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Home My WebLink AboutWQ0003090_Monitoring - 03-2024_20240426 (2)SUBMIT FORM ON YELLOW PAPER ONLY DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024 Facility Name: Town of Liberty WWTP Non -Discharge WQ0003090 UIC Permit Name (if different): NPDES Other Facility Address: P.O. Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED liberty NC 27298 County Randolph ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑■ Spray Field ❑ Remediation: Contact Person: Tremaine Fike Telephone#: 336-215-8795 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: MW 2 No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permit) SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW 2 Date sample collected: 3/18/2024 FIELD ANALYSES: WAS Well Depth: 30.4 ft. Well Diameter: 2 in. pH 0040o: 6.32 units Temp. 000lo: 14.4 °C DRY at Depth to Water Level 82546: 7.35 ft. below measuring point Screened Interval: ft. to _ft. Spec. Cond. 000sa: µMhos time ofsampling, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check Volume of water pumped/bailed before sampling: 3.0 gallons Appearance here:❑ Samples for metals were collected unfiltered: ❑ YES (] NO and field acidified: ❑ YES ■❑ NO LABORATORY INFORMATION Date sample analyzed: 3/18/2024 Laboratory Name: PACE ANALYTICAL LABS, INC. 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 o1o51 ug/L Coliform: MF Fecal 31616 <1.0 /100mL Nitrate (NO3) as N 00620 0.28 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.059 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total70300 62.0 mg/L Al -Aluminum oilo5 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 <1.0 mg/L Ca - Calcium 00916 mg/L Chloride 00940 2.6 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? ❑■ Yes (1) ❑ No (0) Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # 8260D Total Ammonia 00610 <0.10 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% Scott Kidd Town Manager Permittee (or Authorized Agent) Name and Title - Please print or type GW-59 Rev.06-07-2018 9LOZ-LO-90 A92i 69-MJ (alea) j (ea6V pazuoglnV jo) 9all!wj2d,,jCSoleu6!s ad/1 jo juud aseald - ell!1 pue aweN (lu96V pazuoginV jo) aau!wad �J --j jabeuelni urnol pp!>i 33ooS %Ienowaa OOA l/6w :sOOA le;ol;uenl}}3 l/6w :sOOA le;ol;uanljul :(spodaa qel yoe:4V) AluO swalsAS uoileipawab io3 # p04;aw ' I/6n L90LO la�OIN -!N I/6w SZ900 N se N>il # po4;aw ` -7/6n Sow asaue6ueW - uW (lelol'ue60Jl!N eiuowwV'N se6HN'u960A!N eiuowwV) # po4;aw ' I/6w LZ600 wnisau6eW - 6W I/6w oVo> 019oo eluowwV Ie;ol 4o9ze # Po41aw ` sLSL OOA l/6w Ls600 wnlsselod - N so4Wli 96000 aouelonpuo0 of;load (0) ON ❑ W s8,, ❑- 4p943e:gV :pod9N qe-i -i/6n 006LL tinoialN - 6H I/6w 917600 a1ejInS CINOdEIN SV1 HOV11V '# po4law pue ;sal f4lOadS) I/6n 9170LO uwl - a3 I/6n oslzs louaLid (OIdH 'SW/OJ 'OJ Aq) :SOINVE)NO l/6w zvolo jaddo0 - n0 I/6w Z9900 s11O pue aseeJO I/6n vsolo ie;ol :wniwojgo I/6n zomo oluesiv 1/6n LZOW wniwpe0 - PO I/6w 67ov600 aplJOl40 I/6w MOO wnpleO - e0 I/6w 0" I•> 08900 00-L I/6n LooLo wnueg - eg sl!un sovoo (qsl) Hd I/6w soLLo wnuiwnlV - IV 1/6w ZSZ OOSOL le;ol:splloS panlossl :(si!uN uoilei;ueouo0 pue spunodwo0 fq!oedS) je4;0 I/6w L090L a;e4dso4do4liO (saidwes plgjni AILAq Jo; poylaw NdW asn :aION) I/6w 090'0> 99900 d se lelol :snjo4dso4d Iw00L/ vosLs lelol dW :WjOJ!IOO l/6w z60L0 OuIZ - uZ I/6w 0, l oz900 N se ('ON) 91EA!N IWOW 0 L> 9L9Ls leoad dIN :wjo}llo0 1/6n Lgow peal - qd l/6w 94900 N se (zON) 91u;lN I/6w gssoo 000 •suoi;eJ;u90uo3 Iep!olloo pue paAlosslp 1391jaJ pino4s sonleA :310N SN313W"vd E£9# ov# 'ON u0geog!1J80 'ONI 'SSV-I'lV01lA-IVNV 30Vd :aweN tiolejogel vzozisLis :pazAIeue aldwes a;e0 NOIlVWNOdNI kNOiVdOBV1 ON ❑■ S3,k ❑ :P941p!Oe plat; pue ON ❑■ S3A ❑ :pajall!;un pa;oalloo a.lam slelaw jo; saidweS ❑:aja4 aouejeaddV suolle6 gL•g :6ulldwes ajo�aq pal!eq/pedwnd jalemjo awnIOA �{Oa4o :98000 JOPO .4 :uogenal3 -d VY angela�l aoe}lns puel anoge .0 z sl;wod 6uunseen '6uiidwes soywd :176000 •puo0 'oadS .0 o; 'l; :leAJa;ul pau9910S ;wod 6uunseew molaq 'u 96 0 :917sz9 (anal Ja;eM 01 41da0 ;o awl; 1e Aa0 Oo tl•tL :u000 dwal sl!un tti,g :00v00 Hd ul z :Jalewela IIaM 4 s9'0s :41da0 IIaM SVM :S3S.l1VNV 0131d 17zoz/9L/C :Paloalioo aldwes a;e0 vMW :(;!woad woj;) H38Wf1N 01113M 1-13M11 NOIIVW210dN1 JNI1dWVS (11"ed wo») :ja410 ❑ dwnd leaH aoinoS aaleM ❑ g :paldwes aq of sham }o 'ON ti AAn :aweN 94!S/uO480Ol IIaM 96pniS;o uolleoilddV pue-1 ❑ jolnqu1s10 )Ge1oy ❑ 96L9-9LZ-KC :#auogdalal mild auiewail :uoslad 10e1uo0 :u01le1Pawab ❑ plaid AejdS ❑E lialle0 uolleJ;l!lul :uollelpawad ❑ u006el ❑ 4dlopuea Aluno0 26ZLZ ON ]�agil 03NOlINOW ONGS NOIi"3dO 03111W2I3d d0 3d�ll 9001 Xg 'O•d :ssejppV AI!1!0e3 Ja410 S30dN :(;uaJa l!P P) aweN 1lwJ9d Olfl 0600000OM 96Je43sl0-uON dlMM Aljagll;o uMol :aweN Al!I!oed vzoz/ls)s :a;e0 uoilejidx3 :jegwnN lIWN3d ad(1�o (pea��uudasea)d NOIIVWNOdNl Ail110Vd LM-669113N`HE)SlTd'U3lN30301AH3S-11VWLM WNO=l INOd3N 30NVIldW00 11NnEWSS30OadN0IlVWa0:lNl • ' • ' :JNRIOlINOW kinvno 2:131VMaNnoNo ssoun0s3u wzuvm io vua - Ainvno-IV.LN3WN0UlAN3 dO lN3WlVVdan LINO a3ddd M0113A NO moi inanS SUBMIT FORM ON YELLOW PAPER ONLY DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024 Facility Name: Town of Liberty WWTP Non -Discharge W00003090 UIC Permit Name (if different): NPDES Other Facility Address: P.O. Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED liberty NC 27298 County Randolph ❑ Lagoon ❑ Remediation: Infiltration Gallery 0 Spray Field ❑ Remediation: Contact Person: Tremaine Fike Telephone#: 336-215-8795 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: MW 5 No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permo SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW 5 Date sample collected: 3/18/2024 FIELD ANALYSES: WAS Well Depth: 27.15 ft. Well Diameter: 2 in. pH 00400: 6.50 units Temp. 000lo: 15.2 °C DRY at Depth to Water Level 82546: 19.71 ft. below measuring point Screened Interval: ft. to _ft. Spec. Cond. 00094: µMhos time of sampling, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check Volume of water pumped/bailed before sampling: 10.0 gallons Appearance here:❑ Samples for metals were collected unfiltered: ❑ YES H NO and field acidified: ❑ YES A NO LABORATORY INFORMATION Date sample analyzed: 3/18/2024 LaboratoryName: PACE ANALYTICAL LABS, INC. Certification No. #40 #633 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N oo615 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1.0 /100mL Nitrate (NO3) as N 00620 0.42 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.050 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 379 mg/L Al -Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 2.2 mg/L Ca - Calcium 00916 mg/L Chloride 00940 45.2 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? X Yes (1) ❑ No (0) Specific Conductance 00095 FtMhos K - Potassium 00937 mg/L VOC 7873 method # 8260D Total Ammonia 00610 <0.10 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% Scott Kidd Town Manager Permittee (or Authorized Agent) Name and Title - Please print or type (or Authorized Agent) Z_ GW-59 Rev.06-07-2018 SUBMIT FORM ON YELLOW PAPER ONLY • • DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024 Facility Name: Town of Liberty WWTP Non -Discharge WQ0003090 UIC Permit Name (if different): NPDES Other Facility Address: P.O. Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED liberty NC 27298 County Randolph ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑■ Spray Field ❑ Remediation: Contact Person: Tremaine Fike Telephone#: 336-215-8795 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: MW 6 No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permit) SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW 6 Date sample collected: 3/18/2024 FIELD ANALYSES: WAS Well Depth: 30.0 ft. Well Diameter: 2 in. pH 0040o: 6.48 units Temp. 000lo: 15.4 oC DRY at Depth to Water Level 82546: 17.64 ft. below measuring point Screened Interval: ft. to _ft. Spec. Cond. 00094 µMhos time ofsam sampling, 9, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check Volume of water pumped/bailed before sampling: 8.5 gallons Appearance here:❑ Samples for metals were collected unfiltered: ❑ YES ❑■ NO and field acidified: ❑ YES 0 NO LABORATORY INFORMATION Date sample analyzed: 3/18/2024 LaboratoryName: PACE ANALYTICAL LABS, INC. 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 olo51 ug/L Coliform: MF Fecal 31616 <1.0 /100mL Nitrate (NO3) as N 00620 0.75 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.050 mg/L (Note. use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 164 mg/L Al -Aluminum oilo5 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 <1.0 mg/L Ca - Calcium oo916 mg/L Chloride 0094o 7.1 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? 9 Yes (1) ❑ No (0) Specific Conductance 00095 l,tMhos K - Potassium 00937 mg/L VOC 7873 method # 8260D Total Ammonia 00610 <0.10 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen, NH3as N, Ammonia Nitrogen, Total) Mn - Manganese olo55 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% GW-59 Rev.06-07-2018 SUBMIT FORM ON YELLOW PAPER ONLY 11M=DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEFGH, NC 27699.1617 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024 Facility Name: Town of Liberty WWTP Non -Discharge W00003090 UIC Permit Name (if different): NPDES Other Facility Address: P.O. Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED liberty NC 27298 County Randolph ❑ Lagoon ❑ Remediation: Infiltration Gallery 0 Spray Field ❑ Remediation: Contact Person: Tremaine Fike Telephone#: 336-215-8795 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: MW 7 No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permit SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW 7 Date sample collected: 3/18/2024 FIELD ANALYSES: WAS Well Depth: 27.2 ft. Well Diameter: 2 in. pH 00400: 6.29 units Temp. 000lo: 14.9 °C DRY at Depth to Water Level 82546: 8.87 ft. below measuring point Screened Interval: ft. to _ft. Spec. Cond. 00094: uMhos time ofsampling, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check Volume of water pumped/bailed before sampling: 2.0 gallons Appearance here: El Samples for metals were collected unfiltered: ❑ YES ❑■ NO and field acidified: ❑ YES NO LABORATORY INFORMATION Date sample analyzed: 3/18/2024 Laboratory Name: PACE ANALYTICAL LABS, INC. Certification No. #40 #633 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 rng/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 0.96 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.050 mg/L (Note. use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 206 mg/L Al -Aluminum o11os mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 <1.0 mg/L Ca - Calcium 00916 mg/L Chloride 00940 16.0 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? ❑■ Yes (1) ❑ No (0) Specific Conductance 00095 ftMhos K - Potassium 00937 mg/L VOC 7873 method # 8260D Total Ammonia 00610 <0.10 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% GW-59 Rev.06-07-2018 GW-59A COMPLIANCE Ria'ORT C+(7RM Pertatit # WQ0003090 (Submil one each nnnritoring period with G11'-59 f)rms.) j Enter date monitoring results were due. (04/30/2024 ) Will this monitoring report (GW-59 and GW-59A) YES NO be submitted after the established due date? X 2 Was any required information missing on the GNY-59 report forms? YES NO 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 NO identification plate, area overgrown, etc.)? If the answer is " es", contact the RegionaI Office for guidance. X 4 Are any monitored constituents equal to or above the established standards? YES N,Q X 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 "YES", list in the space provided below, each well with constituent(s) exceeding standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years). 6 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 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. 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 tr a and complete to the best of my knowle ge. r ZS Sig ermittee (or Authorized Agent) Date GNV-59A 12/8/2003 � Tv=-W� W ". " .... W C5 Ol IQ I,. 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To: — Preservative Types: (2) nitric acid, (2) sulfuric acid, (3) hydrochloric acid, (4) sodium hydroxide, (5) zinc acetate, E (5) methanol, (7) sodium b sulfate, (8) sodium (C) arnmsnium hydroxide, (D) TSP, (U) Unpreserved, thtosuifate, (0) (9) hexane, Other. (A', ascorbic acid, (8) ammonium sulfate _ Copy To: Site Collection Info/Address: Analyses Ftab Prr McAlne. Customer Project Name/Number: State: County/City: Time Zone Collected: :Fab sample Aecezpt caecZrIlstz 1 i IPT[ )MITI ICT tET ^ustody sells rt" Custody signatures Present. Ca2:lecto 5ignstnre Presetct BM hone;o Site/Facility iD df: Compliance Monitoring? Email: ! ( 1 Yes j ) (Vo eottl intact IN NA Correct ntttles N Na Sufficient s?olame Cone } ( print): Purchase Order #: DW PW5 ID #: Quote #: DW Location Code: Samples Received on ice N N� vc9ts _ $eadsQace Accept slc Y N } $Yegin �N Co' ected By (signature), 4 Turnaround Date Required: fmrredsatzry Pac � or Ice: y s Na } es ( Hod iSoils so= -USDA i samples in Holding Time N Residual r s a Y Sample Disposal: Rush: Field Filtered (if applicable): Dispose as appropriate i 1 Return [ ) Same Day ( 1 Next Day [ 1 Yes [ INC " cl t sChlorin p im sample pH A-- Qt le N t ArcNve: j Hold: I ] 2 Day [ 13 Day [ 14 Day S Day (Expedite Charges Apply) Ana sis: Y 1 PB Stt3&sss sulfide Present Y 23 Lead Acetate stripss Matrix Codes (insert in Matrix box below): Dr eking Water (DVV), Ground Water (GW ), Wastewater (WW), Product (P), soil/Solid (SL}, Oil (OL), Wipe (WP), Air (AR), Tssue (TS), Bioassay (B), Vapor (V), Other (JT) � — bit USE OVLX, Lab sample .' CaaRaazzts: Comp / Collected (or r Composite End Res # of Customer Sample ID matrix � Grab Composite Start) Ci Ctns =t: r,)atei Time Date Time �r a✓-'"' °d ., 6" Lab Sample Temperature Wo: Customer Remarks / Special Conditions/ Possible Hazards: Type of %ce fJsed: W Bute Dry None SHORT-Ha Packing Matertal Li tzb Tracking #; Temp HBank,Receivec(z y fJ f k Therm;D#:2902909 0d—r�-- m Cooler i Temp Upon Receipt: sJ a£ Factor:" Samplesreceived via. - Radchem sa e{s} screened (<Sa 3 cTsm). y P NA=EDEXUPS - Client Courier Pam Courier ,' i {CD Cooler i Theme Corr. aC Cooier I Gorrected Temp: 0C _. Cnmrzen#s: Relinquished by/Company: (Signature) .., Dat / i-7T: Rece, by/Compa?y: !S( nature) Da eJT-me: IVITJL LAB USE filthy r l l Warble #: [X#—Title: ENV-FRM-HUNI-0083 03—Sample Condition Upon Receipt C'Mc.,ictive Date: 12/01/2023 - --- - - ------- - - ...... *Check madt top holf of box if pH and/or dechlorination is verified and Project # withki the accepUwce range for preservation samples, Lnep%iims VQA, (.uhfomi, ToC, Oil '111d (�aoaSe' ORO/801(Wat,,'r) DOC, I'LlAg "Bottom half of boy, Is to list number of bottles `X*' Check all unpre served Nitrates for chlorine < .T 5Vi > X -a sr 13 14� < > t 0J 3 L01 C8 q U, 0 K, 'D Ix M 91 1� ip, M Q ha. 0-1 U, 0 1"1 o' c" ta cd M to '4� W, '9" 0- W rb in < '4 -4 - ------ ------ . .......... . . ........ . ....... .. ... ii w . _ _ __ ___ �� _ _.. ........m _m --------- -- - - --------- ------ 3 -7 0 -- ------ -- ------- --- --------- - VVI Adjustrnent Log for N'eserved Sjmple,�, ....... . .. 11A I Whenever tiwii. iSa ikjciepiolr.y affecOor, Nofih con"Pflaflco Sainpip-,;' a of Oil-, fomn will be Sefit to dvI'Moh CIrobna DUM Cv(tiflxIlion Off u (i,f, Ow of MAI, inculfi.'d out of mcoitr"ct Page 4 of 4 (')'u"Atrax ID: 2 of 2 Monitoring Report Submittal Permit Number#* WQ0003090 Name of Facility:* Town of Liberty WWTP Month: * March Year: * 2024 Report Information Type* Upload Document* NDMR, NDAR-1, NDAR-2, NDMLR mar spray report 2024.pdf 4.36MB PDF Only GW-59 2024 mar gw59.pdf 3.07MB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). Confirmation Email Address: * tfike@townoflibertync.org Name of Submitter: * Elix Fike Signature: sgt4wa"i/- ll.Ar' Date of submittal: 4/26/2024 This will be filled in automatically Initial Review Reviewer: Wanda.Gerald Is the project number correct?* WQ0003090 Is the monitoring report accepted?* Yes No Regional Office* Winston-Salem Reviewer: _anonymous Review Date: 6/27/2024