Figure: 30 TAC §285.90(3)
Figure 3. Sample Testing and Reporting Record.
This testing and reporting record shall be completed, signed and dated after each maintenance check and test. One copy shall be retained by the maintenance company. The second copy shall be sent to the local permitting authority and the third copy shall be sent to the system owner.
1. Required frequency of maintenance check and tests - (daily,
weekly, monthly, quarterly, every 4
months).
Actual date of test: ____________________
2. System inspection:
Property Address: ______________________________________
Permit Number: ________________________________________
Person Performing Inspection: _____________________________
_____________________________
(Signature)
Inspected Item
Operational
Inoperative
Aerators
Filters
Irrigation Pumps
Recirculation Pumps
Disinfection Device
Chlorine Supply
Electrical Circuits
Distribution System
Sprayfield Vegetation/Seeding
(if applicable)
Other as Noted
3. Repairs to system (list all components
replaced):________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
4. Tests required and results:
Test
Required
Results
Test
Yes No
mg/l, mpn/100 ml, or trace
Method
BOD (Grab)
TSS (Grab)
Cl2 (Grab)
Fecal Coliform
5.
Date(s) responded to owner complaints during reporting period (attach
copy of complaint and
findings): _______________________________________________________________
6.
General comments or recommendations: ______________________________
_________________________________________________________________
___________________________________________________________________