WQ0004230_Monitoring - 03-2020_20200511

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Ty
pe
Facility Name: kk 9 Ak
Permit Name (if different):
Facility Address: F OC7�V W\r,.t .-r,
?'elephone #I:
Well LocaticN Site Name: _ 1 No. of Wells to be Sampled:
Well Identification Nuniber (from Permit): For Groundwater Treatment Systems
Well Depth: 1 ft. Well Diameter: -k-- in. Check Onc: ❑ Influent (98)
Screened Interval: ft. to ft. ❑ Effluent (99)
Depth to Water Level: y.q,. ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: L ► 15 _ Date sample collected: al ZC 12
Field analysis: pH r1� V Specific Conductance _ uMhos
Temp. _°C, Odor ADDearance
DEPARTMENT OF ENVIRONMENT S NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION GATE:
Non -Discharge
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
__ Lagoon _ Rernediation: Infiltration Gallery
___ Spray Field _ Remedialiion:
_ :: Rotary Distributor __ Land Application of Sludge
_---_ Other.
NOT, : Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
Laboratory Name:�iYaat_�rv�.
Certification No. _�Q
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified
COD mg/I Nitrite (NOZ) amg/I
Coliform: MF Fecal L /100ml Nitrate (NO3) as N I�EZ`� — mg/I
Coliform: MF Total /I00m1 Phnsnhnn tc- Tntni ne P --A
(Note: Use MPN method for highly tug ---id samples)
Dissolved Solids: Total grits mg/I
pH (when analyzed)
units
TOC W - ��—
m
mg/I
Chloride _ S 4
mg/I
Arsenic _
mg/I
Grease and Oils
mg/I
Phenol _
mg/I
Sulfate _
mg/I
Specific Conductance
uMhos
Total Amrrionia
mg/I
TKN as N
mg/I
Orthophosphato ... _
_ mg/I
Al - Aluminum _
mg/I
Ba - Barium
_ mg/I
Ca - Calcium—
_ mg/I
Cd - Cadmium_
mg/I
Chromium: Total
_ mg/I
Cu - Copper
_ _ mg/I
Fe - Iron
_ _ mg/I
Hg - Mercury w
_ mg/I
K - Potassium_
mg/I
Mg - Magnesium
_ mg/I
Mn - Manganese
— ma/I
YES . _ _ NQ1
Ni - Nickel
mg/I
Pb - Lead
mg/I
Zn - Zinc
mg/I
Ammonia "�;:--
�n _�,(� t� mg/I
Other (sr
Mds<aMconcentration
Units)
bfta'EC90N
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No �,� (0)
VOC : method # =
method # =
method # =
GW-59
Signature of Permittee (or Authorized Agent) _ _ (Date)
Rev. 0312-000 - ._ - __. _ _. .-. - -

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: CkL 1>=Ak INP r c
Permit Name (if different):
Well Location/ Site Name: �, No. of Wells to be Sampled:
Weil Identification Number (from Permit): _J�,_ For Groundwater Treatment systems
Well Depth: _ I Y ft. Well Diameter: _k__ in. Check 0ne: ❑ Influent (98)
Screened Interval: ft. to ft. ❑ Effluent (99)
Depth to Water Level: 'S:70 ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P_ Elevation in ft.:
Gallons of of water purn ed/bailed before sampling: j. S Date sample collected3l dl 1.Crl
Field analysis: pH �l�_ , Specific Conductance _
Temp. A�__°C, Odor Appearance
uMhos
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH. NC 27699-1636 Phone: [phone]:
PERMIT #: EXPIRATION DATE:
Non -Discharge Z1T=)�4'j 1 ____. UIC_`-_
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
t''_Flotary Distributor Land Application of Sludge
__ Other. _
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: _
Laboratory Name:
Certification No. L
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified
COD mg/I Nitrite (NO2) �►s _ mg/I
Coliform: MF Fecal _�_ /100ml Nitrate (NO3) as N --S ).n (0 mg/l
Coliform: MF Total /100ml Phosphorus- Tnta1 ac P rnrill
(Note: Use MPN method for highly tug � -id samples)
Dissolved Solids: Total S l (0 mg/I
pH (when analyzed)
units
TOC "::z , t . �
mg/1
Chloride-- u 9
mg/I
Arsenic _
mg/l
Grease and Oils
mg/I
Phenol _
mg/I
Sulfate _
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophospha*n
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium_
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - lron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mq/I
YES _ _ NQl
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia
��.__ _ 0119 mg/I
. �,.. _ , ten
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No ki_ (0)
VOC ; method # =
method # =
method # =
GW-59
Signature of Pemrittee (or Authorized Agent) (Date)
Rev. 03/2-000 , _ � __ .__ _ ._ _

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name:P�� \CKt_ f 1�w c
Permit Name (if different):
Facility. Address:
tCounty e(-Ar_
fun Slate) G-- (Zi
Contact Pero Telephone #!: 3 S q -
Well Location/ Site Name: No. of Wells to be Sampled:
Well Identification Nwr)ber (from Permit): 3 For Groundwater Treatment Systems
Well Depth: r � ft. Well Diameter: �_- in. Check One: ❑ Influent (98)
Screened Interval: ft. to ft. Depth to Water Level: L ft. below measuring point. El Effluent (99)
Measuring Point (M.P.) is: ft, above land surface. Relative M.P_ Elevation in ft.:
Gallons of water pumped/bailed before sampling: j,,L)� Date sample coltected3_2s
Field analysis: pH n, S: , Specific Conductance _ uMhos
Temp. _Lo _°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field
Rotary Distributor
__ Other:
Remediation:
Land Application of Sludge
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
Laboratory Name: E: ' C:' k t`
Certification No. in
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified
COD mg/I Nitrite (NO2) as _ __ mg/I
Coliform: PAF Fecal i /100ml Nitrate (NO3) as N n C) � mg/I
Coliform: MF Total /100ml PhosDhorus: TntAl ac P mnll
(Note: Use MPN method for highly tu+ -id samples)
Dissolved Solids: Total '3 0 ice_
mg/I
pH (when analyzed)
units
TOC (�(e
mg/I
Chloride I
mg/I
Arsenic _
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophospi ;atA .,. _
_ mg/I
Al - Aluminum
mg/I
Ba - Barium
_ mg/I
Ca - Calcium
mg/I
Cd - Cadmium_,
mg/I
Chromium: Total
_ mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium_
mg/I
Mg - Magnesium
_ mg/I
Mn - Manganese
mg/l
YES . — _ N01
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia O tQ-2 mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No _1&2— (0)
VOC method # =
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
� Facility Name:� \CkL CSC 1�w r c
Permit Name (if different):
Facility Address: Eni--"V X n►t y r. 1?,nK
%­ J County ' ,Q)r_
( by) slate) (L
Contact PersO57 ���9Nr C- Telephone #l: _
Well Location/ Site Name: �� No. of Wells to be Sampled: ,
Well Identification Number (from Permit): _ i n For Groundwater Treatment Systems
Well Depth: ft. Well Diameter: -"L—. in. Check One: ❑ Influent (98)
Screened Interval: ft. to it. ❑ Effluent (99)
Depth to Water Level: in t.�t ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water punt ailed before samplingko Date sample collected: 3127, u
Field analysis: pH Specific Conductance _ uMhos
Temp._°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field _ Remediation:
t'_Rotary Distributor __ Land Application of Sludge
— Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
Laboratory Name:
Certification No.
PARAMETERS (Samples for metals were collected unfiltered YES NO
and field acidified
COD
mg/I
Nitrite (NO2) ds ' _
mg/I
Coliform: MF Fecal /100m1
Nitrate (NO3) as N l I
k .? mg/I
Coliform: MF Total
/100m1
Phosphorus: Total as P
mg/I
(Note: Use MPN method for highly tw -id samples)
Orthophospha+A .„_. . _
mg/I
Dissolved Solids: Total
mg/I
Al - Aluminum
mg/I
pH (when analyzed)
units
Ba - Barium
_, mg/I
TOC 3 1 -23
mg/I
Ca - Calcium
mg/I
Chloride I W
mg/I
Cd - Cadmium
mg/1
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
Rev. 0312-000
YES I _ _ NCt1
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia
�_, _ , d �, mg/I
. ��:. _ n ,
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No - (0)
VOC : method # =
method # =
method # =