Or EPA
United States
Environmental Protection
Agency
m ~	EPA 820-F-20-005
Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
PART 1: BASIC INFORMATION
Name of beach (if applicable):
Date(s) of survey:
Beach ID:
Time(s) of survey:
City/County/State:
Name of waterbody:
Sampling station(s)/ID:
Number of routine surveys used:
WQX organizational ID:
Name(s) of surveyor(s):
Waterbody type:
Surveyor affiliation:
Sampling location
Latitude:
Longitude:
Dates of swim season
Start:
End:
PART 2: QUALITY ASSURANCE
I the data collected use an approved Quality Assurance Project Plan (QAPP)? yes
no
PART 3: DESCRIPTION OF LAND USE IN THE WATERSHED
Current Land Use in the Watershed
Type
Residential
Industrial
Commercial
Agricultural
Other (specify):
Percentage





% Impervious





Development
% Undeveloped:
Describe:
% Developed:
Describe:
How was land use measured:
Waterbody uses: (circle ail that apply) Boating Fishing Surfing Windsurfing
Diving
Other (specify):
Are maps of the swimming area attached? yes
no
Are maps of the watershed attached? yes
no
List maps and their sources:
Do the maps include locations of the following key features: (circle yes/no). We recommend taking photographs to document structures.
Sample points
yes
no
Describe

Hydrometric network*
yes
no
Describe

Pollutant sources
yes
no
Describe

Boat traffic
yes
no
Describe

Marinas
yes
no
Describe

Boat dockage
yes
no
Describe

Fishing
yes
no
Describe

Bathing/swimming
yes
no
Describe

Do the maps include locations of the following bounding structures (circle yes/no):
Jetty
yes
no
Describe

Groin
yes
no
Describe

Seawall/bulkhead
yes
no
Describe

Other bounding structure
yes
no
Describe

Sanitary facilities
yes
no
Describe

Restaurants/bars
yes
no
Describe

Playgrounds
yes
no
Describe

Parking lots
yes
no
Describe

Other relevant locations
yes
no
Describe

'This is a network of monitoring stations that collect data such as rainfall and stream flow
1

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Or EPA
United States
Environmental Protection
Agency
m ~	EPA 820-F-20-005
Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
Erosion/Accretion Measurements (as needed)
Is there erosion/accretion at the shoreline? yes no
Are the high watermark location measurements needed? yes no
High Watermark Location
Identification
Fixed Object Description
(e.g., tree, building)
GPS Reading
Distance from Fixed
Object to High
Watermark (ft/m)
Distance between High
Watermark Locations (ft/m)
A



A~B:
B



B<->C:
C



C<->D:
D (optional)



D~E:
E (optional)




Are there shoreline hardening and circulation control structures? yes no If yes, describe below:
Structure
Number
Description or Comment (include linear extent and width)
Jetty


Groin


Seawall


Natural formation


Pier


Other (specify):


Discuss whether shoreline hardening or circulation control structures are likely to affect water quality circulation and thus bacteria
concentrations in the water (list relevant studies and their sources, if available):
Beach materials that apply or report beach materials/sediment lab analysis conducted below: (check ail that apply)
	~ Sandy	~ Mucky	~ Rocky	~ Other (specify):
Additional description of beach materials/sediment, if needed:
OR Beach Materials/Sediments Lab Analysis (use a map or photographs to document plot locations)
Were beach materials/sediments sampled and analyzed? yes no If yes, detail in this section	
Name of lab used:
Date of sample collection:
Plot ID
Mean Grain Size
Diameter** (mm/in)
Uniformity
Coefficient
Description of Plot Location












Average


Total number of samples:
"Report results from the lab
Describe the results and conclusion of the sediment analysis and potential effects of the sediment distribution at this beach:
2

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Or EPA
United States
Environmental Protection
Agency
m ~	EPA 820-F-20-005
Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
Photos Taken in the Swimming Area or Surrounding Watershed (attach copies of photos)
Image
Number
Date/Time
File Name
Description of Photo
(e.g., Land Use, High Watermark, Fixed Objects, Pollution Sources, Tide Pools)




































Habitat around the swim area: (check ail that apply)
~	Dunes	~ River/Stream ~ Urban/Boardwalk	~ Park ~ Other (specify):
~	Wetlands	~ Forest	~ Protected habitat or reserve ~ Parking
PART 4: WEATHER CONDITIONS AND PHYSICAL CHARACTERISTICS	
Weather Conditions and Physical Characteristics	
Examine the weather data collected over the prior swim season(s) along with bacteria sampling results. Do the bacteria concentrations at
this swimming location appear to correlate with any of the following? (circle yes/no and include the r value if calculated)
Rainfall
yes
no
Describe

Air temperature
yes
no
Describe

Water temperature
yes
no
Describe

Cloud cover
yes
no
Describe

Wind speed
yes
no
Describe

Wind direction
yes
no
Describe

Wave direction
yes
no
Describe

Wave height or intensity
yes
no
Describe

Stream flow
yes
no
Describe

Other weather
yes
no
Describe

Have any statistical analyses been done to calcu
ate the degree of correlation? yes no
If yes, describe:
Average air temperature during swim season
C or F

Averaqe water temperature durinq swim season: C or F
Average wind speed during swim season:
(mph or km/h)

Averaqe wind direction durinq swim season:
Typical weather condition (circle one):
Total rainfall (in/cm)
Spring: Sunny Mostly Sunny
Partly Cloudy
Mostly Cloudy
Overcast
Rainy

Summer: Sunny Mostly Sunny
Partly Cloudy
Mostly Cloudy
Overcast
Rainy

Fall: Sunny Mostly Sunny
Partly Cloudy
Mostly Cloudy
Overcast
Rainy

Winter: Sunny Mostly Sunny
Partly Cloudy
Mostly Cloudy
Overcast
Rainy

Total rainfall for the swim season:
in/cm)
Does rainfall intensity correlate with bacteria sample results? yes no
Averaqe rainfall for the swim season:
(in/cm)
If yes, explain:



Number of significant rain events during swim season:
What constitutes "significant?" (significant may include intensity and duration; e.g., 1 inch in 6 or fewer hours):
Additional comments/observations:
3

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Or EPA
United States
Environmental Protection
Agency

Freshwater Annual Sanitary Survey for Recreational Waters
EPA 820-F-20-005
March 2021
PART 5: BEACH/SHORELINE DIMENSIONS
Draw and annotate a printed map to detail beach/shoreline dimensions and key structures.
Beach/shoreline length or dimensions (indicate Z1, Z2, and Z3 on a map for each beach area)
Total beach/shoreline length (ft/m):
Average beach/shoreline width (average setback, ft/m):
Width Z1 (ft/m):
Width Z2 (ft/m):
Width Z3 (ft/m):
Local water level variation:
ftorm

Hydrographic influence (e.g., seiches):
Characterize any longshore or nearshore currents and their potential effects based on bacteria sampling results:
Approximate beach/shoreline slope at the swimming area (%):
Describe the splash zone at the beach/shoreline (include sediment makeup, rate of erosion, presence of seaweed wrack):
Description and date Of last beach/shoreline rehabilitation (examples: new sand, nourishment, dredging; physical structures will be described in Parts 13 and 14):
Additional comments or observations:
PART 6: People	
Is the number of people measured? yes no If yes, describe how number of people are calculated (e.g., turnstile, counting at noon,
photographs):	
Numbers and Activities
Location of People
Number of People Per Day Using the Swim Area (Daily use)
Peak Use for
the Season
Seasonal
Average
Holiday Average
Weekend
Average
Weekday
Average
Off-Season Average
(if applicable)
Total people in the water






Total people out of water






Total people






Breakdown Of Activities (if activities were broken down on the Routine-Onsite Sanitary Survey, summarize them here)
Activ
ty 1







Activ
ty 2







Activ
ty 3







Activ
ty 4







Activ
ty 5







Activ
ty 6







Frequency of measurements (e.g., daily, weekly, monthly):
Examine people data along with sampling results for the past swim season(s). Look at each sampling point or different area of the beach
or shoreline (light use versus heavy use). Does the number of people appear to correlate with bacteria concentrations at any of these
areas? Does the number of people in the water or out of the water correlate with bacteria concentrations? Describe statistical analysis
that has been done, (add additional pages as needed, or attach a separate report if available):
Take any relevant photographs and provide additional comments or observations:
4

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_e,FRA	EPA 820-F-20-005
v,, ^	ife Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
United States
Environmental Protection
Agency
PART 7: BEACH/SHORELINE CLEANING
Description Of Cleanup Activities (circle activities that were done, specify frequency and equipment used)
Activity
Frequency
Equipment Used
Activity
Frequency
Equipment Used
Leveling sand


Removing trash


Removing debris


Other:


Trimming or removing
vegetation


Construct/Maintain a
temporary pathway
directly to open water


How often are floatables found in the water? (circle one) Never	Sometimes	Frequently	Very frequently
Describe known sources of floatables:
Select all types of floatables found: (check all 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)
~	Building materials (e.g., wood/siding)
~	Fishing-related (e.g., fishing line, nets, lures)
~	Household waste (e.g., household trash, plastic bags)
~	Other: 	
How often is beach debris/litter found on the beach or shoreline? (circle one) Never Sometimes Frequently Very Frequently
Describe known sources of debris:
Select all types of debris found: (check all 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)
Additional comments or observations:
~	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: 	
PART 8: INFORMATION ON SAMPLING LOCATION	
Description of Sample Points (include points for recreational area water & potential pollution sources. We recommend taking photos to document location):
Sample Point
Name/ID
Location
(include lat/long)
Sample Point Description
Sample
Frequency
(daily, weekly,
monthly)
Time of Day
of Sample
Collection
Tidal Stage During
Sample Collection










































Is the sampling tide dependent? yes no
Are any of the sample locations near a possible pollution source? yes no
If yes, describe:
5

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_e,FRA	EPA 820-F-20-005
v,, ^	ife Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
United States
Environmental Protection
Agency
Description Of hydrometric network (note that this is a network of monitoring stations that collect data such as rainfall and stream flow):
Additional comments or observations:
PART 9: WATER QUALITY SAMPLING
Name of laboratory:
Distance to laboratory:.
mi km (circle one)
Sample travel time:
minutes (What is the time between sample collection and sample arrival at the lab?)
Is there a sampling and analysis plan? yes no Is it adequate? yes no
If no, explain
Are the sampling staff property trained on sampling techniques, equipment maintenance, and calibration procedures? yes
no
Were invasive/nonnative species present? yes no If yes, take photographs to document presence
List any infectious snails that were found:
List any dangerous aquatic organisms that were found:
Have algae been observed on the beach or shoreline? yes no If yes, take photographs to document algae presence
Percent of swim season when macroalgae were present in significant amounts in the nearshore water: (circle one)
None	Low (1 %20%)	Moderate (21 %-50%)	High (> 50%)
Percent of swim season where macroalgae was present in significant amounts on the beach or shoreline: (circle one)
None	Low (1 %20%)	Moderate (21 %-50%)	High (> 50%)
Identify 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:	
Are microalgae commonly found at this location? yes no If yes, describe occurrences:
Harmful Algae Blooms
Harmful Algal Bloom 0
oservations (include water and potential pollution sources):
HABs Date
HABs Duration
(in days, weeks, etc)
HABs Species
Effects




















Take photos and provide any additional descriptions:
Presence of Wildlife and Domestic Animals
Type
Degree of
Presence
(high medium low)
Does this presence appear
to correlate with bacterial
results? (yes/no)
Do people feed waterfowl? Is there any management of pet waste? Are fecal
droppings frequently seen? Are there ways to reduce the presence or effects of
these wild and domestic animals?
Geese



Gulls



Dogs



Other (specify)



6

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_e,FRA	EPA 820-F-20-005
v,, ^	ife Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
United States
Environmental Protection
Agency
Were significant numbers of dead birds found on the beach or shoreline during swim season? yes no If yes, describe types,
numbers found, and possible causes (take photos):
Were significant numbers of dead fish found on the beach or shoreline during swim season? yes no If yes, describe types,
numbers found, and possible causes (take photos):
Bacteria Samples Collected
Sampling collector (job title, agency):
Sampling frequency (daily, weekly, monthly):
Sampling time:
What year did you begin monitoring:
Did you test for: (circle yes/no)
Enterococcus ?
yes
no
Analytical method used:
Escherichia coli ?
yes
no
Analytical method used:
Fecal coliform?
yes
no
Analytical method used:
Additional bacteria?
yes
no
List names and analytical method used:
Do you composite any bacteria samples? yes no	If yes, explain:
How do this past season's bacteria results compare to those of previous years?
Do the bacterial results correlate to other parameters, such as water quality, weather flow, people load, algae, or wildlife? yes no
Describe in detail analyses that were performed on the water quality data (add additional lines/pages as needed or reference a separate report):
, . . ~ Temperature ~ Rainfall ~ Conductivity
Check all that are measured regularly	..	T ,....
~ pH	~Turbidity ~ Other (specify):
Describe where water quality measurements are taken:
How does the water quality data compare to data from previous years?
Do any data correlate to bacteria sample results? yes no
Examine the water quality data collected over the prior swim season. Do the bacteria concentrations at this swim location appear to
correlate with any Of the following? (circle yes/no and include the rvalue if calculated.)
Temperature yes no
Describe

pH yes no
Describe

Rainfall yes no
Describe

Turbidity yes no
Describe

Conductivity yes no
Describe

Other: yes no
Describe

What factor (from the list above
appears to have the greatest effect on bacteria levels in the water? Describe effect, (add lines or pages as
needed or attach a separate report if available)
What is the trend in water quality? (circle one) Improving	Deteriorating	About the same
7

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_e,FRA	EPA 820-F-20-005
v,, ^	ife Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
United States
Environmental Protection
Agency
Were there any unusual results, such as extremely high or low values detected, or unusual trends? yes no
If yes, explain what was found and any potential causes:
Can you link to any water quality annual trend? yes no If yes, provide a link to the data:
Do you sample during adverse (e.g., wet-weather) conditions? yes no
Additional comments or observations:
PART 10: MODELING AND OTHER STUDIES
Are models being used? yes no
If yes, list types of models being used and briefly describe the models:
Have you tested for stormwater cross-connections in the sanitary sewer? yes no
If yes, describe results:
Have you tested for human sources of contamination? yes no
If yes, describe the results:
Have you performed visual screening to isolate discharge areas during dry and wet weather? yes no
If yes, describe the results:
Has microbial source tracking been done at this location? yes no
If yes, describe the results and cite any reports:
Additional comments or observations:
PART 11: ADVISORIES/CLOSINGS
List any advisories and closings that occurred, whether bacteria levels were high, and any possible reasons for the advisory or closing or
high bacteria level, such as stormwater runoff, sewage spill, or wildlife.
Advisory or Closing
(specify one)
Start and End
Dates
Length of
Advisory or
Closing (Days)
Did Bacteria
Concentrations Exceed
Statistical Threshold Value
or Beach Action Value?
Reason for Advisory or Closing or Possible Contributing
Factors




























































8

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EPA 820-F-20-005
Sanitary Survey for Recreational Waters	March 2021
Total number of days under an advisory:	
Total number of days swim area was closed:	
Criteria used to issue advisory or close swim area:
Additional comments or observations:
PART 12: POTENTIAL POLLUTION SOURCES (take photographs to document pollution)
Type of Source
Level of
Concern
(H,M,L, or NA)
Distance to
Swim Area
(mi or km)
Latitude/
Longitude*
Does this source
directly affect water
quality (Y or N)?
Describe how this source might contribute to
water pollution & frequency of contribution
Wastewater discharges





Sewage overflows





Septic systems





Subsurface sewage disposal





Stormwater outfalls





Natural outfalls





CAFOsorAFOs





Wildlife





Agriculture runoff





Urban runoff, industrial waste





Marinas/Harbors





Mooring boats





Domestic animals





Unsewered areas





Erosion-prone areas





Landfills/Open dumps





Groundwater seepage





Drains and pipes nearby





Stream or Wetland drainage





Vacant areas





Homeless encampment





Other (specify):





Other (specify):





Other (specify):





*lf latitude and longitude are unknown, show the location on the detailed map and describe in the additional comments or observations section below.
Have potential pollution sources identified above been included on the detailed map? yes no
If yes, describe:	
Given your understanding of the swimming location, which fecal pollution sources are most likely to affect the levels of bacteria in the
water? If you have specific concerns about any of the fecal pollution sources as sources of specific pathogens, please describe:
Has this swim area been associated with the following? (check ail that apply)
~	Cases of swimmer's itch	~ Outbreaks of diarrheal diseases ~ High incidence of skin infection
~	Other adverse health outcomes ~ Other:	
If any are checked above, please describe:
rFPA
United States	Freshwater Annual
Environmental Protection
Agency
Total number of closings issued: _
Total number of advisories issued:
9

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Or EPA
United States
Environmental Protection
Agency
m ~	EPA 820-F-20-005
Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
Has a TMDL for bacteria been done on this waterbody or on any that discharge to it? yes no
If yes, summarize the results and attach report:
Did you collect bacteria samples from any potential pollution sources such as streams or outfalls? yes
no
Are there any discharge reports available for dischargers near this swim area? yes	no
If yes, attach report or pertinent sections and summarize here, including permit limits for bacteria:
Have any sources been remediated or have steps been taken to remediate sources? yes no
If yes, describe:
Additional comments or observations:
PART 13: DESCRIPTION OF SANITARY FACILITIES
Bathhouses and Bathrooms
Total number of bathhouses and por
table sanitation units (PSUs) at the swim area:
Number or ID
Type
(bathhouse or PSU)
Location
Condition
(good, fair, poor)
Distance from
Waterline (tt/m)
Frequency of Cleaning
(Daily, weekly, monthly)




























































How are the sanitary wastes handled? (check ail that apply) ~ Public sewers ~ On-site treatment ~ Septic field ~ Pump-out
	~ Other:		
Detail the number of toilets, showers, sinks, etc., and whether these facilities are adequate to support recreational use:
Trash Cans
Total number of trash cans at the swim area:
Bin Number or ID
Location
Condition
(good, fair, or poor)
Distance from
Waterline (ft/m)
Frequency of Emptying
(daily, weekly, monthly)




















Describe further, including whether number and location of trash cans are adequate to support recreational use:
10

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Or EPA
United States
Environmental Protection
Agency
m ~	EPA 820-F-20-005
Freshwater Annual Sanitary Survey for Recreational Waters	March 2021
PART 14: DESCRIPTION OF OTHER FACILITIES
List and, if possible, photograph, facilities in the nearby area, such as marinas, restaurants, bars, playgrounds, parking lots, etc.:
Facility Name/Type
Location
Condition
(good, fair, poor)
Distance from
Swim Area (ft/m)
How might this facility contribute to water quality
problems?






























Are there boat pump-outs nearby? yes no If yes, describe:
Additional comments or observations:
11

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