ICR Number XXXX.XX Plant ID: Insert Plant ID

OMB Control Number: XXXX-XXXX Plant Name: Insert Plant Name

Expiration Date: mm/dd/yyyy

Section Title Tab Name

Part G Instructions

Part G Section 1

Part G Section 2

Part G Section 3

Part G Section 4

Part G Section 5

Part G Sampling Results

Part G Comments Part G Comments

Leachate Sample Collection Instructions

Sample Collection Information

Laboratory Analytical Data Form

Waste Information

Leachate Generated from Ponds/Impoundments and

 Landfills

Table of Contents

Leachate Collection

Steam Electric Questionnaire 

Second FRN Version Draft

PART G - LEACHATE SAMPLING DATA FOR PONDS/IMPOUNDMENTS AND LANDFILLS

Part G Instructions

Version: February 22, 2010
Steam Electric Questionnaire Part G. Instructions

Plant ID: Insert Plant ID

Plant Name: Insert Plant Name

PART G. LEACHATE SAMPLING DATA FOR PONDS/IMPOUNDMENTS AND 

LANDFILLS

Use the Part G Comments tab to do the following: provide additional information as 

requested in certain questions within Part G; indicate atypical data (e.g.,if the analytical 

data provided from the sample collection is not representative of normal operations); 

and note methods used to make best engineering estimates in the event that exact data 

are not available.

INSTRUCTIONS

Complete Part G of the questionnaire for your plant. As you are completing the 

electronic form, note the following: When you enter your plant name and plant ID on the 

Part G TOC tab, all name and ID fields throughout Part G will automatically populate. 

Refer to the overall questionnaire instructions, the glossary, and the acronym list for 

assistance with completing Part G. 

Please provide all free response answers in the highlighted yellow areas. Throughout 

Part G, you may need to make copies of certain sections/questions. Instructions are 

provided throughout Part G regarding making copies. Note that pond/impoundment unit 

and landfill names must be populated on the copied tab or section, located in the upper 

right corner under "Plant ID" and "Plant Name", in order to correlate the requested 

information with the pond/impoundment or landfill.

Sampling data and the completed Part G of the questionnaire shall be submitted 

to EPA no later than 120 calendar days after receiving the questionnaire. 

A company or plant may be exempt from the leachate sample collection (Question G3-

1). Please refer to Question G1-1 and the "Applicability" section located in the "Part G 

Section 3" tab to determine if you are exempt and how to submit a written explanation.

Version: February 22, 2010
Steam Electric Questionnaire Part G. Leachate Sampling Data for 

Part: G

Section Title:

 Instructions:

CBI? G1-1.

(Skip to next Questionnaire Part)

1. Leachate CollectionPart G requests leachate sampling data for pond/impoundment units and landfills used for the 

disposal of residues or by-products (or sludges or water streams containing the residues or by

combustion of coal or petroleum coke, including, but not limited to, fly ash , bottom ash , boiler s

desulfurization (FGD) system residues. This includes liquid-borne material and solid material.

InseInse

Plant ID:

Plant Name:

(Skip to Section 2)

Is leachate currently collected from any pond/impoundment and/or landfill , including those locaproperty, that contains residues or by-products from the combustion of coal or petroleum coke? complete definition of leachate , which includes the terms seepage, leak, and leakage.

YesNo

Yes

G-1 
Steam Electric Questionnaire Part G. Leachate Sampling Data for Ponds/Im

Part: G

Section Title:

 Instructions:

CBI? G2-1.CBI? G2-2.CBI? G2-3.CBI? G2-4.

(Provide ONLY untreated monitoring data as described in Question 

(Continue)(Skip to Section 3. Provide ONLY untreated monitoring data as described in Question G3-1.)

Is the leachate combined with other waste streams prior to treatment?

(Provide treated and untreated monitoring data as described in Que(Provide treated and untreated monitoring data as described in Que

Insert Plant Insert Plant Insert ID

Plant ID:

Plant Name:

Pond/Impoundment Unit or Landfill ID:

2. Leachate Generated from Ponds/Impoundments and Landfills

(Continue)

Is all collected leachate transported off site for treatment and/or disposal? Is the collected leachate from this pond/impoundment unit or landfill that is not transferred off site currently treated?Make copies of Section 2 (Questions G2-1 through G2-4) for each pond/impoundment unit and landfill , including those located 

property, used for the storage, treatment, and/or disposal of residues or by-products (or sludges or water streams containing tproducts) from the combustion of coal or petroleum coke, including, but not limited to, fly ash , bottom ash , boiler slag, or flue g

(FGD) system residues. This includes liquid-borne material and solid material. Enter the pond/impoundment unit or landfill ID 

above (use pond/impoundment unit and landfill IDs assigned in Table A-4 and Table A-6). Please provide all free response anshighlighted yellow areas.Make a copy of Section 2 for each pond/impoundment unit and landfill, including those located on non-adjoining property, using 

button below.

(Continue)(Skip to Section 3. Provide ONLY untreated monitoring data as described in Question G3-1.)(Skip to Section 5)

Is leachate currently collected from this pond/impoundment unit or landfill (excluding leachate returned to the pond/impoundmeoriginated)?NOTE: "Treatment" refers to the removal of specific pollutants or process wastewater constituents other than suspenFigure G-1 below to help determine the leachate sample collection requirements for this pond/impoundment or landfil

YesNoYesNo

NoYes, combined with ONLY runoff or other stormwaterYes, combined with process wastewater other than runoff/stormwater

YesYesYes

Copy Section 2

YesNo

Yes

G-2 
Steam Electric Questionnaire Part G. Leachate Sampling Data for Ponds/Im

Figure G-1. Leachate Collection Decision Tree

G-3 
Steam Electric Questionnaire Part G. Leachate Sampling Data for Ponds/Impoundm

Part: G

Section Title:

G3-1.

• Metals (total recoverable; antimony, arsenic, beryllium, cadmium, chromium, cobalt, copper, lead, manganese, molybdenum, nickel, selenium, silver, thallium, vanadium, and zinc)

EPA Method 200.8

• Metals (total recoverable: aluminum, barium, boron, calcium, iron, magnesium, sodium, tin, and titanium)

EPA Method 200.7 or 200.8

• Mercury EPA Method 1631E• Chlorides 40 CFR Part 136-approved • Sulfates 40 CFR Part 136-approved • Total dissolved solids (TDS) 40 CFR Part 136-approved • Total suspended solids (TSS) 40 CFR Part 136-approved • pH 40 CFR Part 136-approved 

The following analytes and analytical methods must be used for the sample analysis:Each company or plant is responsible for identifying and contracting an analytical laboratory to perform the analyses. 

Plant ID:

Plant Name:

Insert Plant IDInsert Plant Name

3. Leachate Sample Collection InstructionsOVERVIEW OF THE SAMPLE COLLECTION The samples should be collected as detailed in these instructions. In general, samples should be collected as grab samcomposite samples are not required). The plant should collect samples from each leachate collection point for each pond/impoundment and landfill. If the plant determines that a sample from one or more collection points are representat

individual pond/impoundment or landfill, then the plant may simply collect the representative sample(s). The plant should 

samples from each sampling location once per week for four consecutive weeks, or as soon thereafter as sufficient leachavailable for collection. Sampling data and the completed Part G of the questionnaire shall be submitted to EPA no later than 120 calendreceiving the questionnaire. Collect process wastewater samples of untreated and/or treated leachate streams generated from pond(s)/impoundmenlandfill(s) used for the storage, treatment, or disposal of residues or by-products (or sludges or water streams containin

or by-products) from the combustion of coal or petroleum coke, including, but not limited to, fly ash , bottom ash , boiler s

desulfurization (FGD) system residues (this includes liquid-borne material and solid material).

G-4 
Steam Electric Questionnaire Part G. Leachate Sampling Data for Ponds/Impoundm

Jezebele AliceaUS EPAEngineering and Analysis DivisionMail Code: 4303T1200 Pennsylvania Avenue, N.W. Washington, DC 20460alicea.jezebele@epa.gov

SAMPLE LOCATION 

• Must have data from leachate generated from each pond/impoundment and landfill where leachate • Must have at least four samples of untreated and/or treated leachate, where each sample is collectdays apart; and• Must have tested for every analyte listed above using the specified analytical methods.

Collect untreated and/or treated leachate samples from each pond/impoundment unit and landfill for which you respondeQuestion G2-1.If the pond/impoundment unit and/or landfill has multiple collection points, the untreated sample may be collected from a 

header area, if applicable. If there is not a common header area for the pond/impoundment or landfill, the plant may selecollection points that is "representative" of the pond/impoundment or landfill from which to collect the sample. If warrantecharacteristics of the pond/impoundment or landfill, the plant may need to collect samples from more than one collection representative samples. If the plant collects the samples from one ”representative” collection point, describe how the codetermined the collection point is “representative” of all of the collection points in the “Part G Comments” tab located at tG. 

2. The plant personnel are unable to collect the samples safely.

If you believe you are exempt, you must submit a written explanation justifying one or both of these two circums

within two weeks after receiving the questionnaire by e-mail (preferred) or mailed to: EPA will then determine if the plant is exempt from the leachate sample collection requirement. If the plant can provide collected leachate characterization data, then the plant should skip Section 4 (Questions G4-1 and G4-2) and continue to (Question G5-1). Also, the plant must provide the leachate sampling data in Table G-4 found in the "Part G Sampling Re

the plant cannot collect the samples safely, then the plant should complete Question G4-1, then continue to Section 5 (QThe untreated leachate samples must be collected directly from the leachate collection system or holding tank prior to a

treatment. The treated leachate samples must be collected from the effluent from a leachate treatment system that is de

purpose of removing pollutants or process wastewater constituents, other than suspended solids, prior to discharge or c

with other process wastewaters. A plant may be exempt from the leachate sample collection (and skip to Question G3-2) if one of these two circumstance

1. The plant can provide previously collected leachate characterization data if it fulfills the following data require

APPLICABILITY

G-5 
Steam Electric Questionnaire Part G. Leachate Sampling Data for Ponds/Impoundm

CBI? G3-2.CBI? G3-3.

SAMPLE FREQUENCY Collect one sample of untreated leachate (and one sample of treated leachate if appropriately identified by responses in 

4) once per week for four weeks, or as soon thereafter as sufficient leachate is available for collection, from each pond/imunit and landfill. Please note that the samples must be collected at least five days after the previous sample was collecte

pond/impoundment or landfill does not generate leachate weekly, please collect the samples as soon as the leachate is 

allow at least five days between samples. Please attach an aerial photograph or drawing showing the entire waste management unit (i.e., pond/impoundment unit 

shows the boundaries and identifies all leachate collection points and the active and inactive areas of the pond/impoundmAlso, indicate the leachate sample location(s) used for this sample collection in the aerial photograph or drawing of the 

pond/impoundment unit or landfill. Please identify the leachate sample locations used for this sample collection in the block diagram previously requested in 2. QUALITY ASSURANCE/QUALITY CONTROL 

Example 2: If a plant collects both untreated and treated leachate from both a pond/impoundment unit and a la

each separately has a single leachate collection point and they have separate treatment systems, the plant is r

collect a total of sixteen samples.

Follow the method-specified quality assurance/quality control analyses and attach a data review summary once the analycomplete. SAMPLE ANALYSES After receiving the analytical results from the laboratory, enter the analytical data into the “Part G Sampling Results” tab. results. Identify results that are less than the method detection limit (MDL), and results that are between the detection alimits .

Example1: If a plant collects only untreated leachate from a pond/impoundment unit, and the samples are obta

single leachate collection point, the plant is required to collect a total of four samples.

YesYes

I have attached the aerial photographI did not attach the aerial photograph. Explain why:

G-6 
Steam Electric Questionnaire Part G. Leachate Sampling Data 

Pla

Part: G

Section Title:

 Instructions:

G4-1.

Pond/Impoundment 

Unit or Landfill ID (Use 

IDs from Tables A-4 

and A-6)

Sample Colle

Location Desc

CBI? Leachate Treatment System ID:

CBI? Leachate Treatment System ID:CBI? Leachate Treatment System ID:CBI? Leachate Treatment System ID:CBI? Leachate Treatment System ID:

Common head

Table G-1. Sample Collection Information

In Table G-1, provide a description of the sample collection location, the date the sample was collected, tstream from the collection point (select the units of the flow rate), and identify if the leachate stream is treleachate sample is treated, provide the leachate treatment system ID previously identified in Table F-4.

Sample Collection Location

Example 

Complete Table G-1 for each pond/impoundment unit and landfill that requires leachate sampling and is 

and/or disposal of residues or by-products (or sludges or water streams containing the residues or by-procoal or petroleum coke, including, but not limited to, fly ash , bottom ash , boiler slag, or flue gas desulfuriThis includes liquid-borne material and solid material. Enter the pond/impoundment unit or landfill ID in th

pond/impoundment unit and landfill IDs assigned in Table A-4 and Table A-6). Please provide all free reshighlighted yellow areas.

Collect daily rainfall data starting two weeks prior to collection of the first sample through the day of the ladate and inches of rainfall in Table G-2.4. Sample Collection Information

YesYesYesYesYes

Untreated pond/impoundmentSelectSelectSelectSelect

G-7 
Steam Electric Questionnaire Part G. Leachate Sampling Data 

CBI? G4-2. 

Date Inches of Rainfall Date 

Table G-2. Rainfall Data

In Table G-2, provide the inches of rainfall accumulated at the plant on a daily basis starting two weeks p

Yes leachate sample through the last day of sample collection.

G-8 
Steam Electric Questionnaire Part G. Leachate Sampli

Part: G

Section Title:

 Instructions:

G5-1.

Pond/Impoundment 

Unit or Landfill ID 

(Use IDs from Tables 

A-4 and A-6)

Capped or 

Uncapped?

CBI? tons tons 

tons tons tons tons 

CBI? tons tons 

tons tons tons tons 

CBI? tons tons 

tons tons tons tons 

CBI? tons tons 

tons tons tons tons 

CBI? tons tons 

tons tons tons tons 

5. Waste InformationComplete Table G-3 for each pond/impoundment unit and landfill , inluding those located on non-adjoining property, that is used for the storagresidues or by-products (or sludges or water streams containing the residues or by-products) from the combustion of coal or petroleum cokebottom ash , boiler slag, or flue gas desulfurization (FGD) system residues. This includes liquid-borne material and solid material. Enter the pthe first column of Table G-3 (use pond/impoundment unit and landfill IDs assigned in Table A-4 and Table A-6). Please provide all free respo

areas.Make a copy of Section 5 to complete as many tables as needed to provide information for all pond/impoundment units and landfills, including property, using the "Copy Section 5" button below. 

Table G-3. Waste Information

In Table G-3, indicate all process wastes, residues or by-products that are stored, treated, and/or disposed of in each pond/impoundment unit the landfill is partially capped, complete two rows, one for the amount of waste under the capped portion of the landfill and one for the amount 

of the landfill. Please provide any additional wastes not listed by selecting “Other” and specifying the process waste, residue, or by-product in Complete as many rows of the table as needed to represent all pond/impoundment units and landfills at the plant. If more rows are needed, m

complete as many tables as needed to provide information for all pond/impoundment units and landfills identified in Table A-4 and A-6.

Type and Amount of Waste

Fly ashBottom ashBioler slag

FGD Calcium Sulfate (Gypsum)FGD Calcium Sulfate - Not PozzolonicFGD Pozzolonic Material

Other:Other:Other:

FGD Calcium Sulfate (Gypsum)FGD Calcium Sulfate - Not PozzolonicFGD Pozzolonic MaterialFGD Calcium Sulfate (Gypsum)FGD Calcium Sulfate - Not PozzolonicFGD Pozzolonic MaterialFGD Calcium Sulfate (Gypsum)FGD Calcium Sulfate - Not PozzolonicFGD Pozzolonic MaterialFGD Calcium Sulfate (Gypsum)FGD Calcium Sulfate - Not PozzolonicFGD Pozzolonic Material

Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:

Fly ashBottom ashBioler slagFly ashBottom ashBioler slagFly ashBottom ashBioler slagFly ashBottom ashBioler slag

YesYesYesYesYes

Other:

Closed/CappedActive/UncappedClosed/CappedActive/UncappedClosed/CappedActive/UncappedClosed/CappedActive/UncappedClosed/CappedActive/Uncapped

Copy Section 5

G-9 
Steam Electric Questionnaire Part G. Leachate Sampling Da

Plant ID: Insert P

Plant Name: Insert P

Pond/Impoundment Unit or Landfill ID: Insert ID

Sample Collection Location:

Part: G

Section Title:

 Instructions:

CBI?

Name of Analyte CAS Number

Concentration 

(μg/L)

Method 

Detection Limit 

(MDL) (μg/L)

Reporting Limit 

(μg/L) Qua

Other:Other:Other:Other:Other:Other:Other:Other:

Calcium 7440-70-2 Other:BoronCadmium 7440-43-9

7440-42-8

Analytical Method 

Used

Barium 7440-39-3Beryllium 7440-41-7Antimony 7440-36-0Arsenic 7440-38-2Laboratory Analytical Data FormComplete Table G-4 for each untreated and treated sample collection locations. Enter the pond/impoundment unit or landfill ID (use pond/impo

assigned in Table A-4 and Table A-6) and the sample collection location (identified previously in Table G-1) in the spaces provided above. Alsoanalytical laboratory that conducted the analyses and provide the sample collection location description previously identified in Table G-1. Repoare less than the method detection limit (MDL), and results that are between the detection and reporting limits . Please provide all free response 

yellow areas.Make a copy of Sampling Results Table for the each pond/impoundment unit and landfill chosen for the leachate sample collection using the "Cbutton below.Aluminum 7429-90-5

Example - Arsenic 7440-38-2 350 2 10

Detec

tha

Table G-4. Leachate Sampliing Analytical Data Form

Name of analytical laboratory:

Sample collection location description:

Yes

Copy Sampling Results Table

Data review summary attached.

Select

SelectSelectSelectSelectSelectSelectSelectSelectSelect

G-10 
Steam Electric Questionnaire Part G. Leachate Sampling Da

Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:Other:

7439-97-6No CAS 7440-31-57440-32-67440-62-27440-66-67440-22-47440-23-5No CAS7440-28-07439-95-47439-98-77440-02-07782-49-2No CAS No CAS No CAS7440-47-37440-48-47440-50-87439-89-67439-92-17439-95-4

ChloridesTotal dissolved solids (TDS)Total suspened solids (TSS)pHTitaniumVanadiumZincMercurySodiumSulfateThalliumTinMolybdenumNickelSeleniumSilverIronLeadMagnesiumManganeseChromiumCobaltCopper

SelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelectSelect

G-11 
Steam Electric Questionnaire Part G. Leachate Sampling Data f

Plant 

Pl

Part: G

Section Title: Part G Comments

Instructions:

Question Number

CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?

Cross reference your comments by question number and indicate the confidential status of your co

next to "Yes" under "CBI?" (Confidential Business Information). 

Comment

YesYesYesYesYesYesYesYesYesYesYes

G-12 
Steam Electric Questionnaire Part G. Leachate Sampling Data f

CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?CBI?

YesYesYesYesYesYesYesYesYesYesYesYesYesYes

G-13