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INSTRUCTIONS
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This form is for systems with quarterly Stage 2 DBP monitoring requirements only.
This form is not required to be submitted.
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0. Click on the "LRAA_Calculator" Sheet at the bottom of the page. Steps 1 - 6 are optional.
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1. PWSID #: Enter the Public Water System (PWS) Identification Number assigned by CDPHE.
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2. System Name: Enter the system legal name provided to CDPHE.
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3. Date: Enter the date that the final form is prepared.
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4. Prepared By: Enter the name of the person completing the form.
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5. Phone #: Enter the phone number of the person completing the form
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6. E-mail: Enter the e-mail of the person completing the form, if available.
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7. Peak Month of DBP Formation: Choose from the drop down box the system's historical peak DBP formation month. The peak month was established if the system completed an Initial Distribution System Evaluation (IDSE). If never identified, the default month is August. The peak month is recorded on your Monitoring Schedule.
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8. Compliance Quarter: Choose from the drop down box the appropriate compliance quarter.
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9. Required Sampling Months: Based on the Peak Month of DBP Formation, systems must monitor within the four required sampling months at a minimum.
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10. State Sample Point ID: Enter the State Sample Point ID assigned by CDPHE for your sample points. This information can be found on your Monitoring Schedule.
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11. Sample Site Name: Enter the sample site’s local name, identifier, or address (e.g. SM8 or 100 Main St).
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12. Year Column: Add the year for which the reporting month is associated.
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13. TTHM and HAA5 results: For each sample site enter the monthly average of TTHM and HAA5 sample results for each month samples were collected.
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14. Quarter Average: Computes quarterly average based on monthly averages within each quarter.
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15. Locational Running Annual Average: Computes the Locational Running Annual Average based on an average of the quarterly averages. If the cell is highlighted red, the system has exceeded the Maximum Contaminant Level (MCL).
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16. Operational Evaluation Level (OEL): The sum of the previous two quarterly averages of results plus twice the current quarterly average, then divided by four. If the OEL exceeds the MCL for TTHM or HAA5, the system must conduct an operational evaluation of their source, treatment, and distribution system on how to minimize DBP formation and submit a report to CDPHE within 90 days of receiving the results. If the cell is highlighted red, the system has exceeded the OEL. If the OEL is exceeded prior to three quarters of monitoring, consult with CDPHE to confirm OEL requirements.
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