ETP Functionality Self-Assessment Survey

ETP Self-Assessment Form
Please fill in the cells highlighted in yellow
Factory & ETP Information

Name of Unit
ETP Responsible
ETP Capacity (m3/hour)
Operating hours
Operating days per week
% of recycling (if applicable)
Treatment scheme/flow
Design service provider name
Last 6 Months Effluent Discharge
Month Total effluent discharge per month (m3)
Jan
Feb
Mar
Apr
May
Jun -
Pre-Assessment Documents
Do you have the following documents?
1. Production facility layout
2. Production record
3. Drainage plan
4. Permit on waste water discharge
5. Water consumption meter records & invoices
6. ETP Piping layout
7. ETP operation manual/procedure
8. ETP proposal/design document including hydraulic diagram
9. Waste water test report meeting ZDHC conventional parameters on BOD, COD &
TSS (no older than May 2020 report)
July 2020
BOD (mg/L)
COD (mg/L)
TSS (mg/L)
10. Water balance
# General Information
11. Production Machineries (dyeing, washing, etc.) loading capacity
ETP Operating Log Sheet

Is ETP operating log sheet available and maintained properly?
If you selected yes, do they include the following information:
- daily key process parameters for all treatment levels
- mechanical fault and upsets
- sampling routines & results
- preventive and corrective actions
- cleaning and maintenance schedule & checklist
ETP emergency plan available for review

ETP back up equipment is available and found in accessible areas
Sludge is handled, stored and disposed as per the legal regulation

Any test failure found within the last one year is properly explained in operational
records, corrective and preventive action has been taken
ETP Operator Competence
ETP operator(s) understand the ETP process/ discharge standard /basics required for
job level as per the operation manual
ETP operator(s) have sufficient operating instructions to run the ETP

ETP operator(s) have received adequate training prior to the job with refreshers
training including health & safety and personal protective equipment
ETP operator(s) have knowledge on sampling, test routines including test method and
calibration of devices
ETP operator(s) know how to act with the emergency response plan
ETP operator(s) are able to monitor the key process control parameters and
troubleshoot minor problems
Issues on ETP Operations
Based on your understanding of H&M's ETP Assessment Requirement, do you think

there is anything that might prevent your ETP from achieving Green Grade this year?
Is there any impact to ETP operations caused by the change in production pattern
during this pandemic?
ver. Jul 2020
please select from drop-down list Explanation notes

If no/don't know, please specify reason: …
If no/don't know, please specify reason:
…
June 2020 May 2020

If you selected yes, please list down the back up
equipment available:
If there is any test failure, what is the corrective

and preventice action to ensure the failure does …
not occur again in the future?

…
…
…
…
please select from drop-down list Explanation of ETP issue
If you selected yes, please explain the impact: …
If you selected yes, please explain the impact: …
Explanation notes
Explanation notes
Explanation of ETP issue
…
Design Requirements: Appropriateness of Technology
Design & Actual Pollution Load

Design maximum loading Actual maximum loading within the last 6 months
Unit (ppm or kg/day or Unit (ppm or kg/day
Value Unit (ppm or kg/day or other) Value (Inlet) other) Value (Outlet) or other)
BOD
COD
TSS
pH
Flow Rate
Design flow rate m3/hour Production water consumption
Outlet minimum flow rate within the last 6 months m3/day Minimum production water consumption m3/day
Outlet maximum flow rate within the last 6 months m3/day Maximum production water consumption m3/day
Appropriate Design Technology

This section is divided into 5 sub-sections: preliminary, primary, secondary, tertiary & advanced. For each sub-sections please select the treatment levels according to your ETP scheme, from the drop-down list. If the sub-section/s is/are not applicable, then you may select
N/A.
Preliminary Please select all For each of the treatment level For each key parameters specified, please Please specify the Please provide the range Please provide the
Removal of large solids such as rags, fluffs, floatables, grit, preliminary treatment selected, please write down mention the monitoring device or method frequency of monitoring of of key parameter average of key
grease and adjustment of pH, that may cause damage to levels of your ETP parameters that are being conducted (e.g Jar Test, Imhoff cone test, each key parameters monitored parameters
equipment or operational problems with the treatment monitored (e.g Temperature, pH, automatic DO meter, etc.) monitored
operation processes. (You can select from 1 up to 4 processes, or BOD, COD, DO, SVI, SV30, MLSS, etc)
add on the last row if it's not in the drop-down list)
Process 1 pH Neutralization Example: pH Example: Litmus paper Example: daily Example: 7 - 8 Example: 7
Process 2
Process 3
Process 4
If it's not on the list, please specify here:
Primary Please select all primary Key parameters monitored: Monitoring device/method: Frequency of monitoring: Range of monitoring Average monitoring
Removal of suspended solids & portion of organic matter from treatment levels of your result: result:
the wastewater typically accomplished by chemical addition. ETP
(You can select from 1 up to 4 processes, or add on the last row
if it's not in the drop-down list)
Process 1 Coagulation – flocculationExample: chemical dosing Example: Jar test Example: daily Example: 0.1 - 0.5 ml Example: 0.3 ml
Process 2
Process 3
Process 4
Please select all Key parameters monitored: Monitoring device/method: Frequency of monitoring: Range of monitoring Average monitoring
Secondary secondary treatment result: result:
Removal of biodegradable organic matter and suspended solids levels of your ETP
Process 1 Activated sludge Example: DO Example: automated DO meter Example: hourly Example: 1.5 - 2.5 mg/l Example: 2 mg/l
Process 2
Process 3
Process 4
Please note that monitoring devices should be installed with automation in case the ETP capacity is more than 50 m3/hour where 24/7 control is required (for pH correction and DO sensors). HOwever, if the wastewater pH before aeration tank is
between 7-9, then auto pH correction is not needed.
Please select all tertiary Key parameters monitored: Monitoring device/method: Frequency of monitoring: Range of monitoring Average monitoring
Tertiary treatment levels of your result: result:
Removal of residual suspended solids/dissolved solids (after ETP
secondary treatment) usually by granular medium filtration.
Process 1
Process 2
Process 3
Process 4
Advanced advanced treatment result: result:
Removal of dissolved & suspended materials remaining after levels of your ETP
above treatment when required for water reuses applications.
Process 1
Process 2
Process 3
ETP Self-Assessment Form
Factory & ETP Information

Name of Unit PT. Sukses Jaya Abadi
ETP Responsible Indra
ETP Capacity (m3/hour) 500
Operating hours 24
Operating days per week 7
% of recycling (if applicable) 0%
Inlet - Bar screen - Equalization - Neutralization - Cooling Tower -

Treatment scheme/flow Clarifier - Coagulation - Flocculation - outlet
Design service provider name PT. IPAL Jaya Abadi
Last 6 Months Effluent Discharge
Month Total effluent discharge per month (m3)
Jan 200,000
Feb 300,000
Mar 200,000
Apr 400,000
May 100,000
Jun 300,000
Pre-Assessment Documents
Do you have the following documents?
1. Production facility layout
2. Production record
3. Drainage plan
4. Permit on waste water discharge
5. Water consumption meter records & invoices
6. ETP Piping layout
7. ETP operation manual/procedure
8. ETP proposal/design document including hydraulic diagram
9. Waste water test report meeting ZDHC conventional parameters on BOD, COD &
TSS (no older than May 2020 report)
June 2020
BOD (mg/L) 30
COD (mg/L) 100
TSS (mg/L) 25
10. Water balance
11. Production Machineries (dyeing, washing, etc.) loading capacity
ETP Operating Log Sheet

Is ETP operating log sheet available and maintained properly?
If you selected yes, do they include the following information:
- daily key process parameters for all treatment levels
- mechanical fault and upsets
- sampling routines & results
- preventive and corrective actions
- cleaning and maintenance schedule & checklist
ETP emergency plan available for review

ETP back up equipment is available and found in accessible areas
Sludge is handled, stored and disposed as per the legal regulation

Any test failure found within the last one year is properly explained in operational
records, corrective and preventive action has been taken
ETP Operator Competence
ETP operator(s) understand the ETP process/ discharge standard /basics required for
job level as per the operation manual
ETP operator(s) have sufficient operating instructions to run the ETP

ETP operator(s) have received adequate training prior to the job with refreshers
training including health & safety and personal protective equipment
ETP operator(s) have knowledge on sampling, test routines including test method and
calibration of devices
ETP operator(s) know how to act with the emergency response plan
ETP operator(s) are able to monitor the key process control parameters and
troubleshoot minor problems
Issues on ETP Operations

ver. Jul 2020
PT. Sukses Jaya Abadi

Indra
500
24
7
0%
ion - Neutralization - Cooling Tower - Aeration -

cculation - outlet
PT. IPAL Jaya Abadi

Yes If no/don't know, please specify reason: …
No If no/don't know, please specify reason: Design document is being reques
Yes …
May 2020 April 2020
37 32
120 100
30 15
No If no/don't know, please specify reason: We still need to understand wate
No If no/don't know, please specify reason: We plan to conduct water audit n

Yes
Yes
If no/don't know, please specify reason: Not all results were recorded pro
No
Yes
Yes
Yes
If you selected yes, please list down the back up
Dosing pump, blower
Yes equipment available:
No If no/don't know, please specify reason: Sludge has been stored for more
If there is any test failure, what is the corrective

and preventice action to ensure the failure does Aeration wasn't functioning prop
not occur again in the future?
Yes

…
Yes
Yes
…
Yes
…
Yes
Yes
…
Yes
please select from drop-down list Explanation of ETP issue
There was reduction in our produ

If you selected yes, please explain the impact:
We had to change the chemical d
Yes
There was reduction in our produ
If you selected yes, please explain the impact:
We had to change the chemical d
Yes
Explanation notes
Design document is being requested to the consultant
We still need to understand water use in each wet process
We plan to conduct water audit next year
…
…
Not all results were recorded properly
…
…
…
Dosing pump, blower
Sludge has been stored for more than 90 days
Aeration wasn't functioning properly so we changed the blower
Explanation notes
Explanation of ETP issue
There was reduction in our production which affects our ETP operations.
We had to change the chemical dosing
There was reduction in our production which affects our ETP operations.
We had to change the chemical dosing
Design Requirements: Appropriateness of Technology
Design & Actual Pollution Load

Design maximum loading Actual maximum loading within the last 6 months
Value (Inlet) Unit (ppm or kg/day or Value (Outlet) Unit (ppm or kg/day
Value Unit (ppm or kg/day or other) other) or other)
BOD 400 ppm 1200 ppm 30 ppm
COD 1000 ppm 1500 ppm 150 ppm
TSS 500 ppm 600 ppm 50 ppm
pH 9 11 7
Flow Rate
Design flow rate 500 m3/hour Production water consumption
Minimum production water consumption
Outlet minimum flow rate within the last 6 months 6000 m3/day within the last 6 months 8000 m3/day
Maximum production water consumption
Outlet maximum flow rate within the last 6 months 14000 m3/day within the last 6 months 11000 m3/day
Appropriate Design Technology

This section is divided into 5 sub-sections: preliminary, primary, secondary, tertiary & advanced. For each sub-sections please select the treatment levels according to your ETP scheme, from the drop-down list. If the sub-section/s is/are not applicable, then you may select
N/A.
Preliminary Please select all For each of the treatment level For each key parameters specified, please Please specify the Please provide the range Please provide the
Removal of large solids such as rags, fluffs, floatables, grit, preliminary treatment selected, please write down mention the monitoring device or method frequency of monitoring of of key parameter average of key
grease and adjustment of pH, that may cause damage to levels of your ETP parameters that are being conducted (e.g Jar Test, Imhoff cone test, each key parameters monitored parameters
equipment or operational problems with the treatment monitored (e.g Temperature, pH, automatic DO meter, etc.) monitored
operation processes. (You can select from 1 up to 4 processes, or BOD, COD, DO, SVI, SV30, MLSS, etc)
add on the last row if it's not in the drop-down list)
Process 1 pH Neutralization Example: pH Example: Litmus paper Example: daily Example: 7 - 8 Example: 7
Process 2
Process 3
Process 4
Primary Please select all primary Key parameters monitored: Monitoring device/method: Frequency of monitoring: Range of monitoring Average monitoring
Removal of suspended solids & portion of organic matter from treatment levels of your result: result:
the wastewater typically accomplished by chemical addition. ETP
Process 1 Coagulation – flocculationExample: chemical dosing Example: Jar test Example: daily Example: 0.1 - 0.5 ml Example: 0.3 ml
Process 2
Process 3
Process 4
Secondary secondary treatment result: result:
Removal of biodegradable organic matter and suspended solids levels of your ETP
Process 1 Activated sludge Example: DO Example: automated DO meter Example: hourly Example: 1.5 - 2.5 mg/l Example: 2 mg/l
Process 2
Process 3
Process 4
Please note that monitoring devices should be installed with automation in case the ETP capacity is more than 50 m3/hour where 24/7 control is required (for pH correction and DO sensors). HOwever, if the wastewater pH before aeration tank is
between 7-9, then auto pH correction is not needed.
Please select all tertiary Key parameters monitored: Monitoring device/method: Frequency of monitoring: Range of monitoring Average monitoring
Tertiary treatment levels of your result: result:
Removal of residual suspended solids/dissolved solids (after ETP
secondary treatment) usually by granular medium filtration.
Process 1 Not available
Process 2
Process 3
Process 4
Advanced advanced treatment result: result:
Removal of dissolved & suspended materials remaining after levels of your ETP
above treatment when required for water reuses applications.
Process 1 Not available
Process 2
Process 3

ETP Functionality Self-Assessment Survey

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ETP Functionality Self-Assessment Survey

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ETP Self-Assessment Form

Please fill in the cells highlighted in yellow

Factory & ETP Information

Last 6 Months Effluent Discharge

Month Total effluent discharge per month (m3)

ETP Operating Log Sheet

ETP emergency plan available for review

Sludge is handled, stored and disposed as per the legal regulation

ETP Operator Competence

ETP operator(s) have sufficient operating instructions to run the ETP

Issues on ETP Operations

Based on your understanding of H&M's ETP Assessment Requirement, do you think

please select from drop-down list Explanation notes

If no/don't know, please specify reason: …

If no/don't know, please specify reason: …

If no/don't know, please specify reason:

If there is any test failure, what is the corrective

please select from drop-down list Explanation notes

please select from drop-down list Explanation of ETP issue

If you selected yes, please explain the impact: …

Explanation of ETP issue

Design & Actual Pollution Load

Appropriate Design Technology

If it's not on the list, please specify here:

Factory & ETP Information

Inlet - Bar screen - Equalization - Neutralization - Cooling Tower -

Last 6 Months Effluent Discharge

Month Total effluent discharge per month (m3)

ETP Operating Log Sheet

ETP emergency plan available for review

Sludge is handled, stored and disposed as per the legal regulation

ETP Operator Competence

ETP operator(s) have sufficient operating instructions to run the ETP

Issues on ETP Operations

Based on your understanding of H&M's ETP Assessment Requirement, do you think

PT. Sukses Jaya Abadi

ion - Neutralization - Cooling Tower - Aeration -

please select from drop-down list Explanation notes

Yes If no/don't know, please specify reason: …

If no/don't know, please specify reason: …

If there is any test failure, what is the corrective

please select from drop-down list Explanation notes

please select from drop-down list Explanation of ETP issue

There was reduction in our produ

Design document is being requested to the consultant

Dosing pump, blower

Sludge has been stored for more than 90 days

Aeration wasn't functioning properly so we changed the blower

Explanation of ETP issue

Design & Actual Pollution Load

Appropriate Design Technology

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