Investigation Checklist Worksheet...(DO NOT USE) OSSF INSTALLATION - AEROBIC UNIT WITH LOW PRESSURE DOSING INVESTIGATION (Cont) 50 PUMPED EFFLUENT Adequate Length of Drainfield ( 1000

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Texas Commission on Environmental Quality

CHECKLIST WORKSHEET

(DO NOT USE) DISTRICTS GENERIC (10 ITEMS)

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________

Investigator Name________________________________

Citations NotesAnswerDescriptionItem No

1 Item 1

2 Item 2

3 Item 3

4 Item 4

5 Item 5

6 Item 6

7 Item 7

8 Item 8

9 Item 9

10 Item 10

05/23/2019 (DO NOT USE) DISTRICTS GENERIC (10 ITEMS) Administrator Page 1 of 1


CHECKLIST WORKSHEET

(do not use) LIP - COMPLIANCE EVALUATION

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



GENERAL QUESTIONS

2 Was there citizen collected evidence associated with this complaint?

3 If there was citizen collected evidence, was it acceptable?

4 Was TCEQ regulated activity noted during the investigation?

5 Were violation(s) of TCEQ rules noted during this investigation? If so, itemize in the following questions

6 LICENSE REQUIREMENTS

7 Does the Respondent hold a valid landscape irrigator license?

1903.251

30.5

37.003

8 Did the Respondent use or attempt to use the license of someone else who is a licensed irrigator, technician or inspector?

344.34(b)

9 Did the licensed irrigator, technician or inspector authorize or allow anyone else to use their license?

344.34(d)

10 SEAL REQUIREMENTS

11 Does every document requiring an irrigator's seal contain the licensed irrigator's seal?

344.42(a)

12 Did the licensed irrigator use or attempt to use the seal of another licensed irrigator on a plan or specification without authorization?

344.43(e)

13 LOCAL REGULATIONS

14 Did the licensed irrigator, technician or inspector comply with local requirements, ordinances and regulations?

344.24(a)

15 Did the licensed irrigator ensure that a permit was obtained and all inspections were conducted?

344.35(d)(2)

16 Did the licensed irrigator, install the appropriate backflow prevention device required by the local municipality?

344.35(d)(4)

17 DESIGN AND INSTALLATION REQUIREMENTS

18 Did the design include complete coverage of the area to be irrigated?

344.61(b)

19 Does the design and/or installation of the irrigation system require the use of any component in a way which exceeds the manufacturer's published performance limitations for the component?

344.62(a)

20 Does the design and/or installation of the irrigation system comply with the minimum standards for spacing?

344.62(a)

21 Does the design and/or installation of the irrigation system comply with the minimum standards for water pressure

344.62(c)

22 Did the licensed irrigator ensured that the irrigation zones were appropriate?

344.62(e)

23 Did the licensed irrigator ensure that the irrigation system was not spraying over hard surfaces?

344.62(g)

24 Did the licensed irrigator ensure that a rain or moisture sensor device was installed on the irrigation system?

344.62(j)

25 Does the design and/or installation of the irrigation system ensure that an isolation valve was installed?

344.62(k)

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CHECKLIST WORKSHEET

(do not use) LIP - COMPLIANCE EVALUATION (Cont)26 Does the design and/or installation of the irrigation

system comply with the minimum standards for depth coverage of piping?

344.62(l)

27 Does the design and/or installation of the irrigation system comply with the minimum standards for wiring of irrigation systems?

344.62(m)

ADVERTISEMENT REQUIREMENTS

29 Was the licensed irrigator number on both sides of all vehicles used for the installation, service or repair of irrigation systems?

344.70(a)

30 Do all forms of written and electronic advertisements, including business cards, of a licensed irrigator display the license number?

344.70(b)

31 Is the name, mailing address and telephone number of the commission prominently displayed on any legible sign and displayed in plain view for the purpose of addressing complaints?

344.70(c)

32 Did The Respondent advertise or represent themselves to the public that they can perform services for which a license number is required without possessing a current license number?

30.5(b)

1903.251

37.003

CONTRACT REQUIREMENTS

34 Did the contract to install an irrigation system specify all the required information?

344.71(a)

35 Did all written estimates, proposals, bids and invoices relating to the installation or repair contain the required TCEQ statement?

344.71(b)

WARRANTY REQUIREMENTS

37 Did the licensed irrigator present the customer a written statement of guarantees for materials and honor the warranty?

344.72(b)

38 Did the licensed irrigator's written warranty on a new irrigation system specify the irrigator's name, business address, telephone number and the TCEQ statement?

344.63

COMPLETION OF IRRIGATION SYSTEM

40 Did the irrigation system owner receive an as built plan, a maintenance checklist, a sticker on the controller and a final walk through?

344.63(2)

ADDITIONAL VIOLATIONS NOTED

42 Item 1

43 Item 2

44 Item 3

45 Item 4

46 Item 5

47 Item 6

48 Item 7

49 Item 8

50 Item 9

51 Item 10

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - AEROBIC UNIT WITH LOW PRESSURE DOSING INVESTIGATION

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



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2 SITE AND SOIL CONDITIONS & SETBACK DISTANCES Setback Distances Meet Minimum Standards

3 SEWER PIPE Proper Type Pipe from Structure to Disposal System ( Cast Iron, Ductile Iron, Sch. 40, SDR 26 )

4 SEWER PIPE Slope from the Sewer to the Tank at least 1/8 Inch Per Foot

5 SEWER PIPE Two Way Sanitary-Type Cleanout Properly Installed ( Add. C/O Every 100' &/or 90 Bends )

1 PRETREATMENT Installed (if required) TCEQ Approved List

2 PRETREATMENT Septic Tank(s) Meet Minimum Requirements

2 PRETREATMENT Installed on 4" Sand Cushion / Proper Backfill Used

2 PRETREATMENT Grease Interceptors if required for commercial

2 10

3 PRETREATMENT Inspection/Clean-Out Ports & Risers Provided

3 PRETREATMENT Secondary Restraint System Provided

3 PRETREATMENT Risers permanently fastened to lid or cast into tank

3 PRETREATMENT Riser cap protected against unauthorized intrusions

3 PRETREATMENT Tank Volume Required

4 PRETREATMENT Tank Volume Installed

5 PRETREATMENT Tank Material Type

6 PRETREATMENT Manufacturer

7 AEROBIC TREATMENT UNIT Is Aerobic Unit Installed According to Approved Guidelines?

8 AEROBIC TREATMENT UNIT Chlorinator Properly Installed with Chlorine Tablets in Place ( if required )

9 AEROBIC TREATMENT UNIT Maintenance Tag in Place

9 AEROBIC TREATMENT UNIT Inspection/Clean Out Port & Risers Provided

9 AEROBIC TREATMENT UNIT Secondary restraint system provided

9 AEROBIC TREATMENT UNIT Riser permanently fastened to lid or cast into tank

9 AEROBIC TREATMENT UNIT Riser cap protected against unauthorized intrusions

10 AEROBIC TREATMENT UNIT Size Required

11 AEROBIC TREATMENT UNIT Size Installed

12 AEROBIC TREATMENT UNIT Manufacturer

13 AEROBIC TREATMENT UNIT Model Number

14 AEROBIC TREATMENT UNIT Serial Number

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - AEROBIC UNIT WITH LOW PRESSURE DOSING INVESTIGATION (Cont)15 AEROBIC TREATMENT UNIT Aerator Model

Number

16 AEROBICT TREATMENT UNIT Aerator Serial Number

17 PUMPT TANK Is the Pump Tank an approved concrete tank or other acceptable materials & construction?

18 PUMP TANK Sampling Port Provided in the Treated Effluent Line ( if required)

19 PUMP TANK Check Valve and/or Anti-Siphon DevicePresent When Required

20 PUMP TANK Audible and Visual High Water Alarm Installed on Separate Circuit From Pump

21 PUMP TANK Required Reserve Capactiy Present

22 PUMP TANK Electrical Connections in Approved Junction Boxes / Wiring Buried

22 PUMP TANK Inspection/Clean Out Port & Risers Provided

22 PUMP TANK Secondary restraint system provided

22 PUMP TANK Riser permanently fastened to lid or cast into tank

22 PUMP TANK Riser cap protected against unauthorized intrusions

23 PUMP TANK Volume Required

24 PUMP TANK Volume Installed

25 PUMP TANK Material Type

26 PUMP TANK Manufacturer

27 PUMP TANK Model Number

28 PUMP TANK Serial Number

29 PUMP TANK Type/Size of Pump Installed

30 DISPOSAL AREA Operational & Pressure Check

31 DISPOSAL AREA Dams Present ( If using N. Carolina Sea Grant UNc - S82 - 03 ) (1982) #285.33(d)(1)(C)

32 DISPOSAL AREA Drain Holes Facing Down and placed on at least 6" of porous Media ( pea gravel or larger )

33 DISPOSAL AREA Geotextile Fabric Over Porous Media & Excavation filled with Class Ib, II, or III Soil

34 DISPOSAL AREA Type/Size Supply Line

35 DISPOSAL AREA Type/Size Distribution Piping

36 DISPOSAL AREA Minimum Area Required

37 DISPOSAL AREA Area Installed

38 DISPOSAL AREA Number of Excavations

39 DISPOSAL AREA Width of Excavation ( 6" min. )

40 DISPOSAL AREA Length of Excavations

41 DISPOSAL AREA Depth of Excavations

42 DISPOSAL AREA Type of Media

43 DISPOSAL AREA Depth of Media

44 DISPOSAL AREA Hole Sizing

45 DISPOSAL AREA Hole Spacing

46 DISPOSAL AREA Backfill Material

47 DISPOSAL AREA Distance Between Excavations

48 PUMPED EFFLUENT Utilized Only by Single Family Dwelling

49 PUMPED EFFLUENT Topographic Slopes < 2.0%



CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - AEROBIC UNIT WITH LOW PRESSURE DOSING INVESTIGATION (Cont)50 PUMPED EFFLUENT Adequate Length of

Drainfield ( 1000 Linear ft. for 2 Bedrooms or Less & an additional 400 ft. for each additional bedroom )

51 PUMPED EFFLUENT Lateral Depth of 1.5ft. to 3ft. & Vertical Separation of 2 ft. to restrictive horizon and ground water

52 PUMPED EFFLUENT Lateral Drain Pipe ( 1.25 - 1.5" dia. ) & Pipe Holes ( 3/16 - 1/4" dia. Hole Size ) 5ft. Apart

53 COMMENTS:



CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - DRIP IRRIGATION SYSTEM INVESTIGATION

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 SITE AND SOIL CONDITIONS & SETBACK DISTANCES Site and Soil Conditions Consistent with Submitted Planning Materials


3 SEWER PIPE Proper Type Pipe from Structure to Disposal System (Cast Iron, Ductile Iron, Sch. 40, SDR 26)


5 SEWER PIPE Two Way Sanitary - Type Cleanout Properly Installed (Add. C/O Every 100' &/or 90 degree bends)

6 PRETREATMENT Installed (if required) TCEQ Approved List

7 PRETREATMENT Septic Tank(s) Meet Minimum Requirements

8 PRETREATMENT Installed on 4" Sand Cushion/Proper Backfill Used


10 PRETREATMENT Approved Effluent Filter in Place if required

11 PRETREATMENT Inspection/Clean Out Port & Risers Provided

12 PRETREATMENT Secondary restraint system provided

13 PRETREATMENT Riser permanently fastened to lid or cast into tank





18 PRETREATMENT Tank Manufacturer

19 AEROBIC TREATMENT UNIT Audible and Visual High Water Alarm Installed on Separate Circuit from Pump § 285.34(b)(1)

20 AEROBIC TREATMENT UNIT Is Aerobic Unit Installed According to Approved Guidelines?

21 AEROBIC TREATMENT UNIT Chlorinator Properly Installed with Chlorine Tablets in Place ( if required )

22 AEROBIC TREATMENT UNIT Maintenance Tag in Place







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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - DRIP IRRIGATION SYSTEM INVESTIGATION (Cont)29 AEROBIC TREATMENT UNIT Manufacturer


31 AEROBIC TREATMENT UNIT Type of Aerator

32 AEROBIC TREATMENT UNIT Aerator Serial Number

33 AEROBIC TREATMENT UNIT Aerator Model Number










43 PUMP TANK Serial Numbers

44 PUMP TANK Type and Size of Pump Installed

45 PUMP TANK Filter Installed (100 micron filter) § 285.33(c)(3)

46 PUMP TANK Return line to pretreatment/pump tank

47 PUMP TANK Is the Pump Tank an approved concrete tank or other acceptable materials & construction?

48 PUMP TANK Check Valve and/or Anti-Siphon Device Present When Required


50 PUMP TANK Electrical Connection in Approved Junction Boxes/Wiring Buried § 285.34(b)(4) 285.34(b)(4)

51 PUMP TANK Adequate Working Capacity § 285.34(b)(2)

52 ALL TANKS Installed on 4" Sand Cushion/ Proper Backfill Used

53 IRRIGATION AREA Return line to treatment unit § 285.33(b)(3)(A)

54 IRRIGATION AREA Adequate drainfield layout (buried at least 6" inches deep)

55 IRRIGATION AREA Emitters Work Properly

57 IRRIGATION AREA Type of Line Installed

58 IRRIGATION AREA Pressure Relief Devices

59 IRRIGATION AREA Linear Feet line required

60 IRRIGATION AREA Linear Feet line installed

61 IRRIGATION AREA Distribution Header

62 IRRIGATION AREA Depth of Laterals

63 IRRIGATION AREA Number of Laterals

64 IRRIGATION AREA Length of Laterals

65 COMMENTS:

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - EVAPOTRANSPIRATIVE SYSTEM INVESTIGATION

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________







5 SEWER PIPE Two Way Sanitary Type Cleanout Properly Installed

6 SEPTIC TANK Septic Tank(s) Meet Minimum Requirements

7 SEPTIC TANK Inlet Flowline Greater the 3" and "T" Provided on Inlet and Outlet

8 SEPTIC TANK If Single Tank, are 2 Compartments Provided with Baffle

9 SEPTIC TANK Inspection / Clean Out Port & Risers Provided on Tanks Buried Greater 12" Sealed and Capped

10 SEPTIC TANK Tank(s) Clearly Marked

11 SEPTIC TANK Outlet Liquid Penetration 25% to 50% Total Liquid Depth at Least 30"

12 SEPTIC TANK Greater the ½ of Total Volume in Primary Tank or Compartment (1/3) for Tank 3)

13 SEPTIC TANK Minimum 12 inch drop from the bottom of the outlet pipe to the bottom of the disposal area

14 SEPTIC TANK Inspection/Clean Out Port & Risers Provided on Tanks Buried Greater than 12

15 SEPTIC TANK Secondary restraint system provided

16 SEPTIC TANK Riser permanently fastened to lid or cast into tank

17 SEPTIC TANK Riser cap protected against unauthorized intrusions

18 SEPTIC TANK Volume Required

19 SEPTIC TANK Volume Installed

20 SEPTIC TANK Material of Tank Installed

21 SEPTIC TANK Manufacturer of Tank Installed

22 SEPTIC TANK Installed on 4" Sand Cushion/ Proper Backfill Used

23 ET DISPOSAL SYSTEM Pipe Size and Type between Tanks and from "Final Tank to Disposal and 5' Minimum Length

24 ET DISPOSAL SYSTEM Excavation Depth 18-36" and Level

25 ET DISPOSAL SYSTEM Proper Media Size and Type, Drain-line Type, Geotextile Fabric

26 ET DISPOSAL SYSTEM Liner Required? Proper Material and Specifications

27 ET DISPOSAL SYSTEM Excavation Area Sized and Installed per Design

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - EVAPOTRANSPIRATIVE SYSTEM INVESTIGATION (Cont)28 ET DISPOSAL SYSTEM Class II Backfill and

Placement

29 ET DISPOSAL SYSTEM Vegetative Cover for Final Grade Complete

30 ET DISPOSAL SYSTEM Two or More Excavations with Flow Control Valves

31 COMMENTS:

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - NON - STANDARD SYSTEM INVESTIGATION

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________








6 PRIMARY TREATMENT Treatment Tank(s) Meet Minimum Requirements

7 PRIMARY TREATMENT TANK Inspection/Clean Out Port & Risers Provided on Tanks Buried Greater than 12"

8 PRIMARY TREATMENT TANK Secondary restraint system provided

9 PRIMARY TREATMENT TANK Riser permanently fastened to lid or cast into tank

10 PRIMARY TREATMENT TANK Riser cap protected against unauthorized intrusions

11 PRIMARY TREATMENT Tank Volume Required

12 PRIMARY TREATMENT Tank Volume Installed

13 PRIMARY TREATMENT Tank Material

14 PRIMARY TREATMENT Tank Series

15 PRIMARY TREATMENT Tank Manufacturer

16 PRIMARY TREATMENT Tank(s) Clearly Marked

17 PRIMARY TREATMENT Tank(s) Meet Minimum Requirements

18 PRIMARY TREATMENT Tank(s) Inspection Port or Risers on Tanks Buried Greater than 12"/ Sealed and Capped §285.32(a)(1)(D)

19 PRIMARY TREATMENT Tank(s) Inlet Flowline Greater than 3" and " T " Provided on Inlet and Outlet

20 PRIMARY TREATMENT Tank(s) Outlet Liquid Penetration 25% To 50% Total Liquid Depth at least 30"

21 PRIMARY TREATMENT Tank(s) If Single Tank, Are 2 Compartments Provided with Baffle §285.32(a)(1)(C)

22 PRIMARY TREATMENT Tank(s) Greater than ½ of Total Volume in Primary Tank or Compartment (1/3 for 3 tank)

23 PRIMARY TREATMENT Tank(s) Minimum 12 inch drop from the bottom of the outlet pipe to the bottom of the disposal area

24 SECONDARY TREATMENT (IF PROVIDED) Constructed Wetland

25 SECONDARY TREATMENT (IF PROVIDED) Activated Sludge

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - NON - STANDARD SYSTEM INVESTIGATION (Cont)26 SECONDARY TREATMENT (IF PROVIDED)

Intermittent Sand Filter

27 SECONDARY TREATMENT (IF PROVIDED) Trickling Filter

28 SECONDARY TREATMENT (IF PROVIDED) Other (describe)

29 PUMP TANK (IF PROVIDED) The pump tank shall be constructed according to the following specifications

30 PUMP TANK (IF PROVIDED) Sampling Port Provided in the Treated Effluent Line When Required

31 PUMP TANK (IF PROVIDED) Check Valve and/or Anti Siphon Device Present When Required §285.34(b)(1)

32 PUMP TANK (IF PROVIDED) Audible and Visual High Water Alarm Installed on Separate Circuit From Pump §285.34(b)(1)

33 PUMP TANK (IF PROVIDED) Required Reserve Capacity Present

34 PUMP TANK (IF PROVIDED) Elec. Connections in Approved Junction Boxes / Wiring in Conduit





39 PUMP TANK (IF PROVIDED) Volume Required

40 PUMP TANK (IF PROVIDED) Volume Installed

41 PUMP TANK (IF PROVIDED) Volume Installed

41 PUMP TANK (IF PROVIDED) Tank Material (Type)

43 PUMP TANK (IF PROVIDED) Manufacturer

44 PUMP TANK (IF PROVIDED) Type/Size of Water Pump Installed

45 PUMP TANK (IF PROVIDED) Model Number

46 PUMP TANK (IF PROVIDED) Serial Numbers


48 DISPOSAL SYSTEM Absorptive

49 DISPOSAL SYSTEM Evapo transpirative

50 DISPOSAL SYSTEM Pumped Effluent

51 DISPOSAL SYSTEM Gravelless Pipe

52 DISPOSAL SYSTEM Leaching Chamber

53 DISPOSAL SYSTEM Drip Irrigation

54 DISPOSAL SYSTEM Surface Application

55 DISPOSAL SYSTEM Mound

56 DISPOSAL SYSTEM Soil Substitution

57 DISPOSAL SYSTEM Low Pressure Dosing

58 DISPOSAL SYSTEM Other (describe) (Approved Design)

59 COMMENTS:

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - SEPTIC TANK WITH LPD OR PUMPED EFFLUENT

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________








6 SEPTIC TANK Tank(s) Clearly Marked

7 SEPTIC TANK If SingleTank, 2 Compartments Provided with Baffle

8 SEPTIC TANK Greater than 1/2 of Total Volume in Primary Tank or Compartment (1/3 for Tank 3)

9 SEPTIC TANK Inlet Flowline Greater than 3" and " T " Provided on Inlet and Outlet


11 SEPTIC TANK Inspection / Clean Out Port & Risers Provided on Tanks Buried Greater than 12" Sealed and Capped

12 SEPTIC TANK Outlet Liquid Penetration 25% to 50% Total Liquid Depth at Least 30"

13 SEPTIC TANK Tank Volume Required

14 SEPTIC TANK Tank Volume Installed

15 SEPTIC TANK Material of Tank Installed

16 SEPTIC TANK Manufacturer of Tank Installed

17 PUMP TANK Is the Pump Tank an approved concrete tank or other acceptable materials & construction?

18 PUMP TANK Required Reserve Capacity Present

19 PUMP TANK Check Value and/or Anti-Siphon Device Present When Required










29 LOW PRESSURE DISPOSAL SYSTEM Adequate Trench Length & Width, and Adequate Separation Distance between Trenches

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - SEPTIC TANK WITH LPD OR PUMPED EFFLUENT (Cont)30 LOW PRESSURE DISPOSAL SYSTEM Adequate

Pressure to Drain Field

31 LOW PRESSURE DISPOSAL SYSTEM Adequate Drain Field Pipe Hole Sizing & Spacing

32 LOW PRESSURE DISPOSAL SYSTEM Drain Holes Facing Down and placed on at least 6" of porous Media (pea gravel or larger)

33 LOW PRESSURE DISPOSAL SYSTEM Dams Present ( If using N. Caroling Sea Grant UNC - S82 -03 (1982) #285.33(d)(1)(C)

34 LOW PRESSURE DISPOSAL SYSTEM Geotextile Fabric Over Porous Media & Excavation filled with Class Ib, II, or III soils

35 LOW PRESSURE DISPOSAL SYSTEM Area Required

36 LOW PRESSURE DISPOSAL SYSTEM Area Installed

37 EFFLUENT DISPOSAL SYSTEM Utilized Only by Single Family Dwelling

38 EFFLUENT DISPOSAL SYSTEM Topographic Slopes < 2.0%

39 EFFLUENT DISPOSAL SYSTEM Adequate Length of Drain Field ( 1000 Linear ft. for 2 bedrooms or Less & an additional 400 ft. for each additional bedroom )

40 EFFLUENT DISPOSAL SYSTEM Lateral Depth of 18 inches to 3 ft. & Vertical Separation of 1ft on bottom and 2 ft. to restrictive horizon and ground water respectfully

41 EFFLUENT DISPOSAL SYSTEM Lateral Drain Pipe ( 1.25 - 1.5" dia. ) & Pipe Holes ( 3/16 - 1/4" dia. Hole Size ) 5 ft. Apart

42 COMMENTS:

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - STANDARD SYSTEM INVESTIGATION

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 SITE AND SOIL CONDITIONS & SETBACK DISTANCES Site and SoilConditions Consistent withSubmitted Planning Materials"


3 SEWER PIPE Proper Type Pipe ftom Structure to Disposal System (Cast, lron, Ductile lron, Sch. 40, SDR 26)


5 SEWER PlPE Two Way Cleanout Properly Installed (Add. C/O Every 50'&/or 90 bends)

6 SEPTIC TANK Tank Volume Required

7 SEPTIC TANK Tank Volume Installed

8 SEPTIC TANK Tank Material

9 SEPTIC TANK Tank Manufacturer

10 SEPTIC TANK Clearly Marked


12 SEPTIC TANK Inspection / Clean Out Port & Risers Provided on Tanks Buried Greater than 12" Sealed and Capped

13 SEPTIC TANK Inlet Flowline 3" Higher than Outlet and "T" Provided on Inlet and Outlet

14 SEPTIC TANK Minimum 12 inch drop from the bottom of the outlet pipe to the bottom of the disposal area

15 SEPTIC TANK lf Single Tank, are 2 Compartments Provided with Baffle

16 SEPTIC TANK Greater than1/2 of Total Volume in Primary Tank or Compartment (1/3 for Tank 3)

17 DRAINFIELD Absorptive Drainline 3" PVC or 4" PVC

18 DRAINFIELD Absorptive Drainline 8" or 10 " Gravelless pipe

19 DRAINFIELD Leaching Chambers

20 DRAINFIELD Leaching Chamber Manufacturer

21 DRAINFIELD Area Required

22 DRAINFIELD Area lnstalled

23 DRAINFIELD Excavation Width

24 DRAINFIELD Excavation Depth

25 DRAINFIELD Excavation Separation

26 DRAINFIELD Multiple Excavations

27 DRAINFIELD Depth of Porous Media

28 DRAINFIELD Type of Porous Media

29 DRAINFIELD Chambers - Open End Plates w/Splash Plate, Inspection Port & Closed End Plates in Place (per manufacturers spec.)

30 DRAINFIELD Level to within 1 inch per 25 feet and within 3 inches over entire excavation

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - STANDARD SYSTEM INVESTIGATION (Cont)31 DRAINFIELD Pipe and Gravel - Geotextile Fabric in

Place

32 DRAINFIELD Gravelless Pipe - Couplings, Endcaps, Off-Set Connectors, and Filter Wrap in Place 285.33(a)(1)(D)

33 DRAINFIELD Gravelless Pipe - Inspection Port in Place

34 COMMENTS:

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - SURFACE IRRIGATION INVESTIGATION

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________








6 PRETREATMENT Is Pretreatment Installed if required TCEQ approved list.


8 PRETREATMENT Approved Effluent Filter in place if required - TCEQ Approved List

9 PRETREATMENT Inspection/Clean Out Port & Risers Provided

10 PRETREATMENT Secondary restraint system provided

11 PRETREATMENT Riser permanently fastened to lid or cast into tank





16 PRETREATMENT Manufacturer

17 AEROBIC TREATMENT UNIT Is Aerobic Unit Installed According to Approved Guidelines.







24 AEROBIC TREATMENT UNIT Manufacturer


26 AEROBIC TREATMENT UNIT Serial Number

27 AEROBIC TREATMENT UNIT Aerator Model Number

28 AEROBIC TREATMENT UNIT Aerator Serial Number

29 AEROBIC TREATMENT UNIT Chlorinator Properly Installed with Chlorine Tablets in Place.

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CHECKLIST WORKSHEET

(DO NOT USE) OSSF INSTALLATION - SURFACE IRRIGATION INVESTIGATION (Cont)30 AEROBIC TREATMENT UNIT Maintenance Tag in

Place

31 PUMP TANK Is the Pump Tank an approved concrete tank or other acceptable materials & construction

32 PUMP TANK Sampling Port Provided in the Treated Effluent Line

33 PUMP TANK Check Valve and/or Anti-Siphon Device Present When Required


35 PUMP TANK Required Reserve Capacity Present

36 PUMP TANK Full day +1/3 Day Flow When Property Line Setbacks Are < 20' and Irrigation Timers are Installed If Required







43 PUMP TANK Material (Type)





48 PUMP TANK Disinfection equipment listed by NSF or an ANSI accredited institution under ANSI/NSF Standard 46 or has been approved by the executive director


50 APPLICATION AREA Low Angle Nozzles Used / Pressure is as required

51 APPLICATION AREA Acceptable Area, nothing within 10 ft of sprinkler heads?

52 APPLICATION AREA The Landscape Plan is as Designed

53 APPLICATION AREA Distribution Pipe, Fitting, Sprinkler Heads & Valve Covers Color Coded Purple?

54 APPLICATION AREA Minimum Area Required

55 COMMENTS:

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CHECKLIST WORKSHEET

(DO NOT USE) PWS FOCUS DATA AUDIT

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



Records Retention and Availability

1 Does the system have the last 12 months of SWMORs available for review?

290.46(f)(3)(E)

Are the SWMORs maintained for a period of 10 years?

290.46(f)(3)(E)

Collect the SWMOR for the current month for review (if partially completed). An electronic file is preferred.

2 Does the system have the last 12 months of daily bench sheets or operator logs available for review?

290.46(f)(3)

Are the bench sheets and/or logs maintained for a period of 3 years?

290.46(f)(3)

Collect the current day's bench sheet for review 290.46(f)(3)

SWMOR Setup, Monthly Preparation, and File Management

3 Is the current month's SWMOR up-to-date or do the operator's wait until the end of the month to fill it out?

Are the SWMORs filled out by an administrative technician and checked by the chief operator at the end of the month?

4 Are there data points entered into future days that have not yet occurred on the current month's SWMOR?

Are there data points entered on the bench sheets or logs that have not yet occurred?

5 Does the Chief Operator complete or QA the SWMOR before signing the report?

6 Do system operators use the most recent computerized electronic version of the TCEQ's SWMOR?

290.111(h)

Do system operators use electronic version of the TCEQ's SWMOR to do daily inactivation ratio calculations?

290.111(h)

Do system operators a different spreadsheet or calculation method to do daily inactivation ratio calculations?

7 Does the water system maintain a clean master copy of the SWMOR electronic file for future use?

8 Does the water plant have a backup protection system so that they do not lose electronic files of their SWMORs?

9 Is the raw water turbidity variable or is it unusually consistent?

10 Do the process parameters entered into the SWMOR template match the process parameters in the most current approved CT study?

290.111(h)

11 Do the highest and lowest chlorine/chloramine residual values for each sampling site (D1, D2, D3, etc.) and at the entry point vary less than 0.3 mg/L for each site?

290.111(h)

12 Is there less than a 5 degrees C change in water temperature over the course of the year?

13 Does the pH in the disinfection zones vary less than 0.4 pH units? (i.e., is the highest pH value for zone D1 at least 0.4 pH units greater than the lowest pH value for zone D1?)

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CHECKLIST WORKSHEET

(DO NOT USE) PWS FOCUS DATA AUDIT (Cont)Combined Filter Effluent (CFE) Turbidity (Page 2)

14 Are instruments used to collect CFE turbidity data calibrated and are adequate calibration records available for review?

290.46(s)(2)(B)

15 If this is an online turbidimeter collecting CFE turbidity data, is the output signal capped? Are the SCADA records (or any other recording instrument records) for CFE turbidity data capped?

290.111(e)(5)(E)

16 If present, can online instrument displays and recording instrument records be demonstrated to track with each other?

17 Are the combined filter effluent (CFE) turbidity values skewed? (i.e., are there a disproportionate number of 0.30 NTU entries?)

18 Examine the monthly CFE turbidity record on page 2 of the SWMOR.

Confirm; using plant records, the SCADA record, etc.; that the plant was actually on-line during the times when these CFE turbidity events occurred.

19 Determine if the CFE turbidity entries on the SWMOR(s) are consistent with bench sheets, the SCADA record, the electronic record stored in the turbidimeter, or strip charts, as applicable.

20 If there are discrepancies between the data records (differences of 20% or more) for any of the three days, choose two more days in previous 12 months of SWMORs (a total of five days).

21 If there is only one CFE data entry that is not consistent with other records, cite the problem as an "Additional Issue" and notify the PDW so that they can followup if necessary.

22 If the CFE readings exceed 1.0 NTU, copy the supporting documents and forward to PDW so that they can issue notices of violation, and/or handle as they determine to be appropriate.

290.111(e)(2)(A)

23 If there is more than one CFE turbidity reading that differs from other records by 20% or more, copy the supporting documents and forward to PDW so that they can issue notices of violation, and/or initiate a Special Performance Evaluation (SPE), and/or initiate enforcement action, as they determine to be appropriate.

24 Are the operators filling out the 6 four-hour CFE turbidity measurements at the right times and only when the plant is treating water?

Individual Filter Effluent (IFE) Turbidity (Page 3)

25 Are instruments used to collect IFE turbidity data calibrated and are adequate calibration records available for review?

290.46(s)(2)(B)

26 Are the output signals for the online turbidimeters collecting IFE turbidity data capped? Are the SCADA records (or other recording instrument records) for IFE turbidity data capped?

290.111(e)(5)(E)

27 If present, can online instrument displays and recording instrument records be demonstrated to track with each other?

28 Select three days, lowest IR, highest IFE NTU, and one your choice. Make sure that the plant and the filter can be confirmed to be online for the days chosen. (it's usually good to do at least one day from summer and one day from winter)



CHECKLIST WORKSHEET

(DO NOT USE) PWS FOCUS DATA AUDIT (Cont)29 Determine if the maximum daily IFE turbidity

readings reported on the SWMORs are consistent with the respective 15-minute recorder readings for that filter on that day. [If the 1.0 NTU and 2.0 NTU IFE turbidity triggers are exceeded, ensure that the maximum daily IFE turbidity reading is "confirmed" (two consecutive 15-minute readings above the trigger)].

290.111(e)(2)(A)

30 If there are discrepancies between the data records (differences of 20% or more) for more than one of the three days, choose two more filter-days in previous 12 months of SWMORs (a total of five filter-days).

31 If there is only one maximum daily IFE data entry that is not consistent with other records, cite the problem as an "Additional Issue" and notify the PDW so that they can follow up if necessary.

32 If there is more than one maximum daily IFE turbidity reading that differs from other records by 20% or more, copy the supporting documents and forward to PDW so that they can issue notices of violation, and/or initiate a Special Performance Evaluation (SPE), and/or initiate enforcement action, as they determine to be appropriate.

Concentration Time/Inactivation Ratio Calculations (Page 4 and 5)

33 If present, can online instrument displays and recording instrument records for flow rates, disinfectant residuals, pHs, and temperatures be demonstrated to track with each other?

34 Select three SWMORs, including the current month, from the previous 12 months (you can use the same days from the CFE/IFE)

35 Are the values recorded in the Disinfection Process Parameters boxes in the SWMOR consistent with the information contained in Table 2 of the appropriate CT Study Approval Letter?

290.111(h)

36 Are the disinfectants, disinfectant residuals, flow rates, pHs, and temperatures consistent with the process data recorded on daily bench sheets, operations logs, SCADA records, strip charts and other logs for each disinfection zone?

37 Are the operators collecting samples for disinfectant ratio calculations during peak flow conditions?

38 Are the operators erroneously using the total daily raw water pumpage for inactivation calculations instead of using the maximum daily (peak) raw water flow rate?

290.111(h)

39 Are the operators reporting process data for all disinfection zones on Pages 4 and 5 of the SWMOR, regardless of whether or not those zones are used for inactivation credit?

40 Are the operators taking samples in one disinfection zone and reporting those test results for all disinfection zones even though the quality of the water changes?

290.111(h)

41 If the reported disinfection parameters are not consistent with other records (more than a 20% error) select two additional days (for a total of five days) and repeat the process.

290.46(f)(3)(B)

42 If there is only one day when the disinfection process parameter data differs from other records by 20% , cite the problem as an "Additional Issue" and notify the PDW so that they can follow up, if necessary.



CHECKLIST WORKSHEET

(DO NOT USE) PWS FOCUS DATA AUDIT (Cont)43 If there is more than one day when the disinfection

process parameter data differs from other records by 20% or more, copy the supporting documents and forward to PDW so that they can issue notices of violation, and/or initiate a Special Performance Evaluation (SPE), and/or initiate enforcement action, as they determine to be appropriate.

**Data Audit portion is concluded. If continuing to download plant data, and you have had training, please see the following:

Data Integrity

Turbidimeter maintenance

44 Are they inspecting, flushing, and/or replacing sample lines;

45 Calibration history - required quarterly; 290.46(s)(2)(B)(iii)

46 Verification frequency - required weekly; 290.46(s)(2)(B)(iv)

47 Photocell inspection and cleaning: check for damaged membrane/cells- recommended quarterly

48 Bulb replacement frequency - recommended annually;

49 Flow rate check - HACH instruments usually 200-750, refer to manufacturer manual as needed.

290.46(s)(2)(B)

50 Document all turbidimeters and models with serial numbers

51 Controller model and data logging setting - Check to see if time and date are correct. Check frequency of the data interval. Default is 15 minutes for HACH models

290.46(s)(2)(B)

52 Signal Averaging - Default for HACH models is 30 secs. This is acceptable in most cases

53 Bubble reject - Default is YES for HACH models. This is acceptable in most cases

Error Hold Mode - Specific to HACH 1720E and FilterTrak 660 models. Default is Hold Output (HO) and send last known value to SCADA when turbidimeter loses communication with controller. Better option is Transfer Outputs (TO) to send an operator-selected value to SCADA (e.g., 0, 10) to make operator aware of the problem

55 Output Span - To avoid "capping" of data to SCADA, the output span should be at least 0 to 5.1 NTU (applicable to analog signals). Accessing output span for HACH SC200 controller: Menu/SC200 setup/output setup (select 1 or 2; select Source to see which turbidimeter is highlighted and then Back button)/Activation (low value; high value)



CHECKLIST WORKSHEET

(DO NOT USE) PWS MODIFIED CCI

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Was the condition of the well compliant with requirements (well cap sealed, well casing free of defects or flaws, appurtenances are watertight, etc))? Were there any potential sources of contamination within the regulated distances (e.g. OSSF, WWTP, etc)?

290.41(a)

2 Are water treatment units designed, approved, operated and maintained as required?

290.46(m)

290.42(a)

3 Is a minimum chlorine residual of at least 0.2 mg/L (Free) or 0.5 mg/L (Total) maintained throughout the distribution system?

290.46(d)(2)

Is minimum pressure of 35 psi being maintained throughout the distribution system?

290.44(d)

Is the system flushing dead end mains a minimum of once per month?

290.46(f)(3)(A)(iv)

Does water system have a cross connection program and annual Backflow Assembly test reports on file?

290.46(f)(3)(B)(vi)

4 Are storage tanks designed and maintained as required?

290.46(a)

Are minimum water system capacity requirements met?

290.45(b)(1)(D)(iii)

290.45(b)(1)(C)(iii)

290.45(a)

290.45(b)(1)(B)(iii)

5 Are pumps maintained as required? 290.46(a)

Does the system have duplicate pumps that are in operation?

290.45(b)(1)(B)(iii)

6 Does the system accurately report the residuals on their DLQORs?

290.110(e)

Does the system maintain an up-to-date map of the distribution system?

290.46(n)(2)

Are records of distribution Chlorine Residual Readings kept on file?

290.46(f)(3)(B)(iii)

Are records of daily/weekly Chemical usage kept on file?

290.46(f)(3)(A)(i)

7 Does the system have any outstanding violation(s) from previous investigations (if so pull forward)?

Has the system implemented their approved Emergency Preparedness Plan?

290.39(c)(4)(A)

Does the facility have an emergency power source (only for systems over 250 connections or affected utilities)?

290.45(h)(1)(A)

8 Does an appropriately licensed operator maintain the plant and distribution system?

30.381(b)

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CHECKLIST WORKSHEET

(DO NOT USE) QUALITY REVIEW - DISTRICTS

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Was the report/complaint submitted within established deadlines? If no, explain in the comments.

2 Did the report/complaint contain the appropriate forms (i.e. complaints, EAR, NOV, etc.)

3 Were all the appropriate checklist utilized in the investigation and all applicable sections of the current checklist accurately completed?

4 Is each question on the checklist answered?

5 Are sufficient comments provided to explain the answers?

6 Are answers accurate and do the answers demonstrate correct application of policy/procedures and regulations?

7 Were violations cited correctly and supported with adequate documentation?

8 Were comments included where needed?

9 Comments?

10 Who performed the Quality Review?

3 Were all the appropriate checklists utilized in the investigation and all applicable sections of the current checklist accurately completed?

4 Is each question on the checklist answered?

5 Are sufficient comments provided to explain the answers?

6 Are answers accurate and do the answers demonstrate correct application of policy/procedures and regulations?

7 Were violations cited correctly and supported with adequate documentation?

8 Were comments included where needed?

9 Comments?

10 Who performed the Quality Review?

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CHECKLIST WORKSHEET

(DO NOT USE) STORMWATER CGP CCI

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Does activity at the site meet the definition of Stormwater Associated with Construction Activity? Part I.

2 Total site/project area (in acres):

3 Total planned disturbed area (in acres):

4 Is the site considered a Large or Small Construction Site?

281.25(a)(4)

5 Has authorization been obtained for stormwater discharges in accordance with Part II?

281.25(a)(4)

6 Is the Construction Site Notice appropriate for the site, completed, signed, and posted on site in a location readily available for viewing prior to commencing construction activities? II.E

281.25(a)(4)

7 Was the SWP3 developed to cover all portions of the site where the operator maintains control and was the SWP3 implemented prior to commencing construction activities? II.E.3(a)

281.25(a)(4)

8 Does the shared SWP3 clearly lists the name (and, for large sites, the general permit no. for each operator that participates in the shared plan); or, if the large site's permit no. has not been assigned, has the date the NOI was submitted been specified? Does the SWP3 clearly indicate which operator is responsible for satisfying each shared requirement of the SWP3 (including within shared or common areas)? III.A &B

281.25(a)(4)

9 Does the SWP3 include a description of the following: Site/project, BMPs, Erosion Control and Stabilization Practices, Sediment Control Practices, Permanent Stormwater Controls, and Other Required Controls and BMPs? Part III.F.1 4

281.25(a)(4)

10 Was tracking of sediment and dust generation from vehicles minimized? III.F.4(a)

281.25(a)(4)

11 Were erosion and sediment controls designed, installed, and maintained to minimize the discharge of pollutants? III.F.6 and III.G1

281.25(a)(4)

12 Were pollution prevention measures designed, installed, implemented, and maintained to minimize the discharge of pollutants? III.F.6 and III.G.4

281.25(a)(4)

13 Are inspections conducted as required? If applicable, were actions taken as a result of inspections described within and retained as a part of the SWP3 or was compliance with SWP3 certified? III.F.7

281.25(a)(4)

14 Item 1

15 Item 2

16 Item 3

17 Item 4

18 Item 5

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CHECKLIST WORKSHEET

(DO NOT USE) STORMWATER CGP CCI - REVISED 9/2018

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Does activity at the site meet the definition of Storm Water Associated with Construction Activity? Part I.

05/23/2019 (DO NOT USE) STORMWATER CGP CCI - REVISED 9/2018 Administrator Page 1 of 1


CHECKLIST WORKSHEET

(DO NOT USE) STORMWATER CONSTRUCTION RECON

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Does activity at the site meet the definition of Stormwater Associated with Construction Activity? TXR150000 Part I.

1A Total site project in acres

1B Total planned disturbed area in acres

2 Has a SWP3 been developed to cover all areas under the operator's control prior to obtaining authorization and has it been implemented prior to commencing construction? TXR150000 Part II.E & Part III.C

2A Are discharges from the site eligible for authorization under this general permit? If not, describe the limitation and name the specific permit provision (ex: agricultural/oil and gas activities). TXR150000 Part II.A & B

SMALL SITE AND AUTHORIZATION PROVISIONS WAIVER:

3 Has the operator applied for and received a waiver from otherwise applicable requirements of the permit according to Part II.G of the permit? TXR150000 Part II.G.

281.25(a)(4)

3A Did the operator submit a signed waiver certification form to the TCEQ at least 2 days before construction begins certifying that the construction will commence and be completed within a period when the R factor is


CHECKLIST WORKSHEET

(DO NOT USE) STORMWATER CONSTRUCTION RECON (Cont)5A Was a signed and certified construction site notice

submitted to the operator of any MS4 receiving the discharge 2 days prior to construction? TXR150000 Part II.E.

281.25(a)(4)

6 Has the operator of the construction site obtained authorization under this general permit for small construction sites? TXR150000 Part II.D.2.

281.25(a)(4)

LARGE SITE AND AUTHORIZATION PROVISIONS

7 Has the operator of the construction site obtained authorization under this general permit for large construction sites? TXR150000 Part II.D.1.

281.25(a)(4)

7A For large sites, is a copy of the NOI and a construction site notice containing all required information posted on site in a location where it is readily available for viewing? TXR150000Part II.E.3 & Part III.D.2.

281.25(a)(4)

8 Item 1

9 Item 2

10 Item 3

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CHECKLIST WORKSHEET

(DO NOT USE) UIC URANIUM CLASS III WELLS REQUIREMENTS

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



CONSTRUCTION REQUIREMENTS

1 Were all new Class III wells cased, cemented, and capped, as required?

331.82(a)

2 Were all existing Class III wells cemented and capped, as required?

331.82(a)

3 Were there any alterations to construction plans? 331.82(b)

4 Were logs and other tests conducted, as required? 331.82(c)

5 Were deviation checks conducted during drilling and construction of Class III wells, as required?

331.82(c)(1)

6 Were mechanical integrity tests performed, as required?

331.82(c)(2)(B)

331.82(c)(2)(A)(ii)

331.82(c)(2)(A)(i)

331.82(c)(2)(A)

7 Were all phases of well construction and testing supervised, as required?

331.82(d)

OPERATING REQUIREMENTS

1 Was the injection pressure at the wellhead maintained, as required?

331.83(a)(2)

331.83(a)

331.83(a)(3)

331.83(b)

331.83(a)(1)

MONITORING REQUIREMENT

1 Was the injection fluid analyzed, as required? 331.84(a)

2 Was the injection pressure, injection volumes, and production volume recorded, as required?

331.84(b)

3 Was fluid level and water quality measurement performed, as required?

331.84(c)

4 Was monitoring of the specified wells within ¼ mile of the injection site performed every 3 months, as required?

331.84(d)

5 Was monitoring of all Class III wells conducted, as required?

331.84(e)

6 Was routine monitoring performed, as required? 331.105(1)

7 Was a routine monitoring program maintained, as required?

331.105(1)

8 Was monitoring duration continued in each permit/mine area, as required?

331.105(2)

9 Did the permittee conduct verifying analysis, as required?

331.105(3)

REMEDIAL ACTION for EXCURSION

1 Did the permittee notify the commission regional office and the executive director of an excursion, as required?

331.106(1)

2 Was a groundwater analysis report completed for each well on excursion, as required?

331.106(2)

3 Was the clean-up of the wells on excursions performed, as required?

331.106(2)(A)

331.106(2)(B)

REPORTING REQUIREMENTS

1 Did the permittee submit an annual report by January 31st, or as designated by permit, as required?

331.85(a)

331.85(a)(1)

331.85(a)(3)(E)

331.85(a)(3)(C)

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CHECKLIST WORKSHEET

(DO NOT USE) UIC URANIUM CLASS III WELLS REQUIREMENTS (Cont)331.85(a)(3)(D)

331.85(a)(2)

331.85(a)(3)(A)

331.85(a)(3)(B)

2 Were results of required monitoring maintained on site, as required?

331.85(b)

3 Were results of mechanical integrity test(s) and any other periodic test(s) reported upon request or as specified in the permit?

331.85(c)

4 Was monitoring reported on a project or field basis? 331.85(d)

5 Were reports submitted quarterly to the Executive Director and no later than 10th day following report period, as required?

331.85(e)

6 Were monthly remedial action reports for excursion (s) in designated monitoring wells submitted to TCEQ, as required?

331.85(f)

7 Was the first report to include groundwater analysis for wells on excursion submitted as required?

331.85(g)

8 Were the restoration progress reports submitted to the executive director, as required?

331.107(d)

RECORD KEEPING

1 Were records maintained on site, as required? 331.85(h)

PRODUCTION AREA DEVELOPMENT

1 Was the mining solution confined to the production zone, as required?

331.102

2 Were the production zone monitoring wells completed, as required?

331.103(a)

3 Were the nonproduction zone monitoring wells completed, as required?

331.103(b)

4 Were the nonproduction zone monitoring wells completed, as required?

331.104

1 Was sampling of mine area/production zone, mine area/non-production zone, and baseline wells performed, as required?

331.104(a)(3)

331.104(a)(2)

331.104(a)(1)

331.104(a)

2 Were groundwater from all baseline wells sampled for required parameters for the purpose of the aquifer restoration?

331.104(b)

3 Were a minimum of five baseline wells, or one baseline well for every 4 acres of production area completed in the production zone?

331.104(c)

4 Were all samples collected as required in the permit and TCEQ Quality Assurance Project Plan?

331.104(d)

GROUNDWATER RESTORATION

1 Was the groundwater in the production zone restored, as required?

331.107(a)

2 Was a restoration table established for each production area authorization, as required?

331.107(a)(1)(B)

331.107(a)(1)(A)

331.107(a)(1)

3 Was groundwater restoration achieved, as required?

331.107(a)(2)(A)

331.107(a)(2)

331.107(a)(2)(B)

4 Did the permittee notify the appropriate commission regional office and the executive director of mining completion, as required?

331.107(b)

5 Was aquifer restoration for each permit or production area accomplished, as required?

331.107(c)

6 Did the permittee conduct stability sampling, as required when the restoration table values achieved?

331.107(e)

7 Was the stability sampling performed, as required? 331.107(f)



CHECKLIST WORKSHEET

(DO NOT USE) UIC URANIUM CLASS III WELLS REQUIREMENTS (Cont)8 In case the restoration table values were not

achieved, did the permittee request an amendment to the restoration table or range table value and followed the requirements?

331.107(g)

CLOSURE STANDARDS / PLUGGING AND ABANDONMENT

1 Did the permittee conduct closure of the Class III wells, as required?

331.86(a)

2 Did the executive director conduct a final inspection after the closure to certify that the closure has been accomplished, as required?

331.86(b)

3 Were the wells plugged, as required? 331.46

4 Did the permittee submit a report to the executive director within 30 days after completion of closure?

331.46(n)

5 Did the executive director receive certifications from the owner or operator and an independent licensed professional engineer or licensed professional geoscientist for accomplishment of the plugging and abandonment as required by plugging and abandonment plan?

331.144

FINANCIAL ASSURANCE FOR CLASS III WELLS

1 Did the permittee have financial assurance prior to injection in Class III wells, as required?

331.15

2 Were cost estimates for financial assurance established for aquifer restoration for each production area, as required?

331.109(a)

331.109(b)

3 Did the permittee secure and maintain financial assurance for plugging and abandonment for Class III wells, as required?

331.142(c)

331.142(b)

331.142(a)

4 Did the permittee prepare a written estimate for plugging and abandonment of the Class III wells and aquifer restoration, as required?

331.143

5 Did the executive director approve the plugging and abandonment conducted by the permittee for the purpose of release of the financial assurance?

331.144



CHECKLIST WORKSHEET

(DO NOT USE) UIC URANIUM UIC CLASS III WELLS

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



CONSTRUCTION REQUIREMENTS

2 Was construction done in accordance with casing and cementing requirements?

331.82(a)

3 Were there any alterations to construction plans? 331.82(b)

4 Were logs and other tests conducted as required? 331.82(c)

5 Were deviation checks performed? 331.82(c)(1)

6 Were mechanical integrity tests performed as required?

331.82(c)(2)(A)(i)

331.82(c)(2)(A)(ii)

331.82(c)(2)(B)

7 Were construction and testing performed under supervision?

331.82(d)

OPERATING REQUIREMENTS

1 Was injection pressure performed at the wellhead as required?

331.83(a)(1)

331.83(a)(2)

331.83(a)(3)

2 Were any injection performed between the outermost casing protecting USDWs and wellbore?

331.83(b)

MONITORING REQUIREMENT

1 Was injection fluid analysis performed as required? 331.84(a)

2 Was injection pressure/injection volumes /production volume recorded?

331.84(b)

3 Was fluid level and water quality measurement done twice a month at 15 days interval?

331.84(c)

4 Was monitoring of the specified wells within ¼ mile of the injection site performed every 3 months?

331.84(d)

5 Was monitoring conducted on a field or project basis?

331.84(e)

6 Were production zones monitoring wells located and completed as required?

331.103(a)

7 Was routine sampling performed twice per month at two week intervals as required?

331.105(1)

8 Was a routine monitoring program maintained as required by 30 TAC 331.105(1)?

331.105(2)

9 Were designated non-production zone monitor wells completed and located as required?

331.103(b)

REPORTING REQUIREMENTS

1 Did the permittee submit an annual report by January 31st, or as designated by permit, as required?

331.85(a)(3)(D)

331.85(a)(2)

331.85(a)(3)(A)

331.85(a)(1)

331.85(a)(3)(C)

331.85(a)(3)(B)

2 Were results of required monitoring maintained on site as required?

331.85(b)

3 Were results of mechanical integrity test(s) and any other periodic test(s) reported upon request or as specified in the permit?

331.85(c)

4 Was monitoring reported on a project of field basis? 331.85(d)

5 Were reports submitted quarterly to the Executive Director and no later than 10th day following report period as required?

331.85(e)

05/23/2019 (DO NOT USE) UIC URANIUM UIC CLASS III WELLS Administrator Page 1 of 3


CHECKLIST WORKSHEET

(DO NOT USE) UIC URANIUM UIC CLASS III WELLS (Cont)6 Were monthly remedial action reports for excursion

(s) in designated monitoring wells submitted to TCEQ as required?

331.85(f)

7 Was the first report to include groundwater analysis for wells on excursion submitted as required?

331.85(g)

RECORD KEEPING

1 Were records maintained on site as required? 331.85(h)

REMEDIAL ACTION FOR MONITOR WELL EXCURSION

1 Were verifying analyses performed as required? 331.105(3)

2 Was excursion monitoring performed as required? 331.105(4)

3 Did the permittee notified TCEQ of an excursion as required?

331.106(1)

4 Was a groundwater analysis report completed as required?

331.106(2)

5 Was clean-up performed as required? 331.106(2)(B)

331.106(2)(A)

GROUNDWATER RESTORATION

1 Was aquifer restoration performed as required? 331.107(a)

2 Was a restoration table established for all parameters as required?

331.107(a)(1)(A)

331.107(a)(1)(B)

3 Was restoration achieved as required? 331.107(a)(2)(A)

331.107(a)(2)(B)

4 Was mining completed as required? 331.107(b)

5 Was aquifer restoration accomplished in accordance with the timetable specified in the mine plan?

331.107(c)

6 Were restoration progress reports submitted at 6 months and semi-annually, thereafter, as required?

331.107(d)

7 Were restoration values achieved to the values in the Restoration Table?

331.107(e)

8 Was stability sampling complete as required? 331.107(f)

9 Was an amendment to the restoration table submitted if restoration table values were not achieved?

331.107(g)

SAMPLING

1 Was sampling of production zone (mine area), non-production zone, and baseline wells conducted as required?

331.104(a)(2)

331.104(a)(3)

2 Were all baseline wells sampled for specific parameters for the purpose of aquifer restoration?

331.104(b)

3 Were all sampling conducted in accordance with permit requirements and TCEQ Quality Assurance Project Plan?

331.104(d)

CLOSURE STANDARDS / PLUGGING AND ABANDONMENT

1 Were closure of wells in accordance with closure standards?

331.46(i)

331.46(e)

331.46(k)

2 Was a closure report submitted within 30 days after completion of closure?

331.46(n)

3 Was approval of plugging and abandonment/certification from the owner or operator and an independent registered professional engineer for plugging and abandonment submitted to TCEQ?

331.144

FINANCIAL ASSURANCE FOR CLASS III WELLS

1 Were cost estimates for financial assurance established as required?

331.109(b)

331.109(a)



CHECKLIST WORKSHEET

(DO NOT USE) UIC URANIUM UIC CLASS III WELLS (Cont)2 Did the permittee have financial assurance for

injection for class III wells?331.15

3 Did the permittee have financial assurance for plugging and abandonment, as applicable?

331.142

4 Was there a cost estimate for plugging and abandonment?

331.143

5 Were financial assurance requirements for plugging and abandonment established?

37.7021



CHECKLIST WORKSHEET

(DO NOT USE) WATERMASTER FIELD CITATION

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Field Citation Number

2 Diverting, storing, impounding, using state water, or beginning construction of any work designed for the storage, taking, or diversion of water without first obtaining a water right.

11.121

297.11

11.081

3 Any unauthorized diversions or use of state water (permitted or non permitted) where water diversion or curtailments have been ordered by the Executive Director (including Watermaster)

11.053

4 Diversion without a watermaster approved diversion certification (applicable to water right holders only) (second time noted within 24 months) or the diversion, use, or transport without a watermaster approved declaration of intent or certification (applicable to water right holders only) (second time noted within 24 months)

304.34(d)

303.35(d)

5 Failure to provide a measuring device or alternative method of measurement (second time noted within 24 months)

304.34(d)

303.35(d)

6 Water right holder does not pass water which the holder is not entitled to hold or impound in accordance with special conditions of water rights or watermaster (second time noted within 24 months)

304.34(d)

303.35(d)

7 Late pump operation report (Rio Grande Watermaster) or late report of diversion, transport, use, release, or impoundment (second time noted within 24 months

304.34(d)

303.35(d)

8 Number of Violations

9 Penalty Assessed

10 Is the facility major or minor? (Major = 1, Minor = 2)

11 Payment received?

12 Were all violations corrected?

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CHECKLIST WORKSHEET

(DO NOT USE) WD DISTRICTS REVISED 4/16/2019

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Did TCEQ grant authorization to proceed in federal bankruptcy?

49.456

2 Has the district completed measures necessary to generate sufficient revenues to settle the judgement against it and/or filed necessary reports?

293.88(d)

3 Did the District file with the Executive Director its annual audit as required by 30 Tex. Admin. Code 239.91 and Tex. Water Code 49.194?

293.91(a)(5)

49.194(a)

49.194(b)

4 Did the District file with the Executive Director an annual affidavit for its annual audit as required by 30 Tex. Admin. Code 293.91 and Tex. Water Code 49.194?

49.194(d)

49.194(e)

293.91(a)(6)

05/23/2019 (DO NOT USE) WD DISTRICTS REVISED 4/16/2019 Administrator Page 1 of 1


CHECKLIST WORKSHEET

(DO NOT USE) WQ DOMESTIC FOCUSED CCI

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Are adequate safeguards provided to prevent the discharge of untreated or partially treated wastes during electrical power failure by means of alternate power sources, standby generators and/or retention structures?

305.125(1)

2 Were the treatment units properly operated and maintained?

305.125(5)

305.125(1)

3 Are there a minimum of two functional lift pumps present at the lift station(s)?

305.125(1)

217.61(e)

317.3(c)(2)

4 Are there a minimum of two functional blowers present for the aeration basin(s)?

305.125(1)

217.155(b)(4)

317.4(g)(4)

5 Are backflow prevention devices installed and tested as required?

217.330(a)

317.4(a)(8)

6 Is the Dissolved Oxygen concentration in aeration basin within the recommended range? (2.0 mg/L for plants with ammonia-nitrogen limits, 1.0 mg/L for all others)

305.125(5)

317.4(g)(4)(A)

217.155(a)(1)

7 Is the SV30 and the mixed liquor concentration (take MLSS if SV30 is above 60%) within the recommended range (30-60%)?

305.125(1)

305.125(5)

8 Is the clarifier(s) sludge blanket level(s) within the recommended range (


CHECKLIST WORKSHEET

(DO NOT USE) WQ GENERAL CCI

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Is the facility operating with a current TPDES permit?

26.121(a)(1)

2 If the facility has changed ownership, was an application for transfer of ownership submitted?

305.64(b)

3 If physical alterations have been made to the plant/collection system, was the proper notification submitted?

305.126(b)

305.125(7)

305.125(1)

4 Have unauthorized discharges occurred during the review period?

305.125(1)

26.121(a)(1)

5 Was the flow measured as required by the permit? 305.125(1)

6 Were flow measurement devices properly installed? 305.125(1)

319.11(d)

7 Were flow measurement devices properly maintained?

305.125(1)

305.125(5)

319.11(d)

8 Were the flow measurement devices calibrated annually and did they exhibit a margin of error within 10%? (NPDES Compliance Inspection Manual, Chapter 6 and new 217)

305.125(1)

217.33(a)

9 Was the flow measuring equipment adequate to handle the entire flow range?

305.125(1)

319.11(d)

10 Were the samples collected by the region compliant with the permit limits?

305.125(1)

11 Was the permittee compliant with the self-monitored effluent limits?

305.125(1)

12 Were samples collected at the location specified in the permit?

305.125(1)

319.5(a)

13 Were the correct type of samples collected, as required by the permit?

305.125(1)

14 Were sampling and analyses completed on the parameters specified in the permit?

319.4

305.125(1)

15 Were sampling and analyses performed at the frequency specified in the permit?

305.125(1)

319.5(b)

16 Were the proper sampling procedures, containers and preservatives used? Were the samples analyzed within the required hold times?

319.11(a)

319.11(b)

17 Were the proper analytical methods and techniques used for the sample analyses?

319.11(c)

18 Was the required QA/QC conducted for each analysis?

319.6

319.9(d)

19 Did the required records contain all information, and were they maintained and available for review (including sampling records, calibration records, QA/QC, temp logs and chain of custody)?

305.125(1)

319.7(c)

319.7(a)

20 Are process control and operations and maintenance records maintained?

305.125(1)

21 Were the analytical results consistent with the data reported on the DMRs and /or MERs?

305.125(19)

22 Were effluent calculations performed correctly? 305.125(1)

23 Were DMRs/MERs submitted within the required timeframe?

319.7(d)

24 Were all the required documents maintained (DMRs, lab reports, logs, etc…)?

305.125(1)

05/23/2019 (DO NOT USE) WQ GENERAL CCI Administrator Page 1 of 2


CHECKLIST WORKSHEET

(DO NOT USE) WQ GENERAL CCI (Cont)305.125(11)(B)

319.7(c)

25 Were noncompliance notifications submitted as required?

305.125(1)

26 Are the correct sample types collected for biomonitoring tests?

305.125(1)

27 Are the biomonitoring tests analyzed within the required holding times?

319.11(b)

28 Were any issues noted with the effluent discharge into the receiving stream (foaming, floatables, sludge, etc…)?

305.125(1)

305.125(4)

29 Was the permittee compliant with additional requirements specific to this permit?

305.125(1)


305.125(1)

Other Violations, Areas of Concern or Additional Issues below

31 Item one:

32 Item two:

33 Item three:

34 Item four:

35 Item five:

05/23/2019 (DO NOT USE) WQ GENERAL CCI Administrator Page 2 of 2


CHECKLIST WORKSHEET

(DO NOT USE) WQ INDUSTRIAL CCI

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________



1 Were all of the treatment units and appurtenances properly operated and maintained? (collection system, wastewater units, oil/water separator, filter, ponds, sludge processing, generator, etc…)

305.125(5)

305.125(1)

2 Were the required number of standby and backup units provided for the Domestic Wastewater Plant within the industrial facility if it has an external outfall? (in the collection system, wastewater units, sludge processing, generator, etc…)

3 Were there any design issues noted with regard to treatment units and appurtenances for the Domestic Wastewater Plant within the industrial facility if it has an external outfall?(collection system, wastewater units, sludge processing, generator, etc…)

4 Did the permittee dispose of sludge during the review period? (If no, stop and leave default answers)

A Were the required sludge records maintained? 305.125(1)

B Was the sludge disposed of at a properly permitted or registered site?

305.125(1)


305.125(1)

Other Violations, Areas of Concern or Additional Issues below

6 Item one:

7 Item two:

8 Item three:

9 Item four:

10 Item five:

05/23/2019 (DO NOT USE) WQ INDUSTRIAL CCI Administrator Page 1 of 1


CHECKLIST WORKSHEET

(DO NOT USE) WQ INDUSTRIAL FOCUSED CCI

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________




305.125(1)

2 Were the treatment units properly operated and maintained?

305.125(5)

305.125(1)

3 Were the samples collected (other than chlorine) by the region compliant with the permit limits (if sampling was deemed necessary by visual observations or by process control results)?

305.125(1)

4 Are solids or a sheen observed in the receiving waters or leaving the plant?

305.125(1)

5 Have the flow meter and chart recorder been calibrated within the last 12 months?

319.11(d)


26.121(a)(1)

7 Has the proper stormwater authorization been obtained if required?

26.121(a)(2)

281.25(a)(4)

8 Is the facility compliant with the non-standard items in the "Other Requirements" section in their TPDES permit?

305.125(1)


305.125(5)

26.121(a)(1)


305.125(1)

11 Were DMRs/MERs submitted within the required timeframe?

305.125(1)

319.7(d)

05/23/2019 (DO NOT USE) WQ INDUSTRIAL FOCUSED CCI Administrator Page 1 of 1


CHECKLIST WORKSHEET

(DO NOT USE) WW OFF-SITE DESK AUDIT

Reg Ent Name :_________________________________

Add ID________________________________________

Date :___________________________________________




26.121(a)(1)

2 If the facility has changed ownership, was an application for transfer of ownership submitted?

305.64(b)


26.121(a)(1)

305.125(1)


305.125(1)

5 Were the correct type of samples collected, as required by the permit?

305.125(1)

6 Were sampling and analyses completed on the parameters specified in the permit?

305.125(1)

319.4

7 Were sampling and analyses performed at the frequency specified in the permit?

305.125(1)

319.5(b)

8 Are process control and operations and maintenance records maintained?

305.125(1)

9 Were the analytical results consistent with the data reported on the DMRs and /or MERs?

305.125(19)

10 Were effluent calculations performed correctly? 305.125(1)

11 Were noncompliance notifications submitted as required?

305.125(11)(B)

12 Are the correct sample types collected for biomonitoring tests?

305.125(1)

13 Are the biomonitoring tests analyzed within the required holding times?

319.11(b)

14 Was the permittee compliant with additional requirements specific to this permit?

305.125(1)

15 If the treatment plant has reached 75% or greater of the permitted daily flow for three consecutive months, has the regulated entity taken action to comply with the 75/90 rule requirements?

305.126(a)

305.125(1)

16 Were operators with the proper certification levels operating the collection system and plant?

30.331(b)

305.125(1)

30.350(d)

30.350(e)

17 Were the annual sludge DMR/additional reports submitted as required?

305.125(1)

18 Did the permittee dispose of sludge during the review period? (If no, stop and leave default answers)

19 Were the required sludge records maintained? 305.125(11)(B)

305.125(1)

20 Were the sludge analyses conducted for the required parameters and at the required frequency?

305.125(1)

21 Were pathogen controls and/or vector attraction reduction requirements met?

305.125(1)

22 Was the sludge disposed of at a properly permitted or registered site?

305.125(1)

05/23/2019 (DO NOT USE) WW OF

Documents

Investigation Checklist Worksheet...(DO NOT USE) OSSF INSTALLATION - AEROBIC UNIT WITH LOW PRESSURE DOSING INVESTIGATION (Cont) 50 PUMPED EFFLUENT Adequate Length of Drainfield ( 1000