xvEPA
                                     MARINE BEACH ROUTINE ON-SITE SANITARY SURVEY
     United States
     Environmental Protection
     Agency
                                                                                                    EPA 820-F-13-008
 Name of Beach:
                                                             Date and Time of Survey:
 Beach ID:
                                                             Surveyor Name(s):
 Sampling Station(s)/ID:
                                                             Surveyor Affiliation:
 STORE! Organizational ID:
 PART I - GENERAL BEACH CONDITIONS
 Air Temperature:           °Cor°F    Wind:  Speed (mph)
                                            Direction (e.g., Eor90°
 Rainfall: D <24 hours  Q <48 hours Q <72  Q >72 hours since last rain event and  	
 Rain Intensity:     d Misting     Q Light Rain         Q Steady Rain       Q Heavy Rain
 Weather Conditions:
                                                                           Is wind: n onshore  or  d offshore
                                                                           	  (From which direction the wind is coming)
                                                                                  inches or
                                                                     cm rainfall measured
                                                                                            Other
Sky Condition
Amount of cloud coverage
Wave Intensity:
Tidal phase:
D Sunny
No Clouds
D Mostly Sunny
1/8 to 1/4
D Partly Sunny
3/8 to 1/2
D Calm D Normal Q Rough Wave Height: ft
D High n Low n Ebbing
n Flooding
D Mostly Cloudy
5/8 to 7/8
D Cloudy
Total Coverage
Q Estimated or Q Actual
D Other
 Reference point:                               Orientation of tide to the beach:
 Longshore current speed and direction (cm/sec, S or 180°):	
 Describe the longshore currents:
 Are there visible rip currents?
 Comments or Observations
                            yes
                                   no
                                           Describe:
PART II -WATER QUALITY
Bacteria Samples Collected (list samples collected from beach water and potential pollution sources, if applicable— see Part IV)
Sample Point




Sample #




Parameter (enterococci, E. coll, etc.)




Comments:




 Water Temperature:
 Odor:    Q None
 Turbidity:  Q Clear
 Salinity:
 DO:
                     Q Septic      [
                     D Slightly Turbid
                     DO-5 ppt
                     TSS:
Where are water quality measurements taken?
°Cor°F   Change in Color?  Dyes
         Algae    D Sulfur     C
           n Turbid   n Opaque
           D5-15ppt  D15-40 ppt
           Other:
HI no If yes, describe
 Other
  or
        NTU:
  or Conductivity:
 Comments or Observations
 PART III - BATHER LOAD
 Number of people in the water:
 Number of people at the beach:
 List of Activities Seen (optional):
                                                         Number of people out of the water:
Type of Activity
Number of People












 Comments or Observations
                                                                                                          March 2013

-------
xvEPA
            MARINE BEACH ROUTINE ON-SITE SANITARY SURVEY (continued)
     United States
     Environmental Protection
     Agency
 PART IV- POTENTIAL POLLUTION SOURCES

 Sources of Discharge:
Type
Name(s) of Source(s)
Amount (H, M, L)
Flow Rate (m/sec)
Volume
Characteristics
River(s)





Pond(s)





Wetland(s)





Outfall(s)





Other (specify):





Did you collect any bacteria samples from the sources listed in the table above?    Q yes     Q no

If Yes, did you list the samples in the table in Part II, Water Quality?              Q yes     Q no
Are tide pools present? Q yes  Q no   If yes, how many:                           Average size:

Floatables present:    Q yes  Q no     Please indicate which floatables have been found (examples below):
Debris/Litter present:
 | yes  n no     Please indicate what debris or litter was found (examples below):
Amount of Beach Debris/Litter on Beach:
                    None
                 Low(1%-20%)
                   Moderate (21 %-50%)  Q High (> 50%)
Examples of Floatables and Debris or Litter Found:
Street litter
(e.g.,
cigarette
filters)
Food-related
litter
(e.g.,
packaging,
containers)
Medical items
(e.g.,
syringes)
Sewage-
related
(e.g.,
condoms,
tampons)
Building
materials
(e.g., wood,
siding)
Fishing
related
(e.g., fishing
line, nets,
lures)
Household
waste
(e.g., household
trash, plastic
bags)
Amount of Algae in Nearshore Water: Q None nLow(1%-20%) Q Moderate
Amount of Algae on Beach: Q None nLow(1%-20%) Q Moderate
Circle the types of algae found:
Type
Description
Periphyton
Attached to rocks, stringy
Globular
Blobs of floating materials
Free floating
No obvious mass of materials
Tar/Oil
(e.g., tar
balls)
Oil/Grease
(e.g., oil
slick)
Other:
(21%-50%) |H High (> 50%)
(21%-50%) n High (> 50%)
Other
Please describe
Circle the color of algae found:
     Light green
Bright green
Dark green
Yellow
Brown
Other
Presence of a harmful algal bloom? Q yes Q no   Describe:
Presence of Wildlife and Domestic Animals
Type
Number
Geese

Gulls

Shorebirds

Ducks

Pigeons

Turtles

Dogs

Horses

Rodents (specify)

Other (specify)

List the number of each species of bird found dead on the beach

Type

Number found dead
Common
loons


Herring
gulls


Ring-billed
gulls


Double
crested
cormorants

Long-tailed
ducks


White-
winged
scoter

Horned
grebes


Red-
necked
grebes

Other



Number of dead fish found on the beach:
Comments or Observations (continue on back if necessary):
                                                                                                         March 2013

-------