BC Ministry of Environment Municipal Wastewater Regulation – Technical Information Summary Sheet This summary sheet is referenced in Section 12 of the Municipal Wastewater Regulation (MWR) - Technical Information. Please submit a separate summary sheet for each type of discharge being registered. Note: This sheet is for information only and may not capture all sampling, reporting and notification required for your site. Requirements of the MWR and any requirement(s) imposed by a Director take precedence over this summary sheet. 1. Administrative information Registration # Registered discharger Facility address and EOCP # Discharge type Registration contact Operator contact (for office use) (company name or first and last name) (facility physical address and EOCP #) (select one: water, ground, reclaimed) (name, title, phone, email) (name, title, phone, email) 2. Description of the wastewater facility Describe the type of treatment system listing process components including make and model if applicable. See examples below. Septic tank and disposal field. Siemens™ OMNIPAC® SBR Field-Erected Package Wastewater Plant. Secondary treatment system featuring: bar rack, grit chamber, equalization basin, primary settling tank, biological treatment, secondary settling tank and disinfection. 3. In respect of the discharge from the wastewater facility, a summary of: a. the maximum daily flow of the discharge Maximum Daily Flow (m3/d) b. Effluent quality and sampling requirements Summarize the maximum discharge limits and collection and reporting information for all discharge parameters, including those identified in the Environmental Impact Study (EIS) or by any other source (including requirements or substitution imposed by the director). The summary below should match the parameters identified in the registration form. Add or remove rows as necessary. Effluent Quality and Sampling Requirements Discharge EMS # (for office use) Effluent Discharge Parameter BOD5 TSS Fecal Coliform Organisms Total Nitrogen Nitrate-N Ammonia-N Total Phosphorous Orthophosphate Metals – indicate Limit Units (e.g. 45) (e.g. 45) (e.g. 14 max; 2.2 ave.) (e.g. mg/l) (e.g. mg/l) (e.g. MPN/100ml) Collection Method (e.g. flow meter) (e.g. composite) (e.g. composite) Collection Frequency (e.g. daily, weekly) (e.g. weekly) (e.g. weekly) Reporting Frequency (e.g. quarterly, annually) (e.g. quarterly, annually) (e.g. quarterly, annually) c. Receiving environment sampling requirements Provide a summary of the receiving environment monitoring program. For easy reference, the “Site #” (column 1) should correspond to sites identified on the plan attached as part of Section 4. The “Site ID” column is optional and the “Depth” column refers to depth below the surface of the water (i.e. 0.0m = surface). Add or remove rows as necessary. Receiving Environment Sampling Site # Site ID Site Description Depth (m) EMS ID (for office use) Location (lat/lon) NAD83 datum 1 01 upgradient of groundwater well 0.0 48.000000/ -123.000000 1 02 2.0 1 03 4.0 48.000000/ -123.000000 48.000000/ -123.000000 2 2 2 3 3 3 04 05 06 0.0 2.0 4.0 Environmental Monitoring Parameter Fecal Coliform Organisms Parameter Limit Units Frequency (e.g. 14 max; 2.2 ave.) (e.g. MPN/100ml) (e.g. weekly) Fecal Coliform Organisms (e.g. 14 max; 2.2 ave.) (e.g. MPN/100ml)) (e.g. weekly) Method (e.g. grab) d. Additional notification requirements If a discharge or monitoring parameter fails to meet the requirements of the MWR, the discharger must notify the director immediately, or as directed by the MWR. In addition to the requirement above, provide a summary below of all additional notification required in the event that a discharge or monitoring parameter is exceeded. Additional requirements are those that are not included in the MWR, but imposed by the director, EIS, or any other applicable plan or study. Add or remove rows as necessary. Event (e.g. Fecal Coliform Organisms exceed 50 MPN at monitoring Site #1, ID 001) Notification Timeline (e.g. notify immediately) Parties to Notify (e.g. Ministry of Environment, Capital Regional District, Public Health Officer, Drinking Water Purveyor) 4. For reclaimed water use only: a. indicate the applicable category as described in Section 104 [Categories of reclaimed water] Category Indirect potable reuse Greater exposure Moderate exposure Lower exposure X b. Rationale and application special requirements Explain the rationale for the reclaimed water use category selected above and any application limits 5. Site plan Attach a site plan showing the receiving environment monitoring sites in relation to the location of the wastewater facility and the discharge.