring violation).  In the column labeled 'Follow-up Action
Taken:'

• Check 'Notify the State' AND 'Notify the Public' if you fail to take a required
  sample.
• Check'Notify the State' AND 'Notify the Public' if you have committed an MCL
  violation. Notify the state within 48 hours and your customers within 30 days.

Step #5B   Follow-up action taken (bromide).
If your RAA is below the RAA required to qualify for reduced bromate monitoring,
you may wish to contact your state to see if you qualify for reduced monitoring.
Check 'Notify the State.' You do not have to contact your state if the average is
higher than the average required to  qualify for reduced monitoring.

Step #6    Monitoring report.
All systems must routinely report to their state. Systems that commit a violation
must report the violation to their state. In the column  labeled 'Date Report Sent to
State,' enter the day, month, and year you send your  report to the state.

• Systems monitoring for bromate must report within 10 days of the end of each
  quarter.
• If you are monitoring for bromide, you are not required to report, but you  may
  contact your state if you think your system is eligible for reduced monitoring.
                                                                  Supplement A- B-8

-------
Bromate/Bromide Monitoring Worksheet
MCL for Bromate: 0.010 mg/L RAA for Reduced Monitoring (Bromide): 0.05 mg/L
Date Sample
Collected
Day, month,
and year














Sample Location
Must be taken at EPTDS
(bromate) or source (bromide)














Result
(a)(b)
Use for avg.














Compliance Calculation (c)(d)
RAA computed quarterly














Follow-up
Action Taken
Check
appropriate box
a Notify the State
n Notify the Public
a Notify the State
a Notify the Public
n Notify the State
n Notify the Public
a Notify the State
n Notify the Public
a Notify the State
a Notify the Public
n Notify the State
n Notify the Public
a Notify the State
a Notify the Public
n Notify the State
n Notify the Public
a Notify the State
a Notify the Public
n Notify the State
n Notify the Public
a Notify the State
a Notify the Public
n Notify the State
n Notify the Public
a Notify the State
a Notify the Public
n Notify the State
n Notify the Public
Date Report Sent to
State
Routine or violation report














(a) If you fail to take a required sample, you have committed a monitoring violation and must notify the state and your customers.
(b) If you take more than one sample in one month, you must take the average of the samples you have taken and use that number in your compliance calculations.
(c) You must use your monthly results to calculate your RAA.
(d) If your RAA exceeds the MCL, you have committed an MCL violation and must notify the state within 48 hours and your customers within 30 days.
Supplement A- B-9

-------
Appendix C:  Monitoring  Plan Worksheets  and Examples

MONITORING PLAN REQUIREMENT
Under the Stage 1 DBPR, each regulated system must develop and follow a monitoring plan that describes specific locations and schedules for collecting
samples to fulfill monitoring requirements and the methods the system will use to calculate compliance with the MCLs, MRDLs, and treatment techniques.
If approved for monitoring as a consecutive system or if providing water to a consecutive system, the plan must reflect the entire distribution system. The
plan must have been made available to the state and to the public by January 31, 2004.  Subpart H systems serving between 3,300 and 10,000 people
must have submitted the plan to the state by April 10, 2004 (40 CFR 141.132(f)). Developing a monitoring plan helps ensure that your system meets the
sampling requirements for the Stage 1 DBPR even if there are changes in your system's personnel. Consult Complying With the Stage 1 Disinfectants
and Disinfection Byproducts Rule: Basic Guide for more information on the monitoring plan requirements, including information on completing the basic
portions of a monitoring plan and  additional blank worksheets.  If you have not already developed a monitoring plan, you should contact your state for
assistance

In the pages that follow, you will find completed monitoring plan examples for chlorine dioxide, chlorite, and bromate you can use for reference. The
examples are followed by blank monitoring plan forms you can use to develop a monitoring plan.
                                                    Remember!
     Your state may have additional monitoring plan requirements that are not covered in this worksheet.  Check
                                        with your state for more information.
                                                   Supplement A- C-1

-------
Monitoring Plan Example #1: A Surface Water System Using Chlorine Dioxide to Disinfect
Mountain View, a surface water system serving 850 persons and using chlorine dioxide to disinfect, was required to develop and maintain a monitoring
plan and make it available for state inspection by January 31, 2004. The operator of the system, Carl Piper, completed a monitoring plan providing an
overview of system characteristics as well as individual monitoring plans for the disinfectant (chlorine dioxide) and disinfection byproducts (chlorite,
TTHM, and HAAS) for which it will be monitoring. Together, these plans present basic system information and describe where and when samples will be
collected and how the system will determine compliance with the MCLs and MRDL. Although this information exceeds the minimum information required
in a monitoring plan as described in 40 CFR 141.132(f), the operator is providing it to assist with long term, consistent operation and maintenance of the
system.

First, the operator enters system contact information, including the system's name, address, and PWSID number, and the operator's phone number and
email address. This information can be useful for state officials or customers who need to contact the system. Next, the operator enters the number of
customers (850) and the number of service connections (285) Mountain View serves.  This information can help  state officials who are unfamiliar with the
system determine the Stage 1  DBPR requirements with which the system must comply.

Next, the operator enters the system characteristics, including the type of system (CWS) and types of filtration (none) or disinfection used. He also
indicates that the system does not operate a booster chlorination station in the  distribution system.  All of these can determine which Stage 1 DBPR
requirements the system is required to meet and where it is required to collect  its samples. Since Mountain View is a CWS using chlorine dioxide for
disinfection, it is required to monitor for chlorine dioxide, chlorite, TTHM, and HAA5.

The operator then makes note of the system's source and source type (i.e., surface water), its purpose (primary), its period of operation (year-round), and
how it is treated (with chlorine dioxide at Mountain View Water Treatment Plant).  This information will give the state a better understanding of how and
when the system operates and how the system's source water characteristics affect its Stage 1 DBPR compliance requirements.  This information is also
useful should Mountain View hire a new operator who is less familiar with the system.
                                                             Supplement A- C-2

-------
Stage 1 Disinfectants and Disinfection Byproducts Monitoring Plan
System Information
System Name: Mountain View PWS
PWSID Number: MV98765
Address: 633 Mountain View Rd.
Contact Person: Carl Piper
Phone Number: (555) 555-5432
Email: cpiper@mountainview.com
Population Served: 850
Service Connections: 285

Mountain View, Any State
System Characteristics
Type of System:
/ cws
D NTNCWS
D TNCWS
in Purchased

Type of Filtration:
n Conventional Filtration
n Softening
n Other
/ None

Type of Disinfectant:
n Chlorine and/or Chloramines
Booster Chlorination? D Yes / No
/ Chlorine Dioxide
n Ozone
n Other (please specify)
Source Water Characteristics
Source Name
Mountain View River




Source Type
(GW, SW, Purch.)
SW




Purpose
(Primary, Backup)
Primary




Period of
Operation
Year-round




Treatment Type
Chlorine dioxide




Treatment Plant
Mountain View WTP




Attach your system schematic to this monitoring plan for system, staff, state, and lab reference
Date Last Modified: September 30, 2003
                                                             Supplement A- C-3

-------
System Schematic:



K, ^ ""|


Mountain View River

L 	 s 	 J

















EF




• • - • \ /•
Mountain View
WTP





FDS ^
/
/
/
/















































































,
'












:












ART




i
                                                                                     MRT
                                               Supplement A- C-4

-------
Monitoring Plan Example #2: Mountain View's Chlorine Dioxide and Chlorite Monitoring Plans
Mountain View's monitoring plans for chlorine dioxide and chlorite serve as both sampling plans for the system operator and staffs own reference, and as
guides for the state to determine whether the system is sampling at the correct frequency and locations. Mountain View's operator determined that the
system is required by the state to include sampling site locations, sampling schedules, and a description of compliance determination methods in its
monitoring plans.

First, the operator indicates how often the chlorine dioxide and chlorite samples will be taken ('Sample Frequency') and at which sites ('Sample Location').
The system is required to take one daily sample for chlorine dioxide and one daily sample for chlorite, both at the EPTDS. The system is also required to
take three samples for chlorite consisting of one sample as close as possible to the first customer, one sample at the point of ART, and one sample at the
point of MRT.

Next, the operator notes the scheduled sample times.  For daily samples, the operator will attempt to take the samples as early in the morning as possible.
The system will take its three  monthly samples near the end of the month, because, should the system have to take additional distribution system samples
as a result of an exceedance  of the MCL at the EPTDS, it can substitute the results of the additional distribution system samples for its three monthly
samples.

The operator also notes sampling locations and develops a sampling schedule for additional chlorine dioxide and additional chlorite monitoring should a
routine daily entrance point sample exceed the MRDL or MCL, and for reduced monthly chlorite monitoring, should the system qualify. In this example, the
EPTDS and the first customer locations are the same, since the WTP uses its own finished water for toilets, showers, and drinking fountains.  Next, the
operator writes down a brief description of how the system will determine  compliance with the chlorine dioxide MRDL and chlorite MCL. Lastly, the operator
fills in the date on which the monitoring plan was completed in the 'Date Last Modified' area. If at any point the operator needs to modify the monitoring
plan (e.g., because the state determines that the system must change its  sampling locations, the system wants to take additional compliance  samples, etc.)
he will indicate the date that changes were made as a reference for system staff and the state.
                                                             Supplement A- C-5

-------
                                                   Chlorine Dioxide Monitoring Plan
     Sample Frequency
 Sample Location
Number of Samples Collected
Scheduled Sample Times
                                                   Routine Monitoring - Entry Point
Daily

Mountain View WTP

1

Between 7am and 12pm

                                              Additional Monitoring - Distribution System
  The day after a routine daily
  sample MRDL exceedance
                                 Mountain View WTP
Mountain View WTP
                                 Mountain View WTP
                              One 3-sample set
                                 6 a.m, 12 p.m, and 6 p.m. on the day after an
                                            MRDL exceedance.
                                                      Compliance Determination
 To determine whether Mountain View is in compliance with the MRDL, Mountain View will compare consecutive daily samples to the MRDL (0.8 mg/L).

 Acute Violations

 • If a routine daily entry point sample exceeds the MRDL and one of the required additional distribution system samples exceeds the MRDL as well, the
   violation is acute.

 • If two consecutive routine daily samples (collected at the entrance point to the distribution system) exceed the MRDL, but none of the additional
   distribution system samples exceed the MRDL, the violation is non-acute. If a routine entry point sample is missed the day after a routine entry point
   sample exceeds the MRDL, it is considered a non-acute MRDL violation. If an additional sample (i.e., distribution system sample) is missed the day
   after a routine entry point sample exceeds the MRDL, it is considered an  acute violation.
Date Last Modified: September 30, 2003
                                                           Supplement A- C-6

-------
Chlorite Monitoring Plan
Sample Frequency
Sample Location
Number of Samples Collected
Scheduled Sample Times
Routine Monitoring
Daily
Monthly
Mountain View WTP
Mountain View WTP
65 OakAve.
54 Walnut St.
1 entry point
3
Between 7am and 12pm
Third week of month
Reduced Monitoring1
Quarterly
Mountain View WTP
65 OakAve.
54 Walnut St.
3
Third week of third month of quarter
Additional Monitoring
The day after a routine daily
sample MCL exceedance
Mountain View WTP
65 OakAve.
54 Walnut St.
3
As soon as possible on the day after an
MCL exceedance.
1 Reduced monitoring is only permitted for monthly distribution system chlorite monitoring. There is no reduced monitoring for daily entry point chlorite monitoring.
Compliance Determination
Mountain View will determine the average of the distribution system 3-sample set (either additional daily or monthly) taken in the distribution system by
summing the results of the 3-sample set and dividing by three. If the average of any distribution system 3-sample set exceeds the MCL, the system is in
violation.
Date Last Modified: September 30, 2003
                                                          Supplement A- C-7

-------
Monitoring Plan Example #3: A Surface Water System Using Ozone to Disinfect
Blue Pines, a surface water system serving 1,725 persons and using ozone to disinfect, was required to develop and maintain a monitoring plan and make
it available for state inspection by January 31, 2004. The operator of the system, Mary Creek, completed a monitoring plan providing an overview of
system characteristics as well as individual monitoring plans for DBFs (bromate, TTHM, and HAAS), and any additional substances (bromide) for which it
will be monitoring. Together, these plans present basic system information and describe where and when samples will be collected and how the system
will determine compliance with the MCLs. Although this information exceeds the minimum information required in a monitoring plan as described in 40 CFR
141.132(f), the operator is providing it to assist with long term, consistent operation and maintenance of the system.

First, the operator enters system contact information, including the system's name, address, and PWSID number, and the operator's phone number and
email address. This information can be useful for state officials or customers who need to contact the system. Next, the operator enters the number of
customers (1,725) and the number of service connections (523) Blue Pines serves.  This information can  help state officials who are unfamiliar with the
system determine the Stage 1 DBPR requirements with which the system must comply.

Next, the operator enters the system characteristics, including the type of system and types of filtration (none) or disinfection used. All of these can
determine which Stage 1 DBPR requirements the system is required to meet.  Blue Pines is a CWS using ozone for disinfection.  Therefore, it is required to
monitor for bromate, TTHM, and HAA5.

The operator then makes note of the system's source and source type (i.e., surface water), its purpose (primary), its period of operation (year-round), and
how it is treated (with ozone at Blue Pines WTP).  This will give the state a better understanding of how and when the system operates and how the
system's source water characteristics affect its Stage 1  DBPR compliance requirements. This information is also useful should Blue Pines hire a new
operator who is less familiar with the system.
                                                             Supplement A- C-8

-------
                                   Stage 1 Disinfectants and Disinfection Byproducts Monitoring Plan
                                                         System Information
 System Name:
 PWSID Number:
 Address:
Blue Pines PWS
    Contact Person:   Mary Creek
BP54321
128 Reservoir Rd.
    Phone Number:   (000) 555-5555
    Email:
                            Population Served:
                            Service Connections:
                                      1,725
                                      523
mcreek@bluepines.com
                   Mytown, Any State
                                                       System Characteristics
 Type of System:
 /   cws
 D   NTNCWS
 D   TNCWS
 n   Purchased
                          Type of Filtration:
                          n   Conventional Filtration
                          n   Softening
                          n   Other
                          /   None
                                                 Type of Disinfectant:
                                                 n   Chlorine and/or Chloramines
                                                     Booster Chlorination?  n Yes   n No
                                                 n   Chlorine Dioxide
                                                 /   Ozone
                                                 n   Other (please specify)
                                                    Source Water Characteristics
   Source Name
   Source Type
 (GW, SW, Purch.)
    Purpose
(Primary, Backup)
 Period of
 Operation
Treatment Type
Treatment Plant
 Objective
 Blue Pines River
        SW
     Primary
Year-round
    Ozone
Blue Pines WTP
Disinfection
Attach your system schematic to this monitoring plan for system, staff, state, and lab reference
Date Last Modified: September 30, 2003
                                                          Supplement A- C-9

-------
System Schematic:
                                                       EPTDS









; ,
















































































k *











                                                                                MRT
                                                                                ART
             Blue Pines River
Blue Pines
  WTP
                                           Supplement A -C-10

-------
Monitoring Plan Example #4: Blue Pines' Bromate Monitoring Plan
Blue Pines' monitoring plan for bromate serves as both a sampling plan for the system operator and staffs own reference and as a guide for the state to
determine whether the system is sampling at the correct frequency and in the correct locations. Blue Pines' operator has determined that the system is
required by the state to include sampling site locations, sampling schedules, and a description of compliance determination methods in its monitoring plans.

First, the operator indicates where she is sampling for bromate or bromide. Next, she indicates the sites at which bromate samples will be taken ('Sample
Location'). The system is required to take one monthly sample for bromate at the EPTDS (in this case, the water treatment plant).  The system will also be
taking one monthly sample for bromide (at the source water) to attempt to qualify for reduced bromate monitoring.

The operator then notes the frequency of sampling and the number of samples that will be taken.  Next, the operator notes the scheduled sample dates.
Whenever possible, the operator selects dates early in the sampling period to allow for time to address any compliance problems or lab capacity issues.

The operator also notes sampling locations and  develops a sampling  schedule for reduced bromate monitoring should the system qualify.

Next, the operator writes down a brief description of how the system will determine compliance with the bromate MCL.

Lastly, the operator fills in the date on which the monitoring plan was completed in the 'Date Last Modified' area. If at any point the operator needs to
modify the monitoring plan (e.g., because the state determines that the system must change its sampling locations, the system wants to take additional
compliance samples, etc.) she will indicate the date that changes were made as a reference for system staff and the state.
                                                            Supplement A- C-11

-------
Bromate Monitoring Plan
Sample
Sample Site Location
Sampling Frequency
Scheduled Sample Dates
Routine Monitoring
Bromate
Bromide


Blue Pines WTP
Blue Pines River


1 per month
1 per month


1st week of the month
1st week of the month


Reduced Monitoring
Bromate
Bromide


Blue Pines WTP
Blue Pines River


1 per quarter
1 per month


1st week of the first month of the quarter
1st week of the month


Compliance Determination
When on a routine monitoring schedule, Blue Pines will sample monthly for bromate and monthly for bromide. At the end of every quarter, Blue Acres
will sum the monthly bromate results taken in the last 12 months and divide the result by the number of months in which samples were collected. If the
result is greater than the MCL, the system has committed a violation.
When on a reduced monitoring schedule, Blue Pines will calculate the RAA at the end of every quarter using the quarterly results from the most recent 4
quarters. If the result is greater than the MCL, the system has committed a violation.
Blue Pines will calculate the bromide RAA to determine eligibility for reduced monitoring for bromate using the same method. At the end of every
quarter, Blue Pines will sum the monthly bromide results taken in the last 12 months and divide the result by the number of months in which samples
were collected. If the result is lower than the level required to qual fy for reduced monitoring status, Blue Pines will contact the state to request written
permission to begin reduced monitoring for bromate.
Date Last Modified: September 30, 2003
                                                          Supplement A-C-12

-------
                                              Stage 1 DBPR Monitoring Plan Worksheet Instructions
Step #1 Enter your system information.
Enter your system's name, address, and PWSID. Next, enter the name
of the system's contact person, their phone number, and their email
address.  Then, enter the number of customers and service connections
your system serves.

Step #2 Enter your system's characteristics.
Check off the appropriate boxes to describe the type of system that you
operate, including which disinfectant(s) are used to treat the water and
whether your system uses conventional filtration or softening.

Step #3 Enter your system's source water characteristics.
     Under 'Source Name,' list all the drinking water sources your system
     uses.  Include sources that are used intermittently (e.g., backup
    sources, seasonal sources.)
     Under 'Source Type,' indicate whether the sources used are surface
    water, ground water, or GWUDI.
     Under 'Purpose,' indicate whether the source serves as a  primary,
     backup, or emergency source
     Under 'Period of Operation,' indicate when the source  is in use (e.g.,
    year-round,  only in the summer months).
     Under Treatment Type,' indicate how the water from each source is
    treated (e.g., chlorine, conventional filtration). Then note where
    each source is treated under Treatment Plant.'
Step #4 Attach a system schematic.
Attach a schematic of your system for system staff, state, and lab
reference.

Step #5 Enter the monitoring plan completion date.
In the 'Date Last Modified' area, enter the date on which you completed
this monitoring plan.  If the monitoring plan is modified at any point, enter
the modification date in this area.

Note: If you operate more than one treatment plant, you may want to
photocopy this and use one for each treatment plant.
                                                            Supplement A- C-13

-------
                                 Stage 1 Disinfectants and Disinfection Byproducts Monitoring Plan
                                                      System Information
System Name:

PWSID Number:

Address:
                        Contact
                        Person:
                        Phone
                        Number:
                        Email:
                                               Population Served:

                                               Service Connections:
                                                    System Characteristics
Type of System:
D    CWS
D    NTNCWS

D    TNCWS
n    Purchased
                        Type of Filtration:
                        D    Conventional Filtration
                        D    Softening

                        n    Other
                        n    None
                                               Type of Disinfectant:
                                               D  Chlorine and/or Chloramines
                                                   Booster             n Yes   n No
                                                   Chlorination?
                                               D  Chlorine Dioxide
                                               n  Ozone
                                               n  Other (please specify)
                                                 Source Water Characteristics
 Source Name
  Source Type
(GW, SW, Purch.)
    Purpose
(Primary, Backup)
Period of
Operation
Treatment Type
Treatment Plant
Objective
                                                       Supplement A- C-14

-------
                                       Chlorine Dioxide and Chlorite Monitoring Plan Worksheet Instructions
Step #1 Set up a routine monitoring schedule for chlorine dioxide.
     Under 'Sample Frequency,' note how often you are required to sample
     for the disinfectant (i.e., daily).
     Under 'Sample Location,' enter the site at which you will be sampling.
     Under 'Number of Samples Collected,' enter the number of compliance
     samples you will be taking.
     Under 'Scheduled Sample Times,' indicate when you will be sampling
     for chlorine dioxide.

Step #2 Set up a schedule for additional chlorine dioxide monitoring.
     Under 'Sample Frequency,' note when you are required to conduct
     additional sampling for chlorine dioxide.
     Under 'Sample Location,' enter the site(s) at which you will be
     conducting additional sampling.
     Under 'Number of Samples Collected,' enter the number of additional
     samples you are required to take.
     Under 'Scheduled Sample Times,' indicate when, within the required
     period, you will be conducting additional sampling.

Step #3 Describe how you will determine compliance with the chlorine
dioxide MRDL.
Enter a narrative description of how you will calculate compliance with the
chlorine dioxide MRDL.  Discuss how you will determine whether a violation
of the MRDL is acute or non-acute.

Step #4 Set up a schedule for routine chlorite monitoring.
     Under 'Sample Frequency,' note how often you are required to sample
     for chlorite (i.e., daily and monthly).
     Under 'Sample Location,' enter the sites at which you will be sampling.
     Under 'Number of Samples Collected,' enter the number of compliance
     samples you will be taking.
     Under 'Scheduled Sample Times,' indicate when you will be sampling
     for chlorite.
Step #5 Set up a schedule for reduced chlorite monitoring.
     Under 'Sample Frequency,' note how often you are required to sample
     for chlorite on  a reduced schedule. Remember, only monthly chlorite
     sampling can be reduced.
     Under 'Sample Location,' enter the sites at which you will be sampling.
     Under 'Number of Samples Collected,' enter the number of compliance
     samples you will be taking.
     Under 'Scheduled Sample  Times,' indicate when you will be sampling
     for chlorite.

Step #6 Set up a schedule for additional chlorite monitoring.
     Under 'Sample Frequency,' note when you are required to conduct
     additional sampling for chlorite.
     Under 'Sample Location,' enter the site at which you will be conducting
     additional sampling.
     Under 'Number of Samples Collected,' enter the number of follow-up
     samples you are required to take.
     Under 'Scheduled Sample  Times,' indicate when, within the required
     period, you will be conducting additional sampling.

Step #7 Describe how you will determine compliance with the chlorite
MCL.
Enter a narrative description of how you will calculate compliance with the
chlorite MCL.

Step #4 Enter the  monitoring  plan completion date.
In the 'Date Last Modified' area,  enter the date on which you complete this
monitoring plan. If the monitoring plan is modified at any point, enter the
modification date in  this area.
                                                              Supplement A- C-15

-------
Chlorine Dioxide Monitoring Plan
Sample Frequency
Sample Location
Number of Samples
Collected
Scheduled Sample Times
Routine Monitoring - Entry Point








Additional Monitoring- Distribution System












Compliance Determination
Supplement A -C-16

-------
Chlorite Monitoring Plan
Sample Frequency
Sample Location
Number of Samples Collected
Scheduled Sample Times
Routine Monitoring
















Reduced Monitoring^












Additional Monitoring












1 Reduced monitoring is only permitted for monthly chlorite monitoring. There is no reduced monitoring for daily chlorite monitoring.
Compliance Determination

Date Last Modified:
                                                         Supplement A- C-17

-------
                                         Bromate Monitoring Plan Worksheet Instructions
                                                           J
Step #1 Set up a routine monitoring schedule for bromate.
     Under 'Sample,' indicate the substance for which you will be
     sampling (include bromide if you will be attempting to qualify for
     reduced bromate monitoring).
     Under 'Sample Location,' enter the locations at which you will be
     sampling.
     Under 'Sample Frequency,' indicate how often you are required
     to sample.
     Under 'Scheduled Sample Dates,' enter when you will be taking
     the required samples.

Step #2 Set up a reduced monitoring schedule for bromate.
     Under 'Sample,' indicate the substance for which you will be
     sampling (including bromide).
     Under 'Sample Location,' enter the locations at which you will be
     sampling when on a reduced monitoring schedule.
     Under 'Sample Frequency,' indicate how often you are required
     to sample on the reduced schedule.
     Under 'Scheduled Sample Dates,' enter when you will be taking
     the required samples.
Step #3 Describe how you will determine compliance.
Enter a narrative description of how you will calculate compliance
with the bromate MCL. Discuss how you will calculate the RAA.

Step #4 Enter the monitoring plan completion date.
In the 'Date Last Modified' area, enter the date on which you
complete this monitoring plan. If the monitoring plan is modified at
any point, enter the modification date in this area.
                                                        Supplement A - C-18

-------
                                                Bromate Monitoring Plan
           Sample
Sample Site Location
Sampling Frequency
Scheduled Sample Dates
                                                   Routine Monitoring
                                                  Reduced Monitoring
                                                Compliance Determination
Date Last Modified:
                                                   Supplement A - C-19

-------
Appendix D: Additional  Sources  of Information  on  the  Stage  1 DBPR

Below are some sources of information on topics related to the Stage 1 DBPR.

Regulations                                                Documents
The Federal Register Notice on the Final Rule: National
Primary Drinking Water Regulations: Disinfectants and
Disinfection Byproducts; Final Rule. December 16, 1998.
Federal Register. Volume 63, No. 241, pp. 69390-69476.
Available online atwww.epa.gov/safewater/mdbp/dbpfr.html.

The Federal Register Technical Corrections to the Stage 1
DBPR: Revisions to the Interim Enhanced Surface Water
Treatment Rule (IESWTR), the Stage 1 Disinfectants and
Disinfection Byproducts Rule (Stage 1 DBPR), and Revisions to
the State Primacy Requirements to Implement the Safe Drinking
Water Act (SDWA) amendments; Final Rule. January 16, 2001.
Federal Register. Volume 66, No. 10, pp. 3770-3780. Available
online at
www.epa.gov/fedrgstr/EPA-WATER/2001/January/Day-16/w655
.htm.

The Federal Register Minor Corrections to the Stage 1
DBPR: Revisions to the LT1ESTWR, SWTR, and other National
Primary Drinking Water Regulations; Final Rule.  March 2,
2004. Federal Register. Volume 69, No. 41, pp. 9781-9790.
Available online atwww.epa.gov/fedrgstr/EPA-
WATER/2004/March/Day-02/w4464.htm.
EPA's MDBP Rules Implementation Activities Web site:
www.epa.gov/safewater/mdbp/implement.html EPA has posted
a number of documents, including the text of the Stage 1 DBPR,
an Implementation Guidance, many fact sheets, and a quick
reference guide to the Rule.

Associations

American Waterworks Association:
www.awwa.org/Science/dbp/index.cfm
(800-926-7337)

Association of State Drinking Water Administrators:
www.asdwa.org
(202-293-7655)

Association of Metropolitan Water Agencies:
www.amwa.net/features/sdwa/sbys/ss3.html
(202-331-2820)

National Rural Water Association:
www.nrwa.org
(580-252-0629)

The Natural Resources Defense Council:
www.nrdc.org/water/drinking/default.asp
(212-727-2700)
                                                Supplement A- D-1

-------
Appendix E: Contact Information for Safe Drinking Water Act Primacy
Agencies

For additional information or to learn more about the laws in your own state, please contact your EPA Regional Coordinator or State
Drinking Water Agency.
State Agency
Alabama
Department of Environmental Management:
Water Supply Branch
Alaska
Department of Environmental Management:
Water Supply Branch
American Samoa
Environmental Protection Agency
Arizona
Department of Environmental Quality: Safe
Drinking Water Section
Arkansas
Department of Health: Division of Engineering
California
Department of Health Services: Division of
Drinking Water & Environmental Management
Colorado
Department of Public Health & Environment:
Drinking Water Program
Connecticut
Department of Public Health: Drinking Water
Division
Web Site
www.adem.state.al.us/WaterDivision/Drinking/DWMainlnfo.htm
www. state, ak.us/dec/eh/dw
http://www.epa.gov/safewater/dwinfo/samoa.htm
www.azdeq.gov/environ/water/dw/index.html
www.healthyarkansas.com/eng/
http://www.dhs.ca.gov/ps/ddwem/technical/dwp/dwpindex.htm
http://www.cdphe. state. co. us/wq/Drinking_Water/Drinking_Wate
r_Program_Home.htm
www.dph. state. ct.us/BRS/water/dwd. htm
Phone Number
(334) 271-7700
(907) 269-7647
(684) 633-2304
(602) 771-2300
(501)661-2623
(916) 449-5577
(303) 692-3500
(860) 509-7333
                                     Supplement A- E-1

-------
State Agency
Web Site
Phone Number
Delaware
Delaware Health & Social Services: Division of
Public Health
www.state.de.us/dhss/dph/about.html
 (302) 744-4700
District of Columbia
Environmental Health Administration: Water
Resources Management Division
www.epa.gov/reg3wapd/drinkingwater
 (215) 814-2300
Florida
Department of Environmental Protection:
Drinking Water Program
www.dep.state.fl.us/water/drinkingwater/index.htm
 (850) 245-8335
Georgia
Department of Natural Resources: Water
Resources Branch
www.gaepd.org
 (404) 657-5947
Guam
Guam Environmental Protection Agency: Water
Programs Division
www.guamepa.govguam.net/programs/water
 (671)475-1658
Hawaii
Department of Health: Environmental Health
Division
www.hawaii.gov/health/environmental/water/sdwb/index.html
 (808) 586-4258
Idaho
Department of Environmental Quality: Water
Quality Division
www.deq.state.id.us/water/
 (208) 373-0194
Illinois
Environmental Protection Agency: Division of
Public Water Supplies
www.epa.state.il.us/water/index-pws.html
 (217) 785-8653
Indiana
Department of Environmental Management:
Drinking Water Branch
www.in.gov/idem/water/dwb/
 (317)232-8603
Iowa
Department of Natural Resources: Water Supply
Program
www.iowadnr.com/water/drinking/index.html
 (515) 725-0275
                                                   Supplement A- E-2

-------
State Agency
Kansas
Department of Environmental Protection: Bureau
of Water
Kentucky
Department for Environmental Protection:
Division of Water
Louisiana
Office of Public Health: Safe Drinking Water
Program
Maine
Maine Department of Human Services: Drinking
Water Program
Maryland
Department of the Environment: Public Drinking
Water Program
Massachusetts
Department of Environmental Protection:
Drinking Water Program
Michigan
Department of Environmental Quality: Water
Bureau
Minnesota
Department of Health: Drinking Water Protection
Section
Mississippi
Department of Health: Division of Water Supply
Missouri
Department of Natural Resources: Water
Protection and Soil Conservation Division
Web Site
www.kdhe.state.ks.us/pws/
www.water.ky.gov/dw
www.oph.dhh.louisiana.gov/engineerservice/safewater
www. state, me. us/dhs/eng/water/
www.mde. state. md.us/programs/WaterPrograms/Water_Supply
/index.asp
www.mass.gov/dep/brp/dws/dwshome.htm
www.michigan.gov/deq
www.health. state. mn.us/divs/eh/water/index. html
www.msdh.state.ms.us/msdhsite/index.cfm/44. 0.76. html
http://www.dnr.mo.gov/wpscd/wpcp/dw-index.htm
Phone Number
(785) 296-5503
(502) 564-3410
(225) 765-5038
(207) 287-2070
(410) 537-3000
(617)292-5770
(517)373-7917
(651)215-0770
(601)576-7518
(573)751-1300
Supplement A- E-3

-------
State Agency
Montana
Department of Environmental Quality: Public
Water Supply Program
Nebraska
Department of HHS: Public Water Supply
Program
Nevada
Department of Environmental Services: Safe
Drinking Water Program
New Hampshire
Department of Environmental Services: Water
Division
New Jersey
Department of Environmental Protection: Water
Supply Administration
New Mexico
Environment Department: Drinking Water Bureau
New York
Department of Health: Bureau of Water Supply
Protection
North Carolina
Department of Environment and Natural
Resources: Public Water Supply Section
North Dakota
Department of Health: Division of Water Quality
Ohio
Environmental Protection Agency: Division of
Drinking & Ground Water
Web Site
www.deq. state. mt.us/wqinfo/PWS/index.asp
www.hhs. state. ne.us/enh/pwsindex. htm
http://ndep.nv.gov/bsdw/index.htm
www.des.state.nh.us/wseb/
www.state.nj.us/dep/watersupply/
www.nmenv. state. nm.us/dwb/dwbtop. html
www. health . state, ny. us/nysdoh/water/main . htm
www.deh.enr.state.nc.us/pws/
www. health, state, nd.us/mf
www.epa.state.oh.us/ddagw/
Phone Number
(406) 444-4071
(402) 471-0521
(775) 687-6353
(603)271-2513
(609) 292-5550
(505) 827-1400
(518)402-7650
(919) 733-2321
(701)328-5211
(614) 644-2752
Supplement A- E-4

-------
State Agency
Oklahoma
Department of Environmental Quality: Water
Quality Division
Oregon
Department of Human Services: Drinking Water
Program
Pennsylvania
Department of Environmental Protection: Office
of Water Management
Puerto Rico
Department of Health: Public Water Supply
Supervision Program
Rhode Island
Department of Health: Office of Drinking Water
Quality
South Carolina
Department of Health & Environmental Control:
Drinking Water Program
South Dakota
Department of Environment & Natural
Resources: Drinking Water Program
Tennessee
Department of Environment & Conservation:
Division of Water Supply
Texas
Texas Commission on Environmental Quality
Utah
Department of Environmental Quality: Division of
Drinking Water
Vermont
Vermont Agency of Natural Resources
Web Site
www.deq.state.ok.us/WQDnew/index.htm
http://oregon.gov/DHS/ph/dwp/index.shtml
www. dep. state, pa. us/dep/deputate/watermgt/wsm/WSM . htm
www.epa.gov/region02/cepd/prlink.htm
www.health.ri.gov/environment/dwq/index.php
www.scdhec.net/eqc/water/html/dwater.html
www.state.sd.us/denr/des/drinking/dwprg.htm
www.state.tn.us/environment/dws/index.html
www. tceq . state . tx. us/nav/uti l_water/
www.drinkingwater.utah.gov
www.anr.state.vt.us/dec/watersup/wsd.htm
Phone Number
(405) 702-8100
(971)673-0405
(717)772-4018
(787) 977-5870
(401)222-6867
(803) 898-4300
(605) 773-3754
(615)532-0191
(512) 239-4691
(801) 536-4200
(802) 241-3400
Supplement A- E-5

-------
State Agency
Virgin Islands
Department of Planning & Natural Resources:
Division of Environmental Protection
Virginia
Department of Health: Office of Drinking Water
Washington
Department of Environmental Health: Office of
Drinking Water
West Virginia
Bureau for Public Health: Department of Health
and Human Resources
Wisconsin
Department of Natural Resources: Drinking
Water and Ground Water
Wyoming
EPA Region VIII: Wyoming Drinking Water
Program
Web Site
http://dpnr.gov.vi/dep/home.htm
www. vdh. state. va.us/dw/index.asp
www.doh.wa.gov/ehp/dw/
www.wvdhhr.org/oehs/eed/
www.dnr.state.wi.us/org/water/dwg/
www.epa.gov/region08/water/dwhome/wycon/wycon.html
Phone Number
(340)773-1082
(804) 864-7500
(360)236-3100
(304)558-6715
(608) 266-0821
(303) 312-6812
Supplement A- E-6

-------
Appendix F: Tribal  Contacts
For additional information or to learn more about the laws governing your tribe, use the contact information provided in this Appendix.
U.S. EPA Headquarters
American Indian Environmental Office
www.epa.gov/indian
(202) 564-0303
U.S. EPA Regional Tribal Capacity Development Coordinators
U.S. EPA Region 1
U.S. EPA Region 2
U.S. EPA Region 4
U.S. EPA Region 5
U.S. EPA Region 6
U.S. EPA Region 7
U.S. EPA Region 8
U.S. EPA Region 9
U.S. EPA Region 10
www.epa.gov/region01/topics/government/tribal.html
www.epa.gov/region02/nations/index.html
www.epa.gov/region04/ead/indian/index.htm
www.epa.gov/region5/water/stpb/
www.epa.gov/region06/6xa/tribal.htm
www. epa.gov/region07/govern ment_tribal/index. htm
www.epa.gov/region08/tribes
www. epa.gov/region09/cross_pr/indian/index. html
yosemite.epa.gov/r10/tribal.NSF/webpage/tribal+office+homepage?o
pendocument
(888) 372-7341
(212)637-3600
(404) 562-6939
(312)353-2123
(800) 887-6063
(913)551-7030
(303)312-6116
(415)744-1500
(206) 553-401 1
Other Contacts
Administration for Native Americans
Bureau of Indian Affairs
Indian Health Service
Native American Water Association
www.acf.dhhs.gov/programs/ana/
www.doi.gov/bureau-indian-affairs.html
www.ihs.gov
www.nawainc.org
(877) 922-9262
(202)208-3710
(301)443-3024
(775) 782-6636
                                             Supplement A- F-1

-------
Appendix G: Other STEP  Documents
This Supplement, the Basic Guide, and Supplement B are part of a series of Simple Tools for Effective Performance (STEP) documents
for small drinking water systems. The currently available STEP documents can be obtained from EPA by calling the Safe Drinking Water
Hotline at 1-800-426-4791 and requesting the document by its publication number or by visiting EPA's Small Drinking Water Web site at
www.epa.gov/safewater/smallsys.htm.
Safe Drinking Water Act (SDWA) Regulation Overview Brochure
for Small Systems
This brochure summarizes SDWA regulations that currently exist,
are proposed, or are under development that affect or will affect
small water systems. The brochure emphasizes how the
regulations relate to each other and explains the multi-barrier
approach to microbial and chemical risks and how SDWA
regulations fit into this type of framework. The brochure also
emphasizes how most small systems can achieve compliance
through process optimization and more efficient system
management.
Publication number EPA 816-R-02-004

Complying With the New Drinking Water Standard for Arsenic
This workbook is designed to help systems understand and
achieve compliance with the Arsenic Rule.  The workbook provides
sample worksheets to help systems organize data and provides
guidance for small systems on their selection of appropriate
compliance options.
Publication number EPA 816-R-02-008A

Asset Management: A Handbook for Small Water Systems
This workbook guides small systems through a four-step process
of developing an asset management plan and includes worksheets
on completing a thorough asset inventory;  prioritizing the
maintenance, rehabilitation, and replacement of your assets;
developing a simple asset management plan; and carrying out the
plan. The workbook also provides information about how asset
management can help improve your system's financial health and
ability to provide safe drinking water.
Publication number EPA 816-K-03-016
Strategic Planning: A Handbook for Small Water Systems
This workbook is designed to help systems understand the
concept of strategic planning and how it can help them
prepare to meet public expectations and regulatory
requirements while maintaining organizational and financial
stability in the future.  The workbook provides worksheets to
help systems create a vision statement and mission, assess
their capacity, define their area of service, identify challenges,
and develop a strategic plan for their system.
Publication number EPA 816-R-03-015

Taking Stock of Your Water System: A Simple Asset Inventory
for Very Small Drinking Water Systems
This workbook will guide very small systems through a simple
asset inventory of their drinking water system and the  first
steps of an asset management plan.  The workbook includes
worksheets on asset condition and prioritization.
Publication number EPA 816-K-03-002

Preventive Maintenance Tasks for Tribal Drinking Water
Systems: Guide Booklet and Log Sheets
The log cards and guidance booklet provide a schedule of
routine operation and maintenance tasks for small drinking
water systems that use a groundwater supply.  The booklet is
divided into sections that outline daily, weekly, and monthly
tasks,  plus individual sections that describe specific tasks for
each month of the year.  Each section contains guidance
notes that provide additional information on some tasks. The
notes correspond to the tasks on the accompanying cards.
Publication number EPA 816-F-01-017
                                                    Supplement A- G-1

-------