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Technical Guidance Document for Wastewater and Marine Water ...

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AnnexTable A-4. Example of a St<strong>and</strong>ard Limit Exceedance Form to <strong>Document</strong> a St<strong>and</strong>ard LimitExceedance Event <strong>and</strong> Increased <strong>Water</strong> Quality Monitoring Following the EventSt<strong>and</strong>ard Limit Exceedance Record (SLER)Facility:IndividualCompleting ThisSheet:Permit No.:LaboratoryPer<strong>for</strong>mingAnalyses:St<strong>and</strong>ard Exceedance Event DescriptionMonitoring Stationor Location Parameter Sample IDSample CollectionDate <strong>and</strong> Time Value Units St<strong>and</strong>ard Limit<strong>Water</strong> Quality Data—Post-Exceedance monitoringMonitoring Stationor Location Parameter Sample IDSample CollectionDate <strong>and</strong> Time Value Units NotesPlease describe the cause of the event:Cause of ExceedanceCorrective ActionPlease describe your Corrective Action Plan <strong>and</strong>/or corrective actions taken:<strong>Document</strong> Tracking Number: 03.02.457.WP.03Date of Issue: 30Jan12A-5

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