Wastewater Pathogen Monitoring Form
Use this form to record details and results from routine wastewater sampling and pathogen monitoring. Please complete all fields accurately.
Sampling Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Sampling Location
*
Sample ID or Description
*
Sample Type
*
Please Select
Influent
Effluent
Sludge
Surface Water
Other
Sample Volume (mL or L)
*
Pathogen Target(s)
*
SARS-CoV-2
Norovirus
E. coli
Enterovirus
Other
Testing Method
*
Please Select
qPCR
RT-qPCR
Culture
ELISA
Other
Observed Results
*
Notable Conditions (e.g., weather, flow, anomalies)
Submitter Name and Contact Information
*
Submit
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