The URL can be used to link to this page

Home My WebLink AboutWQ0001664_Monitoring - 11-2016_20161219SUBMIT FORM ON YELLOW PAPER ONLY DWATER QUALITY MONITORING: ANCE REPORT FORM Name: Belvedere Plantation Name (if different): Address: 130 Fairway Or Hampstead N.C. 28443 County Pander act Person: Jimmie Hagwood Telephone#: 910-443-0280 Location/Site Name # 3 Green No. of wells to be sampled: r XPARTMENT OF ENVIRONMENT & NATURAL RESOURCES 31VISION OF WATER RESOURCES - INFORMATION PROCESSING UNIT 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919607-6306 PERMIT Number: 044&�l4ly Expiration Date: 1/31/2020 Non -Discharge UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: L ID NUMBER (from Permit): MW7 Date sample collected: 11/4/2016 FIELD ANALYSES: Depth: 17 ft. Well Diameter: 2 in. pH 00400: 6.3 units Temp. 000lc 117 IC n to Water Level 82546: 5'6" ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos luring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none ne of water pumped/bailed before sampling: 5 gallons Appearance Tan )les for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO at of L-Ak1UKA I UKT INrUKMAI IUN Date sample analyzed: ?F4i294Cs Ay/& Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. rnn COD 00335 mg/L Nitrite (NO,) as N oosi 5 0.09 mg/L Pb - Lead 01 '\ jED ug/L Coliform: MF Fecal 31616 15 /100mL Nitrate (NO3) as N oos2o 0.11 mg/L Zn -Zinc o1 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.78 mg/L (hole: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify CompRlltlMc�o�lnr!ceptrsntion Units). issolved Solids:Total 70300 135 mg/L Al - Aluminum oleos mg/L ' aTlrlhtpRWG$S(IRl pH (Lab) oo4w 6.25 units Be - Barium olow ug/L �F� TOC oomo mg/L Ca - Calcium ooele mg/L KH Chloride 00940 9 mg/L Cd - Cadmium 01027 ug/L Arsenic olow uglL Chromium: Total olo34 ug/L DEC 1 TM6 Grease and Oils oo552 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) pecific Conductance 000g5 µMhos K - Potassium oo937 mg/L VOC 7873 , method # Total Ammonia ooslo <0.2 mg/L Mg - Magnesium 00927 mg/L , method # Nitren; NH3asN; Ammonia Nitrogen, Total) (Ammonia og Mn - Manganese 01055 ug/L , method # TKN as N 00625 mg/L Ni - Nickel 01067 uglL method # For Remediation Systems Only (Attach lab Reports): Influent Total VOCs: Danny Lassiter Regional Manager Permittee (or Authorized Anent) Name and l dwlassiter@ulwater.com GW -59 Rev. 812013 800-525-7990 mq/L Effluent Total VOCs: mg/L VOC Removal% SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM Name: Belvedere Plantation Name (if different): Address: 130 Fairway Dr Hampstead N.C. 28443 County Fender act Person: Jimmie Hagwood Telephone#: 910-443-0280 Location/Site Name # 7 Green No. of wells to be sampled: 0 'ARTMENT OF ENVIRONMENT 6 NATURAL RESOURCES ISION OF WATER RESOURCES - INFORMATION PROCESSING UNIT 7 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919$07.6306 RMIT Number: Expiration Date: 1/31/2020 n -Discharge UIC 'DES Other PE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other L ID NUMBER (from Permit): MW8 Date sample collected: 11/4/2016 FIELD ANALYSES: IWAS Depth: 18 ft. Well Diameter: 2 in. pH 00400. 6.1 units Temp. 000lt 79.1 'C DRY at 1 to Water Level 82546: 7.3 ft. below measurin pec. Cond. 00094: µMhos time li g point Screened Interval: 5 ft. to 15 ft. S samplir luring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor olloe5: slight check ne of water pumped/bailed before sampling: 5 gallons Appearance Tan here: r ales for metals were collected unfiltered: El YES [I NO and field acidified: C1 YES El NO L Date sample analyzed: 11/4/2016 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N oll615 0.41 mg/L Pb - Lead o1os1 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N Do62o 0.11 mg/L Zn -Zinc 01092 mg/L Coliform: MF Total 315o4 /100mL Phosphorus: Total as P oo665 3.5 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): )issolved Solids:Total 70300 74 mg/L At -Aluminum o1105 mg/L pH (Lab) 00403 6.14 units Be - Barium 01007 ug/L TOC owito mg/L Ca - Calcium oo91s mg/L Chloride oo94o <5 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total mom ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 uglL Fe - Iron 01D45 ug/L (Specify test and method If. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71 9D ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) ipecific Conductance 00095 µMhos K - Potassium oo937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L , method # (Ammonia Nitrogen; NHsas N; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L , method # TKN as N 00625 mg/L Ni - Nickel 01087 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal Danny Lassiter Regional Manager Penniftee (or Authorized Agent) Name and Title - Please a dwlassiter@uiwater.com GW -59 Rev. 8/2013 800-525-7990 SUBMIT FORM ON YELLOW PAPER ONLY DWATER QUALITY MONITORING: ANCE REPORT FORM Name: Belvedere Plantation Name (if different): Address: 130 Fairway Dr Hampstead N.C. 28443 County Pander act Person: Jimmie Hagwood Telephone#: 910-443-0280 Location/Site Name # 3 Green near woods No. of wells to be sampled: 9 DEPARTMENT OF ENVIRONMENT a NATURAL RESOURCES DIVISION OF WATER RESOURCES - INFORMATION PROCESSING UNIT 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919.807-6306 PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: L ID NUMBER (from Permit): MW9 Date sample collected: 11/4/2016 FIELD ANALYSES: Depth: 23 ft. Well Diameter: 2 in. pH oo ioo: 5.7 units Temp. 000lc 20'2 eC T to Water Level 82546: 16 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: pMhos luring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor Doom- slight ne of water pumped/bailed before sampling: 5 gallons Appearance Tan )les for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO ate sample analyzed: 11/4/2016 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 kRAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N oo615 0.35 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 <0.02 mg/L Zn -Zinc olo92 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P ooee5 1.19 mg/L (Note: Use MPN metho4 for taghly Wrbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): ;solved Solids:Total 70300 138 mg/L Al - Aluminum o11o5 mg/L pH (Lab) 00403 5.65 units Be - Barium 01007 ug/L TOC omm mg/L Ca - Calcium 00916 mg/L Chloride oo94o 27 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total olom 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 Dims ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate oo94s mg/L Hg - Mercury 71900 ug1L Lab Report Attached? ❑ Yes (1) ❑ No (0) lecific Conductance Dews µMhos K - Potassium oo937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L , method # TKN as N 00625 mg/L Ni - Nickel 01057 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal°/ at of Danny Lassiter Permittee (or Authorized Adam) Name and l Regional Manager GW -59 Rev. 8/2013 dwlassiter@uiwater.com 800-525-7990 For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mq/L Effluent Total VOCs'. mg/L VOC Removal% SUBMIT FORM ON YELLOW PAPER ONLY DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES GROUNDWATER QUALITY MONITORING: , , DIVISION OF WATER RESOURCES -INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 276994617 Phone: 919.607.6306 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 1/31/2020 Facility Name: Belvedere Plantation Non -Discharge UIC NPDES Other Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery County Pander ❑ Spray Field ❑ Remediation: Contact Person: Jimmie Hagwood Telephone#: 910-443-0280 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name # 3 green near tee box No. of wells to be sampled: 9 ❑ Water Source Heat Pump ❑ Other: (from Penn SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW10 Date sample collected: 11/4/2016 FIELD ANALYSES: WAS Well Depth: 18 ft. Well Diameter: 2 in. pH 00400: 6 units Temp. 0001( 20.1 IC DRY at Depth to Water Level 62546: 3.4 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of sampling, Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor 000e6: slight check Volume of water pumped/bailed before sampling: 5 gallons Appearance tan here:❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed: 11/4/2016 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 0.07 mg/L Pb - Lead olo51 uglL Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N oo62o <0.02 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 1.3 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 85 mg/L Al -Aluminum o11o5 mg/L pH (Lab) 00403 6.01 units Be - Barium o1oo7 ug/L TOC oo68o mg/L Ca - Calcium 00916 mg/L Chloride 00940 5 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01om uglL 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) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Ndrogen: NH3 as N; Ammonia Nitrogen, TeteO 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: mq/L Effluent Total VOCs'. mg/L VOC Removal% SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM Name: Belvedere Plantation Name (if different): Address: 130 Fairway Dr Hampstead N.C. 28443 County Pander act Person: Jimmie Hagwood Telephone#: 911}443-0280 Location/Site Name Basin A right comer No. of wells to be sampled: 9 WELL ID NUMBER (from Permit): MW11 Date sample collected: 11/4/2016 Well Depth: 15 ft. Well Diameter: 2 in. Depth to Water Level 82546: 7.8 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Volume of water pumped/bailed before sampling: 5 gallons Samoles for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO 'ARTMENT OF ENVIRONMENT & NATURAL RESOURCES ISION OF WATER RESOURCES - INFORMATION PROCESSING UNIT 7 MAIL SERVICE CENTER, RALEIGH, NC 27999-1617 Phone: 9198074306 RMIT Number: Expiration Date. 1/31/2020 n -Discharge UIC 'DES Other PE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other FIELD ANALYSES: pH 00400: 5 units Spec. Cond. 000g4: Odor 000e5: Appearance Temp. 000ic 08 °C DRY at µMhos time of strong tan ate sample analyzed: 11/4/2016 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 tRAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N oGB15 0.03 mg/L Pb - Lead o1o51 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00820 <0.02 mg/L Zn -Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.52 mg/L (Note: Use MPN method for highly hxNd sariples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): solved Solids:TOtal 70300 51 mg/L Al - Aluminum 01105 mg/L pH (Lab) oo4o3 4.96 units Be - Barium 01007 ug/L TOC oosso mg/L Ca - Calcium oo916 mg/L Chloride oo94o <5 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total o1o34 uglL Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron o1o45 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) ecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NHsas 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 V()r- 192?11,9Danny Lassiter Regional Manager Permittee (or Authorized Anent) Name and Title - Pleas dwlassiter@ulwateLCOm GW -59 Rev. 8/2013 800-525-7990 mg/L Effluent Total VOCs: mg/L VOC Removal% SUBMIT FORM ON YELLOW PAPER ONLY ROUNDWATER QUALITY MONITORING: OMPLIANCE REPORT FORM Name: Belvedere Plantation Name (if different): Address: 130 Fairway Dr Hampstead N.C. 28443 County Fender act Person: Jimmie Hagwood Telephone#: 910443-0280 Location/Site Name Back of Basin B No. of wells to be sampled: 9 DIVISION OF WATER RESOURCES - INFORMATION PROCESSING UNIT 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: 919407-6306 PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other WELL ID NUMBER (from Permit): MW12 Date sample collected: 11/4/2016 FIELD ANALYSES: WAS Well Depth: 15 ft. Well Diameter: 2 in. pH o0400: 5.4 units Temp. cool( 21.e IC DRY at Depth to Water Level 82546: 7.3 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. h Odor Doom: sli 9 t sampling,check Volume of water pumped/bailed before sampling: 5 gallons Appearance cloudy here:❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed: 11/4/2016 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO,) as N 00615 <0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 <0.02 mg/L Zn -Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.38 mg/L (Note: Use MPN method for highly turNd samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 55 mg/L Al - Aluminum oil os mg/L pH (Lab) 00403 5.4 units Be - Barium oloo7 ug/L TOC 00680 mg/L Ca - Calcium oo916 mg/L M Chloride 00940 8 mg/L Cd - Cadmium o1o27 ug/L Arsenic 01002 ug/L Chromium: Total o1o34 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 o1o45 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) pacific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 , method # Total Ammonia oo610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Am nia Nitmg.; NHs es N; Ammonia Nitrogen, Total) Mn -Manganese oloss ug/L ,method # TKN as N 00625 mg/L Ni - Nickel o1o67 ug/L , method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mq/L Effluent Total VOCs: mg/L VOC Removal% 800-525-7990 SUBMIT FORM ON YELLOW PAPER ONLY UNDWATER QUALITY MONITORING: PLIANCE REPORT FORM Iry n reneRA • rrnwr Please Print Clearly or Facility Name: Belvedere Plantation Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 County Pander act Person: Jimmie Hagwood Telephone#: 910-443-0280 Location/Site Name Basin left corner. No. of wells to be sampled: 9 L ID NUMBER (from Permit): MW14 Depth: 15 ft. h to Water Level 82546: 7.4 ft. below measuring point wring Point is 3 ft. above land surface ne of water pumped/bailed before sampling: 5 Dies for metals were collected unfiltered: ❑ YES ❑ Date sample collected: 11/4/2016 Well Diameter: 2 in. Screened Interval: 5 ft. Relative M.P. Elevation: iPARTMENT OF ENVIRONMENT & NATURAL RESOURCES VISION OF WATER RESOURCES - INFORMATION PROCESSING UNIT 17 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919-807-6306 ERMIT Number: Expiration Date: 1/31/2020 on -Discharge UIC PEES Other YPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge to 15 ft. ft. YES ❑ NO ❑ Water Source Heat Pump ❑ Other FIELD ANALYSES: I WAS pH 00400: 6 units Temp. 000lc 22 eC DRY at Spec. Cond. 00094: µMhos time of strop Odor 00095: g sampling,check Appearance cloudy here: El ate sample analyzed: 11/4/2016 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 I RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N oo615 0.09 mg/L Pb - Lead 01051 uglL Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO;) as N 00620 <0.02 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P oo665 0.5 mg/L (Note: Use NIPN method for highly tud Ad samples) Orthophosphate 70507 - - mg/L Other (Specify Compounds and Concentration Units): ,solved Solids:Total 70300 47 mg/L Al -Aluminum 01105 mg, L pH (Lab) 00403 5.97 units Be - Barium 01007 ug/L TOC oo68o mg/L Ca - Calcium 0o916 mg/L Chloride 00940 <5 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total o1o34 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) ,ecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 , method # Total Ammonia ooslo <0.2 mg/L Mg - Magnesium 00927 mg/L , method # (Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 uglL method # TKN as N 00625 mg/L Ni - Nickel olow uglL method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: Danny Lassiter Regional Manag dwlassiter@uiw Permittee for Authorized Aqent) Name and Title - Please print or type 800-525-7990 GW -59 Rev. 812013 mo/L Effluent Total VOCs: mq/L VOC Removal% GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM or SUBMIT FORM ON YELLOW PAPER ONLY Facility Name: Belvedere Plantation Permit Name (if different): Facility Address:. 130 Fairway Dr Hampstead N.C. 28443 County Pender act Person: Jimmie Hagwood Telephone#: 910-443-0280 Location/Site Name 1 st Basin C near front right corner No. of wells to be sampled: 9 DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES DIVISION OF WATER RESOURCES -INFORMATION PROCESSING UNIT 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919.807-6306 PERMIT Number: Expiration Date. 1/31/2020 Non -Discharge UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other WELL ID NUMBER (from Permit): MW13 Date sample collected: 11/4/2016 FIELD ANALYSES: Well Depth: 15 ft. Well Diameter: 2 in. pH 00400: 5 units Temp, 1 21.1 °C Depth to Water Level 82546: 8.4 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094 µMhos Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor o0085: SLIGHT Volume of water pumped/bailed before sampling: 5 gallons Appearance light tan Samnles for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO ate sample analyzed: 11/4/2016 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 1RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N oo615 0.07 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 <0.02 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.54 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): solved Solids:Total 70300 29 mg/L Al - Aluminum 01105 Fri pH (Lab) 00403 4.98 units Be - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium o0916 mg/L Chloride 00940 <5 Fri Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 1 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 oo945 Fri Hg - Mercury 71900 uglL Lab Report Attached? ❑ Yes (1) ❑ No (0) ,ecific Conductance 00095 µMhos K - Potassium o0937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L , method # (Ammonia Nitrogen; Ni N: Ammonia Nitrogen. Total) Mn - Manganese o1065 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 ni VOC Removal% at of here:❑ Regional Manager Penniftee (or Authorized AOent) Name anc dwiassiter@ulwater.Com GW -59 Rev. 812013 800-525-7990 UNDWATER QUALITY MONITORING: PLIANCE REPORT FORM or FORM ON YELLOW PAPER ONLY ty Name: Belvedere Plantation it Name (if different): ty Address: 130 Fairway Or Hampstead N.C. 28443 County Pander act Person: Jimmie Hagwood Telephone#: 910-443-0280 Location/Site Name Between Basin B & C No. of wells to be sampled: 9 nrnm Per M DIVISION OF WATER RESOURCES - INFORMATION PROCESSING UNIT 1617 MAIL SERVICE CENTER, RALEIGH, NC 276994617 Phone: 919-807-6306 PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other WELL ID NUMBER (from Permit): MW15 Well Depth: 18 ft. Depth to Water Level 82546: 8 Measuring Point is 3 ft. above land surface Volume of water pumped/bailed before sampling: 5 Samples for metals were collected unfiltered: ❑ YES Date sample collected: 11/4/2016 Well Diameter: 2 in. Screened Interval: 5 ft. to 15 ft. Relative M.P. Elevation: ft. gallons ❑ NO and field acidified: ❑ YES ❑ NO FIELD ANALYSES: pH 00400: 5 units Temp. 0001r 21.6 IC Spec. Cond. 00094: µMhos Odor oo08s: sli g Appearance grey WAS DRY at time of sampling, check here:❑ LABORATORY INFORMATION Date sample analyzed: 11/4/2016 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 0.05 mg/L Pb - Lead o1o51 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 <0.02 mg/L Zn -Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.82 mg/L (Nate: Use MPN method for high"And samples) orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 47 mg/L At -Aluminum 01105 mg/L pH (Lab) 00403 4.96 units Be - Barium 01007 ug/L TOC oo68o mg/L Ca - Calcium 00916 mg/L Chloride oo94o 11 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total olo34 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug1L Fe - Iron o1o45 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) peciffc Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia oo610 <0.2 mg/L Mg - Magnesium 00927 mg/L , method # (Ammonia Nitrogen; NHsas 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: mq/L Effluent Total VOCs: mg/L VOC Removal°/ GW -59A COMPLIANCE REPORT FORM Permit #�J� (Submit one each mmnitoring period n•ith GII -59 (onn j L. ] Enter date monitoring results were due. Will this monitoring report (GIN -89 and GW -59A) YES N9 be submitted after the established due date? �( 2 Was any required information missing on the GW -59 report forms? YES K 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 Arc 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 "Yes ", contact the Regional Officefor guidance. X 4 Are any monitored constituents equal to or above the established standards? YK 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: Mwft7 li/(L 7/YA 3//< f 4w /5 f'4 a 5 For the constituents identified in question 4 above, have standards been exceeded previously for the YES NO same constituents) 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 ff the answer is "YES", a groundwater quality problem maybe occurring. CONTACT THE REGIONAL OFFICE IMMEDIATELY FOR GUIDANCE. ff 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 I "NO", contact the Realonal Office within 90 days: an evaluation may be reaulred M determine the Impact the waste disposal system is havina at the review and compliance boundaries surroundina this facility. Failure to do so may subled 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. 1 Ms1 in this 91 zy,41�,t /0�4 S-= re oty rmly a or Danny Lassiter Regional Manavpr dwlassfter@uiwater.com CNN -59% 12/8/2003 800-525-7990