WQ0004972_Monitoring - 03-2022_20220419

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DWR - NonDischarge Monitoring Report Submittal •4 ..
NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0004972
Name of Facility:* Forest Lake ELS
Month:* March Year:* 2022
Report Information
Type* Upload Document*
GW-59 Forest Lake Groundwater.pdf 1.82MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2,NDMLR,GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter:* Arnie Ferguson
Signature:
Date of submittal: 4/19/2022
This will be filled in automatically
Initial Review
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0004972
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date: 4/25/2022

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY- IV.OF WATER RESOURCES
GROUNDWATER € UALITY MONITORING: INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM --an ° Y
1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0004972 Expiration Date:
Facility Name: Forest Lake ELS Non-Discharge UIC
Permit Name(if different): 192 Thousand Trails Drive NPDES Other
Facility Address: TYPE OF PERMITTED OPERATION BEING MONITORED
Advance NC 27006 County Davie ❑ Lagoon ❑ Remediation: Infiltration Gallery
L Spray Field ❑ Remediation:
Contact Person: Tracy Overdurf Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Welt Location/Site Name: No.of wells to be sampled: 4 ❑ Water Source Heat Pump ❑Other:
dram Permit) 4_
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-1 Date sample collected: 03/29/2022 FIELD ANALYSES: WAS
Well Depth: 90.00 ft. Well Diameter: 2 in. pH 00400: 6.44 units Temp.00o10: 17.6 °C DRY at
Depth to Water Level s254s: 65.98 ft.below measuring point Screened Interval: ft. to ft. Spec.Cond.00094: pMhos time of
sampling,
Measuring Point is ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 6.50-Dry gallons Appearance here:il
Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: 0 YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:03/29-03/31/2022 Laboratory Name: Pace Analytical Services Certification No. 40&633
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N o0615 mg/L Pb-Lead 01a51 ug/L
Coliform: MF Fecal 31616 <1.0 /100mL Nitrate(NO3)as N 00620 0.045 mg/L Zn-Zinc 01092 mg/L
Coliform:ME Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note" use MPN method for highly turbid samples) Orthophosphate 7oso7 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 7030a mg/L Al-Aluminum 011as mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 3.3 mg/L Ca-Calcium a0916 mg/L
Chloride 00940 1.3 mg/L Cd-Cadmium 01027 ugh.
Arsenic 01a02 ugfL Chromium:Total et034 ugfL
Grease and Oils 00552 rng/L Cu-Copper 01042 mg/L ORGANICS: (by GC,GC/MS, HPLC)
Phenol 32730 ugfL Fe-Iron 01045 ugfL (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance coos pMhos K-Potassium 00937 mg/L VOC 7873 , method
Total Ammonia 00610 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen,NFi,as N,Ammonia Nitrogen,Total) Mn-Manganese©1055 uglL method#
TKN as N 00625 mg/L Ni-Nickel 01067 ugfL , method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. tam aware that there are significantpenalties for submittingfalse information,includingthe possibility of fines and imprisonment knowingViolations.
9 p y P
Permittee riSr Authorized Agent)Name and Title-Please print or type Signature o Permittee(or'uthorized A t( (Date)
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
Mail oI gtnal DEPARTMENT OF ENVIRONMENTAL QUALITY-DIV,OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: ��a �� INFORMATION PROCESSING uNrr
COMPLIANCE REPORT FORM = dol�Yfra
1617 MAIL SERVICE CENTER,RALEtGN,NC 2799=1617
FACILITY INFORMATION Please P,,nf Clearly or Type PERMIT Number:WQ0004972 Expiration Date:
Facility Name: forest Lake ELS Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 192 Thousand Trails Drive TYPE OF PERMITTED OPERATION BEING MONITORED
Advance NC 27006 County Davie El Lagoon El Remediation: Infiltration Gallery
El Spray Field ❑Remediation:
Contact Person: Tracy Overduf Telephone#: [phone] El Rotary Distributor El Land Application of Sludge
Well Location/Site Name: No.of wells to be sampled: 4 El Water Source Heat Pump El Other:
(rpm Permit) _-__ -.---.
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-2 Date sample collected: 03/29/2022 FIELD ANALYSES: WAS
Well Depth: 39 00 ft- Well Diameter: 2 in. pH moo:6.81 units Temp.00010: 18.0 °C DRY at
Depth to Water Level 82546: 33.24 ft.below measuring point Screened Interval: ft. to ft. Spec.Cond,00094: fiMhos time of
sampling,
Measuring Point is ft.above land surface Relative M.P. Elevation: ft, Odor 00085: check
Volume of water pumped/bailed before sampling: 1.50-Dry gallons Appearance here:
Samples for metals were collected unfiltered: ❑YES El NO and field acidified: I1 YES El NO
LABORATORY INFORMATION
Date sample analyzed: 03/29-30/31/2022 Laboratory Name: Pace Analytical Services Certification No. 40 Si:633
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1.0 /100mL Nitrate(NO3)as N 00620 2.5 mg/L Zn-Zinc 01092 mg/L
Conform:ME Total 31504 f100mL Phosphorus:Total as P 00665 mg/L
Nate use MPN method for highly turbid sampled Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
?issoived Solids:Total 70300 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 <1.0 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 6.3 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils o0s52 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC.GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron o1045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? El Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 ,method#
Total Ammonia 00610 mg/L Mg-Magnesium 00927 mg/L , method
(Ammonia Nitrogen;Nti,as N;Ammonia Nitrogen,Tatal)
Mn-Manganese 01055 ugfL ,method#
TKN as N 00625 mgfL Ni-Nickel 01067 ug/L , method
.._--.----_
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs. mg/L VOC Removal%
I certify that,to the best of my knowledge and;belief the information submitted to this report is true accurate and complete,and that l i crat analytical data was produced using approved of analysis bya. ';P p t�� � ytt produced methodsan ys
,_.n n,including io i
r� R-certifieddabeoratary. laiYsativare that there are sigz€Ificaittpenalties for eubmlttsrsg false lt�forrrttat�ptl4netudtng.:the�SdgsibIllto[ftrzes:artdrinlrrlsnnmerlt for knt�wlrtgYlr�ahens:�., � �....: �. _
Perrnittee(or Authorized Agent)Name and Title-Please print or type Signature of Permiitee(or Authorized Agent} (Date)
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
Mall original DEPARTMENT OF ENVIRONMENTAL QUALITY-DIV.OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT
? 11fly 1617 MAIL SERVICE CENTER. ,
COMPLIANCE REPORT FORM — -_ i RALEIGH NC 27666-1e17
FACILITY INFORMATION Pt1fl Clearly or Type PERMIT Number: WQ000497 p 2 Expiration Date:
Facility Name: Forest Lake ELS Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 192 Thousand Trails Drive TYPE OF PERMITTED OPERATION BEING MONITORED
Advance NC 2700E County Davie ❑ Lagoon ❑ Remediation:. Infiltration Gallery
ES Spray Field ❑ Remediation:
Contact Person: Tracy Overdurf Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: No.of wells to be sampled: 4 ❑ Water Source Heat Pump El Other:
{from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER(from Permit): MTV-3 Date sample collected. 03/29/2022 FIELD ANALYSES: WAS
Well Depth: 19.10 ft. Well Diameter: 2 in. pH aa4o0: 6.79 units Temp,name: 17.4 °C DRY at
Depth to Water Level 82546: 10.1 1 ft.below measuring point Screened Interval: ft. to ft, Spec.Cond.00094: pMhos time of
sampling,
Measuring Point is ft. above land surface Relative M.P. Elevation: ft. Odor meas. check
Volume of water pumped/bailed before sampling: 1.25-Dry gallons Appearance here:n
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: 0 YES ❑NO
LABORATORY INFORMATION -
Date sample analyzed:03/29-03/31/2022 Laboratory Name: Pace Analytical Services Certification No.
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Ph-Lead oio51 ug/L
Coliform: MF Fecal 31616 /100mL Nitrate(NO3)as N oo62o 1 1,5 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 <1.0 /100mL Phosphorus:Total as P 0066s mg/L
Note; use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 703oc mg/L AI-Aluminum ones mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC C0680 <I,t) mg/L Ca-Calcium 00916 mg/L
Chloride o094o 25.1 mg/L Cd-Cadmium 01027 uglL
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils oas52 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe- Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance awns fiMhos K-Potassium 00937 mg/L VOC 7873 , method#
Total Ammonia ea61a mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;Nh,as N Ammonia Nitrogen.,.Total) Mn-Manganese 01055 ug/L --__ ,method
TKN as N 00625 mg/L Ni-Nickel 01067 ug/L , method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowledge and belief,.the information submitted in this reportialtrue,eccurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory,I sin aware that there are significant penalties for submitting false Information,Including the possibility oftines end Imprisonment for knowing violations.
Permitt6e(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: iviall original DEPARTMENT OF ENVIRONMENTAL QUALITY-DIV.OF WATER RESOURCES
and I op INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM _ti 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617
FACILITY INFORMATION Meese Print Clearly orType PERMIT Number: WQ0004972 Expiration Date: -
1_
Facility Name: Forest Lake ELS Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 192 Thousand Trails Drive TYPE OF PERMITTED OPERATION BEING MONITORED
Advance '. NC 27006 County Davie ❑ Lagoon ❑ Remediation: Infiltration Gallery
Q Spray Field ❑ Remediation:
Contact Person: Tracy Overdurf Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name. No.of wells to be sampled: 4 ❑ Water Source Heat Pump ❑Other:
tram Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-4 Date sample collected: 3/29,12022 FIELD ANALYSES: WAS
Well Depth: 46.00ft. Well Diameter: 2 in. pH 00400: 6,52 units Temp.00o10: 17.4 °C DRY at
Depth to Water Level 82546: 30.73 ft. below measuring point Screened Interval: ft, to ft. Spec.Cond.00094: ttMhos time of
sampling,
Measuring Point is ft.above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 2.75-Dry gallons Appearance here:
Samples for metals were collected unfiltered: .YES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: 03/29 0 /. 1r2022 Laboratory Name: Pace Analytical Services Certification No. 40&633
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 uglL
Coliform: MF Fecal 31616 <i.0 /100mL Nitrate(NO3)as N 00620 <0.040 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
Note: Use N1'N method tar highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 mg/L Al-Aluminum o110s mg/L
pH(Lab)00403 units Ba-Barium o1007 uglL
TOG 00680 <1 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 3.8 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ugiL
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC,GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance 0o09s itMhos K-Potassium 00937 mg/L VOC 7873 ,method#
Total Ammonia 00610 mg/L Mg-Magnesium 0a927 mg/L , method#
(Ammon€a Nitrogen;NH,as N;Ammonia Nirotten,Total) Mn-Manganese 01055 uglL , method
TKN as N 00625 mg/L NI=Nickel 01067 ug/L , method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowiedge and belief,the information submitted in this report Is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. 1 am aware that there are significant penalties for submitting false information,including the possibility-of fines and imprisonment for knowing violations. ;
Permitte (or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) ` (Date)
GW-59 Rev.06-07-2018