Effect on Receiving Stream
| Effect on Receiving Stream | |||
| Name and amount of chemicals used in treatment process | |||
| Sludge Removal from Plant: | |||
| NAME OF RECEIVING STREAM | - | - | - |
| - | - | - | - |
| - | - | - | during month. |
| - | - | - | a. Amount |
| - | - | - | gallons |
| - | - | - | a. Chlorine |
| - | - | - | lbs. |
| - | - | - | b. Solid Content |
| - | - | - | % |
| - | - | - | b. Sodium Hypochlorite |
| - | - | - | gal. |
| - | - | - | c. |
| - | - | - | Volatile Solids Content |
| - | - | - | % |
| - | - | - | c. soda Ash |
| - | - | - | lbs. |
| - | - | - | d. Disposal Site |
| - | - | - | Superior Sanitation |
| - | - | - | d. |
| - | - | - | lbs. |
| - | - | - | e. |
| - | - | - | lbs. |
| - | - | - | f. |
| - | - | - | lbs. |
| - | - | - | Amount of electrical power consumed |
| - | - | - | Other Solid Waters: |
| - | - | - | a. Commercial |
| - | - | - | kilowatt hours |
| - | - | - | a. Screening |
| - | - | - | cubic feet |
| - | - | - | b. Stand-by |
| - | - | - | kilowatt hours |
| - | - | - | b. Grit |
| - | - | - | cubic feet |
| - | - | - | c. |
| - | - | - | Ashes |
| - | - | - | tons |
| - | - | - | Amount of fuel consumed |
| - | - | - | d. |
| - | - | - | a. Natural Gas |
| - | - | - | cubic feet |
| - | - | - | e. |
| - | - | - | b. Oil |
| - | - | - | gallons |
| - | - | - | f. |
| - | - | - | c. Gasoline |
| - | - | - | gallons |
| - | - | - | g. Disposal Site Private hauler |
| - | - | - | d. Coal |
| - | - | - | tons |
| - | - | - | e. Digester Gas |
| - | - | - | cubic feet |
| - | - | - | f. |
| - | - | - | Propane |
| - | - | - | gallons |
| - | - | - | Digester Gas Wasted |
| - | - | - | cubic feet |
| - | - | - | Labor expended: |
| - | - | - | POSITION NAME |
| - | - | - | NUMBER FULL TIME |
| - | - | - | NUMBER PART TIME |
| - | - | - | TOTAL HOURS |
| - | - | - | Supervisor |
| - | - | - | Chief Operator |
| - | - | - | Operator |
| - | - | - | Mechanic |
| - | - | - | I hereby affirm under penality of perjury that information proided on this form is true to the best of my knowledge and belief. False statements made |
| - | - | - | herein are punishable as a Class A misdemeanor pursuant to Section 210.45 of the Penal Law. |
| - | - | - | Signature of Chief Operator or Designated Facility Representative |
| DATE | |||
| STATION | PARAMETER | RESULT | |
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