Treatment Monitoring Plan

As your certified operator, Northwest Water Systems (NWS) is responsible for ensuring the required testing, monitoring, and reporting of chemical residuals and equipment operation is completed each day. Daily residual testing for your system is required by the Department of Health (DOH) and the monthly forms must be turned into NWS by the 5th of each month, with data from the previous month.

This agreement establishes the roles and responsibilities of applicable parties to this process. This agreement shall be reviewed and updated at least annually by NWS and the named point of contact and onsite party responsible for monitoring. Any modification to this agreement must be made in writing, though you may follow a verbal notification if immediate changes are necessary.

The failure or inability to meet the terms of this monitoring plan will result in NWS fulfilling the deficient roles and responsibilities at the other services rate. If the system has continuous disinfection and fails to take and report chlorine residuals for two consecutive months, the system must discuss installing a remote monitoring system and other options. The Treated System Monitoring Plan (TMP) to be completed and signed along with the contract is non-negotiable. If a monitoring plan meeting DOH minimum requirements cannot be agreed upon or operated effectively by either party, all operation and management service contracts will be terminated immediately.

Our goal is to always operate and maintain a safe and effective treated water system. It is imperative to see this through our partnership and we appreciate the involvement and commitment of all.

Treatment System Monitoring Plan

Water System Name

Water System ID #

Primary Party Responsible for Treatment System Operation and Maintenance:

Secondary Onsite Party Responsible for Daily Monitoring of Residuals and/or Treatment Equipment (Please Include Name and Contact Information)

Minimum Residual and Testing Location Requirement:

Equipment Observed and/or Maintained: (Stenner, LMI, Other)

Back Up Onsite or Secondary Party Information:

Additional Information:

Monthly chlorine residual reports must be submitted to NWS by the 5th of the following month*

Send reports by email to treatmentreports@nwwatersystems.com

by fax to 360-876-4196

by mail to: PO Box 126, Port Orchard, WA 98366.

Statement of Procedure of the following events occur:

Minimum disinfectant residual not being met:

Flush test site thoroughly (minimum 5 minutes) and retest
If residual is still below minimum, contact NWS to notify.
1. NWS' 24/7 business line is 888.881.0958 (This will include instructions for after-hours contact information if applicable)

Determine the process to ensure equipment is working properly.

Verify that the chemical injection pump is functioning normally with no leaks.
Verify that the chemical solution tank has a measurable amount of solution above the suction line of chemical pump inside the solution tank.

During routine site visits outlined in the contract, NWS will observe and verify the chemical pump operation and solution levels. Settings and adjustments will be made to ensure the target free chlorine residual is being met. In the event of a failure of the chemical pump, repair or replacement will be completed as soon as possible.

Additional steps to verify operations:

Establish if a Precautionary Boil Water Advisory (PBWA) or other Public Notification (to include DOH) is necessary.

Review procedural steps taken, determine if any additional steps are necessary, and make corrections that will improve the process going forward.

Additional Relevant Information:

Form Completed and Reviewed By:

Full Name

Date

Signature

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