WQ0023634_Monitoring - 08-2021_20211001 (2)

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0023634
Name of Facility:*
Month:* August
Report Information
Type *
GW-59
Waterside Villages WWTP
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
Waterside Villages Signed 652.66KB
GW59.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Rod Holley
elegy
Reviewer: Plummer, Lauren
10/1 /2021
This will be filled in automatically

Is the project number correct?* WQ0023634
Is the monitoring report t: Yes r No
accepted?*
Regional Office* Washington
Accepted Date: 10/6/2021

GW-59A COMPLIANCE REPORT FORM Permit #LJQDD_363 y
(Submit one each monitoring period with Gll<59 forms.)
l
Enter date monitoring results were due. ( 3— 3 i"71 ) Will this monitoring report (GW-59 and GW-59A)
YES
Q,
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
ET
IF the answer to question 1 or 2 is `YES, list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
0)
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Lice for guidance.
4
Are any monitored constituents equal to or above the established standards?
YES
NO
If the answer to question 4 is 'NO; skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below:
S
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) In the last two years?
If the answer to question 5 is NO" skip to section 8.
If the answer to question 5 is -Z", list in the space provided below, each well with constituent(s) exceeding
standards, concentrations) reported, and sample collection date for each occurrence (for the last two years).
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES'; a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells may be improperly
located, contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is 'YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the R eL ional Ofce within 90 da • an evaluation ma be
reouired to determine the impact the waste dis osal sVstem is ftM LIng at the review and cam !fence
baundarles surroungLng this facNf . Failure to do so ma su a to a Notice of wolation.
fines. and/or Aenaltles.
g
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
1 hereby acknowledge that the above information was evaluated and the information submitted in this
report (Compliance Report GW-59A) is true and complete to the best of my knowledge.
Signature of Permittee (or A orized Agent) Date
GW-59A 12I812003

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