Or EPA
United States
Environmental Protection
Agency
& v	EPA 820-F-20-004
ife Freshwater Routine Sanitary Survey for Recreational Waters	March 2021
GENERAL INFORMATION
Name of beach (if applicable):
Date(s) of survey:
Beach ID:
Time(s) of survey:
Name of waterbody:
Waterbody type:
Sampling station(s)/ID:
Surveyor affiliation:
WQX organizational ID:
Name(s) of surveyor(s):
Sampling location
Latitude:
Longitude:
Dates of swim season
Start:
End:
QUALITY ASSURANCE
I the data collected use an approved Quality Assurance Project Plan (QAPP)? yes
no
PART 1: WEATHER AND GENERAL WATERBODY CONDITIONS
Weather Conditions
Survey the weather using the method of your choice. You may use the National Weather Service as your source.
Air temperature: °C or °F
Method for temperature: (check one) ~ Liquid-in-glass therm. ~ Electronic thermometer
~ Weather app ~ Weather report: from airport or weather station? ~ Other:	
Wind speed: units:
Wind aust speed: units:
Method for wind speed: (check ail that apply) ~ Wind vane for direction ~ Weather app
~	Wind sock for direction/speed ~ Anemometer for wind speed
~	Beaufort scale for wind speed ~ Aerovane for wind direction/speed
~	Weather report: from airport or weather station? ~ Other (specify):
Wind direction:
Is the wind: (circle one) Onshore or Offshore
If you collected wind speed from a local weather station, how far were you from the station: mi or km
How recent was the last rain event: (circle one)
0-24 hrs 24-48 hrs 48-72 hrs 72+hrs
Rain intensity: (circle one) Misting Light rain
Moderate rain Heavy rain Other:
Total measured rainfall: in or cm
Distance to the qauqe/station when recordinq rainfall amount: mi or km
Method for rainfall: (check one) ~ Rain qauqe ~ Weather report ~ Weather app ~ Other (specify):
Sky condition/amount of
Sunny/
Mostly sunny/
Partly sunny/
Mostly cloudy/
Cloudy/
cloud cover: (circle one)
No clouds
1/8 to 2/8
3/8 to 1/2
5/8 to 7/8
Total coverage
Method for weather conditions: (check one) ~ Visual observations
~ Weather app
~ Other (specify):
Waterbody Conditions
Water flow speed:
units:
Method for water flow speed: (check one) ~ Stick with fishing reel with water balloon on end ~ Ball and tether ~ Other:	
Direction from which the wave is coming (e.g., N, SW):
How tall are the waves:
m or ft
Is the wave height measured or estimated? (circle one)
Measured
Estimated
Method for measuring wave height: (check one) ~ Visual examination of wave height ~ Graduated stick and ranging pole
~ Other (specify):	
Is the stream bank/shoreline eroding? yes no
Width of riparian vegetation on river/stream left (looking downstream)
(circle one) none 0-25 ft 25-50 ft 50+ft
Width of riparian vegetation on river/stream right (looking downstream)
(circle one) none 0-25 ft 25-50 ft 50+ft
Add additional comments for general waterbody conditions.
1

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Or EPA
m v	EPA 820-F-20-004
united states	ifc Freshwater Routine Sanitary Survey for Recreational Waters	March 2021
Environmental Protection
Agency
Aquatic Organism Passage Barrier	
What is the outlet drop
(e.g., 3.5ft)
Severity of barrier debris, sediment, or rock
for the structure with the least amount of
debris (None, minor, moderate, severe)
Location
(lat/long)
Description




















* Minor = <10% open area of structure blocked; Moderate = 10-50% open area of structure blocked; Severe = 50% open area structure blocked
Take images to document aquatic organism passage barriers and provide detailed descriptions where possible:
PART 2: WATER QUALITY	
List bacteria samples collected at the beach. Potential pollution sources, if applicable, can be recorded in Part 4.
Sample Point
Sample
Number
Location
(lat/long)
Date & Time
Parameter
(enterococci, E. coli, etc.)
Comments






























General Water Quality
Water temperature: °C or °F
Water color: (circle one) Clear Blue Brown Green Red Other:
Method for water temperature: (check one) ~ IV
ultiprobe ~ Electronic meter ~ Graduated thermometer
~ Report from local radio station	~ Report from NOAA weather band radio ~ Other:
Has the water color changed since the last visit? yes no don't know If yes, take photographs and describe:
Select the best description of the water smell: (circle one) None Septic Algae Sulfur Other:
How did you measure turbidity?	~ Observed: (circle one) Clear Slightly turbid Opaque
	(check one)	~ Measured: NTU value:	Secchi disc depth:
What method was used to measure the turbidity of the water: (circle one) Simple visual observation	Visual test kit
	Titrimetric test kit	Nephelometer/Turbidimeter	Other:		
Describe other measurements taken and report values:
Additional water quality observations:
PART 3: PEOPLE	
Are there recreators (swimmers, boaters, waders, etc.) present at the beach or waterbody? yes	no
Total people in water:	 + Total people out of water:	 = Total people at the beach or waterbody:
Total number of boats:	
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_0,FRA	m*	EPA 820-F-20-004
Vl_l ^	ife Freshwater Routine Sanitary Survey for Recreational Waters	March 2021
United States
Environmental Protection
Agency
Report activities observed at the beach or shoreline and in the water. Quan
ify and take photographs, if possible.
Activity (swimming, fishing, etc.)






Approximate # of people participating






Describe notable activities that could af
ect water quality (Example: babies in disposable diapers in the water):
Method for numbers of people participating in various activities: (check one) ~ Counting by surveyor ~ Photos
	~ Counting by lifeguard	~ Turnstiles	~ Other:		
PART 4: POTENTIAL POLLUTION SOURCES
Identify visible sources of pol
utants up to 500 feet from the beach or waterbody boundary. Quantify and photograph sources, if possible.
Type of Source
Discharge
Source Name
Discharge Source
Amount (H, m, l)
Discharge
Flow Rate
Discharge Volume
Discharge Source Characteristics
Wetland drainage





Outfall/Pipe (stormwater)





Leaking pit latrines/septic





Runoff (impervious surfaces)





Homeless encampments





Other (specify):





Did you collect samples and complete the Bacteria Samples section in Part 2? yes no
If no, describe why not:
How did you identify the source of discharge? (circle one) Visual observation WWTP notification/report Other:
How did you measure flow/velocity or volume? (circle one) Mechanical flow meter Electric flow meter
USGS gauging station WWTP notification/report Orange (float) and stopwatch Other:	
Are floatables present in the water? yes no	If yes, select the types found: (check ail that apply)
~	Street litter (e.g., cigarette filters)	~ Building materials (e.g., wood/siding)
~	Food-related litter (e.g., packaging/containers)	~ Fishing-related (e.g., fishing line, nets, lures)
~	Medical items (e.g., syringes)	~ Household waste (e.g., household trash, plastic bags)
~	Sewage-related (e.g., tampons, condoms)	~ Other:	
Method for determining floatables presence: (circle one) Visual observation Cleanup event results
Other:
Is there debris or litter present on the beach or shoreline? yes no
Select the amount (%) of debris/litter on the beach or shoreline: (circle one)
None Low (1 % - 20%) Moderate (21 %- 50%)
High (>50%)
Select the types of debris found? (check ail that apply)
~	Street litter (e.g., cigarette filters)
~	Food-related litter (e.g., packaging/containers)
~	Medical items (e.g., syringes)
~	Sewage-related (e.g., tampons, condoms)
~	Natural debris (e.g., driftwood, algae)
~	Building materials (e.g., wood/siding)
Method for determining debris presence: (circle one) Visual observation Cleanup event results Other:	
Is algae present in the nearshore water, beach and/or shoreline? yes no don't know If present, document with photographs.
Select the amount (%) of algae in nearshore water: (circle one)
None	Low (1 %—20%)	Moderate (21 %-50%)	High (> 50%)	
~	Fishing-related (e.g., fishing line, nets, lures)
~	Household waste (e.g., household trash, plastic bags)
~	Tar/Oil (e.g., tar balls)
~	Oil/Grease (e.g., oil slick)
~	Other: 	
3

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Or EPA
United States
Environmental Protection
Agency
& v	EPA 820-F-20-004
ife Freshwater Routine Sanitary Survey for Recreational Waters	March 2021
Select the amount (%) of algae on the beach or shoreline: (circle one)
None	Low (1 %—20%)	Moderate (21 %-50%)
High (> 50%)
Method for determining amount and color of algae: (circle one)
Visual observation	Other:	
Circle the types of algae found: (check all that apply) ~ Periphyton (attached to rocks, stringy) ~ Globular (blobs of floating material)
~ Free floating (no obvious mass of materials) ~ Other:	
Algae colors: (circle ail that apply) Light green Bright green Dark green
Yellow
Brown
Other:
Is the nearshore water discolored? yes
no don't know
If yes, specify the color: (circle ail that apply) Clear
Green
Dark red
Brown
Yellowish
Other:
Harmful Algae Blooms
Is there presence of harmful algal blooms? yes
no
don't know If yes, photograph and describe:
Method for identifying harmful algae blooms in nearshore water and beach: (circle one)
Field guide or internet site for taxonomic identification	Other:
Are there mats or scum in nearshore waters? (circle ail that apply) Mats-floating
Foam
Scum
None
Are there dead fish or other dead wildlife deaths present with bloom? yes
no
Have any illnesses (e.g., itchy throat, cough, gastrointestinal) been reported by local or state health departments? yes no
If yes, describe:
Is algal toxin monitoring conducted? yes no don't know If yes, have algal toxins been detected?	
Have algal species been identified? yes no don't know If yes, specify the species:
Presence of Wildlife and Domestic Animals
Are wildlife and domestic animals present? yes no
If yes, document with photographs.
Are dead birds found on the beach?
Type
Number
Geese

Shorebirds

Pigeons

Type
Number
Otters

Turtles

Horses

yes no
Type
Number
Deer

Toads

Gulls

If yes, specify the num
Type
Number
Ducks

Dogs

Frogs

per and species of deac
Type
Number
Rodents

Beavers

Raccoons

birds.
Type
Number
Snakes

Other



Method for determining presence of wildlife and domestic animals: (circle one)
Counting using hand-held counter and if necessary, binoculars	Other (specify):.
List the number and species of birds found dead on the beach
Type
# Dead

Type
#Dead

Type
#Dead

Type
# Dead
Common loon


Black-crowned night-heron


Long-tailed ducks


Ospreys

Herring gulls


Double crested cormorants


Horned grebes


Common tern

Ring-billed gulls


White winged scoter


Snowy egrets


Belted kingfisher

Mallard ducks


Red-necked grebes


Great blue herons


Other:

Method for determining the number of dead birds: (circle one)
Counting using hand-held counter and if necessary, binoculars
Other:
Method for identifying dead birds: (circle one)
Field guide or internet site for taxonomic identification
Other:
Are dead fish found in the waterbody, on the beach or along the shoreline?
on the beach or in/at the waterbody and take photographs:
yes no
If yes, specify the number of dead fish found
Method for determining the number of dead fish: (circle one) Visual observation
Other:
Additional comments or observations on pollution sources, algae, or animals. Describe any photos taken.
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