In Pennsylvania, Appalachian oil and gas wastewaters (OGW) are permitted for release to surface waters after some treatment by centralized waste treatment (CWT) facilities. While this practice was largely discontinued in 2011 for unconventional Marcellus OGW at facilities permitted to release high salinity effluents, it continues for conventional OGW. This study aimed to evaluate the environmental implications of the policy allowing the disposal of conventional OGW. We collected stream sediments from three disposal sites receiving treated OGW between 2014 and 2017 and measured ²²⁸Ra, ²²⁶Ra, and their decay products, ²²⁸Th and ²¹⁰Pb, respectively. We consistently found elevated activities of ²²⁸Ra and ²²⁶Ra in stream sediments in the vicinity of the outfall (total Ra = 90–25,000 Bq/kg) compared to upstream sediments (20–80 Bq/kg). In 2015 and 2017, ²²⁸Th/²²⁸Ra activity ratios in sediments from two disposal sites were relatively low (0.2–0.7), indicating that a portion of the Ra has accumulated in the sediments in recent (<3) years, when no unconventional Marcellus OGW was reportedly discharged. ²²⁸Ra/²²⁶Ra activity ratios were also higher than what would be expected solely from disposal of low ²²⁸Ra/²²⁶Ra Marcellus OGW. Based on these variations, we concluded that recent disposal of treated conventional OGW is the source of high Ra in stream sediments at CWT facility disposal sites. Consequently, policies pertaining to the disposal of only unconventional fluids are not adequate in preventing radioactive contamination in sediments at disposal sites, and the permission to release treated Ra-rich conventional OGW through CWT facilities should be reconsidered.