Pond Weekly Observations Form

Pond Weekly Observations Form Wastewater Program Doc Type: Discharge Monitoring Reports

Instructions: This form must be filled out and submitted electronically with the Discharge Monitoring Reports.

Facility name: Permit number: Month: Year:

Type of Pond (Aerated, Primary, Secondary, etc.) Pond: Acres: Pond: Acres: Pond: Acres:

Week of the month 1st 2nd 3rd 4th 5th 1st 2nd 3rd 4th 5th 1st 2nd 3rd 4th 5th 1. Date of observation (mm/dd/yyyy):

2. Odor (Yes or No): 3. Aquatic plants (% of coverage, type): 4. Floating mats (% of coverage, type):

5. Water depth (inches): 6. Muskrats, rodents, etc. (Yes or No): 7. Dike condition (Erosion, etc.):

8. Ice cover (% of coverage):

www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • Use your preferred relay service • Available in alternative formats wq-wwprm7-61a • 6/4/13 Page 1 of 2 Type of Pond (Aerated, Primary, Secondary, etc.) Pond: Acres: Pond: Acres: Pond: Acres:

Week of the month 1st 2nd 3rd 4th 5th 1st 2nd 3rd 4th 5th 1st 2nd 3rd 4th 5th 1. Date of observation (mm/dd/yyyy):

2. Odor (Yes or No): 3. Aquatic plants (% of coverage, type): 4. Floating mats (% of coverage, type):

5. Water depth (inches): 6. Muskrats, rodents, etc. (Yes or No): 7. Dike condition (Erosion, etc.):

8. Ice cover (% of coverage):

Comments:

www.pca.state.mn.us • 651-296-6300 • 800-657-3864 • Use your preferred relay service • Available in alternative formats wq-wwprm7-61a • 6/4/13 Page 2 of 2