WQ0001077_Monitoring - 03-2022_20220505

GW-59A COMPLIANCE REPORT FORM Permit# W t 0001011
(Submit one each monitoring period with GW-59 forms.)
1 Enter date monitoring results were due.(c41;u 12V ) Will this monitoring report(GW-59 and GW-59A) YES
be submitted after the established due date?
2 Was any required information missing on the GW-59 report forms? YES ls./
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 6-D
identification plate,area overgrown,etc.)?If the answer is "Yes",contact the Regional Office for guidance.
4 Are any monitored constituents equal to or above the established standards? YES 1�i0
If the answer to question 4 is"NO", skip to section 8. l-
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:
5 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?
LL;
If the answer to question 5 is"NO", skip to section 8. „,>
If the answer to question 5 is "YES",list in the space provided below, ekjh wQl;with..cci}stituent(s)exceeding
standards, concentration(s)reported, and sample collection date for each 0®surrs Ace(for me last two years).
�1 G
6 Are the monitoring wells listed in section 5 located at or beyond the twiew boundar).i' YES NO
If the answer is "YES';a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE.If the answer is "NO'; monitoring wells maybe 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 Regional Office within 90 days;an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility. Failure to do so may subject the permittee to a Notice of Violation,
fines,and/or penalties. M ES
kiAY 0 3 2n22
8 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.
I 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 Aut orized Agent) Date
GW-59A 12/8/2003

SUBMIT FORM ON YELLOW PAPER ONLY
Mall original DEPARTMENT OF ENVIRONMENTAL QUALITY-DIV.OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to: INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617
COMPLIANCE REPORT FORM Phone:[phone]
FACILITY INFORMATION Please Print CleanyorType PERMIT Number: Expiration Date: 6/30/2027
Facility Name: Innospec Performance Chemicals Non-Discharge WQ0001077 UIC
Permit Name(if different): NPDES Other
Facility Address: 500 Hinkle Lane TYPE OF PERMITTED OPERATION BEING MONITORED
Salsibury,NC 28144 County Rowan ' ❑ Lagoon ❑ Remediation:Infiltration Gallery
(City) (Stole) (Zip) X Spray Field ❑ Remediation:
Contact Person: Clay White Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name Long Ferry Road No.of wells to be sampled: 3 ❑ Water Source Heat Pump❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-6 Date sample collected:3/22/2022 FIELD ANALYSES: WAS
Well Depth: 30 ft. Well Diameter: 2 in. pH 00400: 5.85 S units Temp.00010: 15.2 °C DRY at
Depth to Water Level 62546: 11 ft.below measuring point Screened Interval:30 ft. to 15 ft. Spec.Cond.00094: RMhos time of
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: NIL sampling,
Volume of water pumped/bailed before sampling: 10 gallons Appearance Clear checlt
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑NO here:)
LABORATORY INFORMATION
Date sample analyzed 03/24-04/06/2022 Laboratory Name: Statesville Analytical Certification No. 440
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 /100mL Nitrate(NO3)as N ooszo mg/L Zn-Zinc o1os2 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note:Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 146 mg/L Al-Aluminum D11Ds mg/L MBAS=<0.1 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 <1.0 mg/L Ca-Calcium Oos1s mg/L
Chloride oos4o mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium:Total 01034 ug/L
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) pi No(0)
Specific Conductance 00095 124.1 µMhos K-Potassium 00937 mg/L ,method#
Total Ammonia ooslo mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NH3as 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 report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. lam aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Allen Robey,SHE Director,NA "VL 4'2/�'.22
.
Permittee(or Authorized Agent)Name and Title-Please print or typo Signature of Permittee(or Autorize4444tttr"''Age ' (Date)
GW-59 Rev.06-07-2018

!-
SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY-DIV.OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to: INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617
COMPLIANCE REPORT FORM Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 6/30/2027
Facility Name: Innospec Performance Chemicals Non-Discharge WQ0001077 UIC
Permit Name(if different): NPDES Other _
Facility Address: 500 Hinkle Lane TYPE OF PERMITTED OPERATION BEING MONITORED
Salsibury,NC 28144 County Rowan ❑ Lagoon ❑ Remediation:Infiltration Gallery
(City) (State) (Zip) X Spray Field ❑ Remediation:
Contact Person: Clay White Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:Long Ferry Road No.of wells to be sampled: 3 ❑ Water Source Heat Pump ❑ Other:
(horn Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-7 Date sample collected: 3/22/2022 FIELD ANALYSES: WAS
Well Depth: 38 ft. Well Diameter: 2 in. pH 00400: 5.08 units Temp.00010: 15.9 °C DRY at
Depth to Water Level 82546: 27 ft.below measuring point Screened Interval: 38 ft. to 18 ft. Spec.Cond.00094: µMhos time of
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: NIL sampling,
Volume of water pumped/bailed before sampling: 6 gallons Appearance Turbid yellow-orange check
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑NO here
LABORATORY INFORMATION
Date sample analyzed: 03/24-04/06/2022 Laboratory Name: Statesville Analytical Certification No. 440
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 /100mL Nitrate(NO3)as N 00620 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 36 mg/L Al-Aluminum 01105 mg/L MBAS=<0.1 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 <1.0 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1o02 ug/L Chromium:Total 01034 ug/L
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) I I No
Specific Conductance 00095 16.8 µMhos K-Potassium 00937 mg/L ,method#
Total Ammonia 00610 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 report is true:accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment0 for knowingviolations.
Allen Robey,SHE Director,NA a ,4' e. ( l(21 u �y
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authonze gent) (Date)
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY-DIV.OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to: INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617
COMPLIANCE REPORT FORM Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 6/30/2027
Facility Name: Innospec Performance Chemicals Non-Discharge WQ0001077 UIC
Permit Name(if different): NPDES Other
Facility Address: 500 Hinkle Lane TYPE OF PERMITTED OPERATION BEING MONITORED
Salsibury,NC 28144 County Rowan ❑ Lagoon ❑ Remediation:Infiltration Gallery
(Coy) (Stare) (Zip) X Spray Field ❑ Remediation:
Contact Person: Clay White Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:Long Ferry Road No.of wells to be sampled: 3 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-8 Date sample collected: 3/22/2022 FIELD ANALYSES: WAS
Well Depth: 40 ft. Well Diameter: 2 in. pH 00400: 5.40 units Temp.00010: 11.8 °C DRY at
Depth to Water Level 82646: 8 ft.below measuring point Screened Interval: 40 ft. to 20 ft. Spec.Cond.00094: µMhos time of
Measuring Point is 3 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: NIL sampling,
Volume of water pumped/bailed before sampling: 16 gallons Appearance Clear check
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑ YES ❑NO here
LABORATORY INFORMATION
Date sample analyzed: 03/24-04/06/2022 Laboratory Name: Statesville Analytical Certification No. 440
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 /100mL Nitrate(NO3)as N 00620 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 28 mg/L Al-Aluminum 01105 mg/L MBAS=<0.1 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 1.32 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
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? n Yes(1) E No(0)
Specific Conductance 00095 29.6 µMhos K-Potassium 00937 mg/L ,method#
Total Ammonia 00610 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen:NH3as 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 report is true,accurate.and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. lam aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonmentri0 for knowing violations. �/ r�
Allen Robey,SHE Director,NA (/f/. `!o..�/ 7 ' -C GP• .?a
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Ay�nt) (Date)
GW-59 Rev.06-07-2018