Professional Documents
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National Ecology Center, East Avenue, Diliman, Quezon City, Metro Manila
http://www.llda.gov.ph | info@llda.gov.ph
If the head office is not located at the above address, please fill-up
Note:
Please observe the required frequency of analysis and submission of SMR
Flowrate Type Frequency Submission of SMR
3
0-150 m /d BOD, conventional parameters Once every quarter Semi-Annually
0-150 m3/d Hazardous waste Once every month Quarterly
3
> 150 m /d BOD, conventional parameters Once every month Quarterly
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B. Wastewater Treatment Plant (WTP) Record
B.1 Average Duration of Time Operated & Ave. Volume of Discharge Per Day
ZERO DISCHARGED
ZERO DISCHARGED
7 8hrs 8hrs 8hrs
8 8hrs 8hrs 8hrs
9 8hrs 8hrs 8hrs
10 8hrs 8hrs 8hrs
11 8hrs - 8hrs
12 8hrs 8hrs 8hrs
13 8hrs 8hrs 8hrs
14 8hrs 8hrs 8hrs
15 8hrs 8hrs 8hrs
16 8hrs 8hrs 8hrs
17 8hrs 8hrs 8hrs
18 8hrs 8hrs 8hrs
19 8hrs 8hrs 8hrs
20 - 8hrs 8hrs
21 8hrs 8hrs 8hrs
22 8hrs 8hrs 8hrs
23 8hrs - 8hrs
24 8hrs - 8hrs
25 8hrs - 1hr
26 8hrs 8hrs -
27 8hrs 8hrs -
28 8hrs 8hrs -
29 8hrs 8hrs -
30 8hrs 8hrs -
31 8hrs - -
Total hrs. 224hrs 208hrs 177hrs
Were there any major interruptions in WTP operation? For example, due to equipment breakdown or major maintenance
procedures. Yes No . If yes, please attach explanation on separate page.
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B.2 Record of the Cost of Treatment
Cost
kwH Cost (pesos) kwH Cost (pesos) kwH (pesos)
Persons Employed Total Avg. Hrs. Total Cost Total Avg. Hrs. Total Cost Total Avg. Hrs. Total Cost
Full-time for the Number per Day (pesos) Number per Day (pesos) Number per Day (pesos)
WTP
Persons Employed Total Avg. Hrs. Total Cost Total Avg. Hrs. Total Cost Total Avg. Hrs. Total Cost
Part-time for the Number per Day (pesos) Number per Day (pesos) Number per Day (pesos)
WTP
Cost of Chemicals
Used by WTP (pesos)
Total Maintenance
Cost-repairs, spare
parts etc. (pesos)
Administrative and
Overhead Cost (pesos)
Laboratory Cost
File: frm_smr.xlsx\PAGE 3
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C.1 Monthly Report of Wastewater Characteristics for Conventional Pollutants
Description of the
Outlet: X-UTM ____________________________ Y-UTM ________________________
If No, please submit this report for other outlets
Is this the only outlet for the wastewater also
Yes No
Make a copy of this table if needed. For zero discharge scheme, you may not fill-up this page
BOD TSS
COD Color Temperature pH Oil & Grease Coliform
(mg/l) (mg/l) (mg/l) . (°C) (mg/l)
Date . (MPN/100ml)
Effluen
Influent Effluent Influent Effluent Influent Effluent Influent Effluent Influent Effluent Influent Effluent Influent Influent Effluent
t
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Ave./
Mo.
Is this the only outlet for the wastewater: Yes No If No, please submit this report for other outlets also
Parameter Name Parameter Name Parameter Name Parameter Name Parameter Name Parameter Name Parameter Name
Effluent
Flow rate
Date in terms unit Unit Unit Unit Unit Unit unit
of
m³/day
Influent Effluent Influent Effluent Influent Effluent Influent Effluent Influent Effluent Influent Effluent Influent Effluent
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D. Background Data
D.1 Sources of Wastewater during this Quarter
8 26
Number of hours of production/day ___________ Number of days of production per/month _________
-
Total value of investment in the factory: (Pesos)___________________
Average Energy Consumption: Coal (tons) Gas (m3) Oil (m3) Electricity (kwh)
(please check monthly or annual) Monthly or Annual Monthly or Annual Monthly or Annual Monthly or Annual
Max. Allowable
Production Capacity 180,000mt
per Year
Actual Average
Production per 12,042.31mt
Month
1
Please use generic product name; not brand names.
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D.4 Water Pollution Information
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D.5 FLOW METER INFORMATION
What type of flow meter is used for measuring the wastewater discharge rate?
Rectangular Weir Triangular Weir Other Weirs Venturi Meters
Magnetic flow Meters Current Meters Flow Measurements
If other, please specify__________________________________
_______________________________________________________________________________
D.6 MANAGEMENT OF SLUDGE FROM WASTE WATER TREATMENT SYSTEM (Not applicable)
May 8, 2017
Submitted on Date ______________
Name and Signature of the Pollution Control Officer Name and Signature of the Chief Executive Officer
SUBSCRIBED AND SWORN to before me a Notary Public, this _____ day of ___________________,
affiant exhibiting to me his/her Community Tax Receipt No. 21853576, issued at Quezon City on Jan 12, 2017.
NOTARY PUBLIC
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