WQ0000962_Monitoring - 03-2020_20200408

GW-59A COMPLIANCE REPORT FORM Permit # W00000962
(Submit one each monitorhte oeriod with GW-59 fornu. )
1
Enter date monitoring results were due. 4-30-20) Will this monitoring report
Yes
No
(GW-59 and GW-59A) be submitted after the established due date?
X
2
Yes
No
Was any required information missing on the GW-59 report forms?
X
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
Yes
No
or missing cap, missing identification plate, area overgrown, etc.)? Ifthe answer is "Yes",
X
contact the Regional Qice or guidance.
4
Yes
No
Are any monitored constituents equal to or above the established standards?
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:
See Attached Listing
5
For the constituents identified in question 4 above, have standards been
Yes
No
exceeded previously for the same constituent(s) in the same well(s) in the last
X
two ears?
f 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) repotted, and sample collection
date for each occurrence (for the last two years).
See Attached Listing
6
Are the monitoring wells listed in section 5 located at or beyond the review
Yes
No
boundary?
X
If the answer is "YES", a groundwater quality problem may be occurring.
CONTACT THE REGIONAL OFFICE IMMEDIATELYFOR 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
Yes
No
Division involving this groundwater quality problem?
X
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.
Treatment lagoons were closed. Monitoring of groundwater beneath the
former lagoons continues.
g
The person completing this portion (GW-59A) of the monitoring report should
sign below and submit this form with G W-59 forms for required wells to the
address provided at the top of the current G W-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.
�[ 9
lePo
/
SiSi n�f Permittee or Authorized Agent Date

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT& NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Pnnt Cleany or Type PERMIT Number: Expiration Date: 11/30/2021
Facility Name: Culp Ticking Non -Discharge UIC
Permit Name (if different): NPDES Other W00000962
Facility Address: 7209 Highway 158 TYPE OF PERMITTED OPERATION BEING MONITORED
Stokesdale (street) NC 27357 County Guilford ❑ Lagoon ❑ Remediation: Infiltration Gallery
(city) (slate) (zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Miles Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Culp Ticking No. of wells to be sampled: 2 ❑ Water Source Heat Pump Other. Closed LQgoon
LID NUMBER (from Permit): MW-4
Depth: 28 ft.
n to Water Level 82546: 6.17 ft. below measuring point
Luring Point is 0 ft. above land surface
ne of water pumped/bailed before sampling: 2
oles for metals were collected unfiltered: Z YES ❑
Date sample collected: 3/16/2020
Well Diameter: 2 in.
Screened Interval: 18' ft.
Relative M.P. Elevation: 93.95
gallons
NO and field acidified: ® YES
ate sample analyzed: 3/z7/zozo Laboratory Name: Meritech
\RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
to
ft.
26 ft.
COD oo335 mg/L Nitrite (NO3) as N 110615 mg/L
Col'Iform: MF Fecal 31616 /100mL Nitrate (NO3) as N 00620 <0.10 mg/L
Colifonn: MF Total 31504 /100mL Phosphorus: Total as P 00665 mg/L
(Note: Use MPN method forhighly lur wmpmles) Orthophosphate 70507 mg/L
)solved Solids:Total 70300 1030 mg/L Al -Aluminum ollo5 mg/L
PH (Lab) 00403 6.7 units Ba - Barium 01007 ug/L
T00 0068o 2.78 mg/L Ca - Calcium oo916 mg/L
Chloride 00940 162 mg/L Cd - Cadmium o1o27 ug/L
Arsenic 01002 ug/L Chromium: Total 01034ug/L
Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L
Phenol 32730 ug/L Fe -Iron 01045 145000 ug/L
Sulfate oo945 mg/L Hg - Mercury 71900 ug/L
)ecific Conductance 00095 µMhos K - Potassium 00937 mg/L
Total Ammonia 00610 mg/L Mg - Magnesium 00927 mg/L
(Armnone Nitrogen; NH6as N; Ammonia Nitrogen, Total) Mn - Manganese olo55 2370 ug/L
TKN as N oo625 mg/L Ni - Nickel o1oS7 ug1L
For Remediation Systems Only (Attach Lab Reports)
H. Derr Leonhardt II -Authorized Agent
Permittee (or Authorized Agent) Name and Title -Please prim or type
GW-59 Rev. 2/2010
Influent Total VOCs:
mg/L
FIELD ANALYSES:
pH 00400: 6.7 units
Spec. Cond. 00094:
Odor 00085: _
Appearance
Pb -Lead o1051
Zn - Zinc o1092
Temp.
00010: °C DRY at
µMhos time of
Certification No. 165
Other (Specrfy Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? El Yes (1) ❑� No (0)
VOC 78732: , method #
method #
method #
method #
Effluent Total VOCS:
mg/L VOC Removal
check
here: ❑
For Remediation Systems Only (Attach Lab Reports)
H. Derr Leonhardt II -Authorized Agent
Permittee (or Authorized Agent) Name and Title -Please prim or type
GW-59 Rev. 2/2010
Influent Total VOCs:
mg/L
FIELD ANALYSES:
pH 00400: 6.7 units
Spec. Cond. 00094:
Odor 00085: _
Appearance
Pb -Lead o1051
Zn - Zinc o1092
Temp.
00010: °C DRY at
µMhos time of
Certification No. 165
Other (Specrfy Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? El Yes (1) ❑� No (0)
VOC 78732: , method #
method #
method #
method #
Effluent Total VOCS:
mg/L VOC Removal
check
here: ❑

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: Culp Ticking
Permit Name (if different):
Facility Address: 7209 Highway 158
Stokesdale (stet) NC 27357 County Guilford
act Person: Chris Miles Telephone#: [phone]
Location/Site Name: Culp Ticking No. of wells to be sampled: 2
L ID NUMBER (from Permit):
MW-5
Date sample collected:
3/18/2020
Depth: 13.5 ft,
Well Diameter.
2 in.
h to Water Level 82546: 6.42
ft. below measuring
point Screened Interval:
3.5 ft. to 13.5 ft.
curing Point is 0 ft.
above land surface
Relative M.P. Elevation:
96.98 ft.
ne of water pumped/bailed before sampling: 2
gallons
01es for metals were collected
unfiltered:
❑
YES
❑ NO and field acidified: ®
YES
LINO
Ite sample analyzed: 3lz6/zozo Laboratory Name: Meritech
�RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD
00335
mg/L
Nitrite (NO2) as N
00615
mg/L
Coliform: MF Fecal
31616
/100mL
Nitrate (NO3) as N
00620 1.69
mg/L
Coliform: MF Total
$1504
/100ml-
Phosphorus: Total as P
00665
mg/L
(Nate: Use MPN method forhighly Wrbldwmples)
Orthophosphate7o5o7
mg/L
solved Solids:Total
70300 166
mg/L
AI -Aluminum
oil 05
mg/L
pH (Lab)
00403 6.4
units
Be - Barium
01007
ug/L
TOC
00660 <1.0
mg/L
Ca -Calcium
00916
mg/L
Chloride
0094o 22.0
ni
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
Phenol
32730
ug/L
Fe - Iron
01045 939
ug/L
Sulfate
00945
mg/L
Hg - Mercury
71900
ug/L
ecific Conductance
00095
µMhos
K - Potassium
00937
mg/L
Total Ammonia
00610
mg/L
Mg - Magnesium
00927
mg/L
(Ammonia Nitrogen;
Micas N; Ammonia Nitrogen, Total)
Mn -Manganese
01055 116
ug/L
TKN as N
00625
mg/L
Ni - Nickel
olo67
ug/L
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
ENTOF ENVIRONMENT & NATURAL RESOURCES
ISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
7 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]'
'.RMIT Number: Expiration Date: 11/30/2021
n-Discharge UIC
'DES Other W00000962
'PE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon El Remediation: Infiltration Gallery
❑ Spray Field El Remediation:
❑ Rotary Distributor El Land Application of Sludge
❑ Water Source Heat Pump 0 Other: Closed Logoon
FIELD ANALYSES:
pH ooaoo: 6.4 units
Spec. Cord. 00094:
Odor 00085: _
Appearance
Temp. 00010: °C )DRY at
time of
Certification No. 165
Pb -Lead 01051 ug/L
Zn - Zinc 01092 mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? El Yes (1) 0 No (0)
VOC 78732: , method #
method #
method #
method #
Cs:
mg/L Effluent Total VO
H. Derr Leonhardt II -Authorized Agent �f✓ � � �/ //
Pennittee (or Authorized Agent) Name and Title - Please print or type Signature of Permittee (or A orized Agent) (Date)
GW-59 Rev. 212010

Historical Groundwater Monitoring Data
Form GW-59A
Culp Ticking facility
Permit No. WO0000962
standard sampling event sampling event sampling event sampling event sampling event sampling event sampling event units
March, 2020 November, 2019 July, 2019 March, 2019 November, 2018 July, 2018 March, 2018
MW-2
iron
0.3
NS
6.69
NS
NS
1.77
NS
NS
mg/I
manganese
0.05
NS
0,239
NS
NS
0,063
NS
NS
mg/I
TDS
500
NS
43
NS
NS
47
NS
NS
mg/I
chloride
250
NS
11
NS
NS
16
NS
NS
mg/I
nitrate
10
NS
0.2
NS
NS
0.23
NS
NS
mg/I
TOC
10
NS
<1.0
NS
NS
<1.0
NS
NS
mg/I
pH
6.5-8.5
NS
5A
NS
NS
6.2
NS
NS
su
MW-3
Up -Gradient Well
iron
0.3
NS
22.5
NS
NS
25.5
NS
NS
mg/I
0.05
NS
0,603
NS
NS
0.65
NS
NS
mg/I
manganese
TDS
500
NS
11
NS
NS
47
NS
NS
mg/I
chloride
250
NS
1
NS
NS
10
NS
NS
mg/I
nitrate
10
NS
0.78
NS
NS
1.06
NS
NS
mg/I
TOC
10
NS
<1.0
NS
NS
<1.0
NS
NS
mg/I
pH
6.5-8.5
NS
5.3
NS
NS
5.8
NS
NS
su
MW-4
iron
0.3
145
66.3
72.5
211
43.4
85.1
87.1
mg/I
0.05
2,37
2.13
2,32
2.33
2.12
2,21
2.27
mg/I
manganese
TDS
500
1030
907
947
922
908
972
932
mg/I
chloride
250
162
142
95
200
100
85
60
mg/I
nitrate
10
<0.10
0.16
<0.10
<0.10
0.21
0.16
0.13
mg/I
TOC
10
2.78
3.87
5.57
4.38
5.77
10.1
17
mg/I
pH
6.5-8.5
6.7
6.5
6.5
5.3
6.2
6.1
6.6
su

Historical Groundwater Monitoring Data
Form GW59A
Culp Ticking facility
Permit No. WO0000962
standard sampling event sampling event sampling event sampling event sampling event sampling event sampling event units
March, 2020 November, 2019 July, 2019 March, 2019 November, 2018 July, 2018 March, 2018
MW-5
iron
0.3
0.939
0,873
0,394
0.986
2,38
1
0.947
mg]]
manganese
0.05
0,116
0.082
0.036
0,064
0.222
0,118
0,091
mg/I
TDS
500
166
161
161
159
164
213
212
mg/1
chloride
250
22
27
25
20
15
37
37
mg/1
nitrate
10
1.69
2.64
1.57
1.43
3.09
2.14
3.19
mg/I
TOO
10
<1.0
2.88
<1.0
1.1
1.84
<1.0
2.64
mg/I
pH
6.5-8.5
6.4
6.8
6.3
5.4
6.2
6.9
6.4
su
MW-6
iron
0.3
NS
6.33
NS
NS
1.11
NS
NS
mg/1
manganese
0.05
NS
0,125
NS
NS
0.086
NS
NS
mg/1
TDS
500
NS
217
NS
NS
135
NS
NS
mg/I
chloride
250
NS
37
NS
NS
45
NS
NS
mg/I
nitrate
10
NS
2.6
NS
NS
0.97
NS
NS
mg/I
TOO
10
NS
<1.0
NS
NS
<1.0
NS
NS
mg/I
pH
6.5-8.5
NS
5.2
NS
NS
6.4
NS
NS
su
NS -Not Sampled

Client: Culp Ticking
P.O. Box 488
Stokesdale, NC
27357
Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Meritech Work Order # 03182010
Parameters
Total Dissolved Solids
Chloride
Nitrate, Nitrogen
Iron, total
Manganese, total
TOC
pH
Well Depth
Report Date
Date Sample Rcvd
Sample: MW-4 Grab
4/1/2020
3/18/2020
3/18/20
Result Analysis Date Reporting Limit Method
1030 mg/L 3/19/20 10 mg/L SM 2540 C
162 mg/L 3/24/20 0.1 mg/L SM 4500-CI B
<0.10 mg/L 3/18/20 0.10 mg/L EPA 353.2
145 mg/L 3/27/20 0.025 mg/L EPA 200.7
2.37 mg/L 3/26/20 0.005 mg/L EPA 200.7
2.78 mg/L 3/20/20 1.0 mg/L SW846 9060A
6.7 S.U. 3/18/20 1.0 -14.0 S.U. SM 4500-H B
6'2" - 3/18/20 - -
I hereby certify that I have reviewed and approve these data.
Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Chain of Custody Record (COC)
MERITECH INC.
642 Tamco Rd
Reidsville, NC
27320
Sample
Location/ID #
M VII�II
Environmental Laboratories
A Division of Water Technology and Control, Inc.
Phone [phone]
Fax, 1-336-342-1522
Email. wtclab6E belisouth.net
Web Site: www,meritech-labs.com
NEW
Sampling Dates & Times
START END
Comments:
Method oPInV"Lw I-
� uPs
Fed Ex
71 Hand Delivery
Other
win thr;;(��s
Relinquishe i f
Relinquished by:
uislted by:
V I�
Client:
Address:
Attention:
Culp
erson faking Sample (Signature): C
Comp? #of Tests
Grab? Conts,
G TOC (H3PO4)
Fe,MN (w/H2SO4)
NO3,TDS L�
Water Level (p
�t
NPDES #:
Phone:
Fax
Email:
Project:
PO #:
Turn Around I tme�
Std (10 days) 3 5 Day 24 - 48 Hr
Lab Use Only
On pH OK?
Ice? C12 OK?
Lt
ults bP used for regulatory purposes_? � *RUSH work must he approved prior to subrnifitinc� samples.
Dat Time:: Received by: Date: Time:
"ID
- — -- --- - - - Date: Time: IReceived by: Date: Time:
Date:
Time:
at JgJf by;

Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Client: Culp Ticking
P.O. Box 488
Stokesdale, NC 27357
Meritech Work Order # 03182011 Sample: MW-5 Grab
Report Date: 3/30/2020
Date Sample Rcvd: 3/18/2020
3/18/20
Parameters Result Analysis Date Reporting Limit Method
Total Dissolved Solids 166 mg/L 3/19/20 10 mg/L SM 2540 C
Chloride 22.0 mg/L 3/24/20 0.1 mg/L SM 4500-CI B
Nitrate, Nitrogen 1.69 mg/L 3/18/20 0.10 mg/L EPA 353.2
Iron, total 0.939 mg/L 3/26/20 0.025 mg/L EPA 200.7
Manganese, total 0.116 mg/L 3/26/20 0.005 mg/L EPA 200.7
TOC <1.0 mg/L 3/20/20 1.0 mg/L SW846 9060A
pH 6.4 S.U. 3/18/20 1.0 -14.0 S.U. SM 4500-1-1 B
Well Depth 615" - 3/18/20 - -
I hereby certify that I have reviewed and approve these data.
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Chain of Custody Record (COC)
MERITECH INC.
`:..
642 Tamco Rd
Reidsville, NC
27320
Sample
Location/ID #
Environmental Laboratories
A Division of Water Technology and Control, Inc.
Phone [phone]
Fax. [phone]
Email: wtclab(cDbellsouth.net
Web Site: www.meritech-labs.com
Sampling Dates & Times
START END
Comments:
--Method of Shipment: I -
UPS
fed Ex
n Hand Delivery
Other
,: res rlts be used for regulatory purposes?
Yes No
Client
Address:
Attention:
Culp
erson faking Sample
Comp? # of
Grab? Conts.
nature):
Tests Req
G � TOC (H3PO4)
Fe,MN (w/H2SO4
N031TDS „ Ll
G pH
Water Level
PDES #:
Phone:
Fax
Email:
Project:
PO #:
l urn Arouna i lme--
Std (10 days) 3 - 5 Day 24 - 48 Hr
Lab Use Only
On pH OK?
�( Ice? C12 OK?
"hUSI-/ Work muse be approved prior to submitii, i; :.�mples.
Relinquish d b � �p \— T1ime: Received by: Date: Time:
Relinquished by: Date: Time: Received hy: Date: Time:
Relinquished by:
Date:
Time:
a
Time,
JG ;� � b