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Home My WebLink AboutWQ0040918_Monitoring - 03-2020_20200429GN-Y-59A,001-VIPLLANCE REPORT FORM Perm'! it 4 (SLZb,Vdt one each monitoring period with GVV--59 forms.) j Enter date monitoring results were due. ill this monitoring report (GIN-59 and GW-59A) YES NO be submitted after the established due date . 2 Was any required information missing on the GW-59 report forms? YES O IF the answer to question i 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 -CO 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 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: 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? 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). e>S qce., cw'c o L`�10 Or \,1 6 Are the monitoring wells listed in sectied5 located at qr eyond the review bounds ? YES NO If the answer is "YES", a groundwater quality problem may be 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 th,a waste disposal system is having at the review and compliance boundaries surrounding this facili t Failure to dQ4o may subject the permittee to a Notice of Violation fines, and/or penalties. 141 _s `� A '-n W G -n MAY X 12020 <"7 --4 N 8 The person completing this portion. fGW--59Aj oq monitoring report should sign below and submit this form with GW-59 forms for require(t- wells to the ress provided at the top of the current GW-59 form. t hereby ilhs# f afire s= eked. and the kdonnaikasubmH29d in this mport (CompRance and cmupkta to the best of my Jul. 70 17, 7r 1f- � -a Signature of a i e (o A i Agent) Date �/� GW-59A 12i312003 SUBMIT FORM ON YELLOW PAPER ONLY DEPARTMENT OF ENVIRONMENTAL QUALITY • DIV. OF WATER RESOURCES uROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RA4EIGH, NC 21699.1617 Phone: 919.807.6306 FACILITY INFORMATION Please Print Clearly or Type ` PERMIT NumberWQ00W1 I6xpiration Date: Facility Name: C,, �CQI' �,j� `�c��,\1,1G1`j� Non -Discharge o UIC Permit Name (if different): NPDES Other tnt Facilit Address: LT r C TYPE,OF PERMITTED OPERATION BEING MONITORED S10 1 G "free" �— �. County Lt l Lagoon ❑ Remediation: Infiltration Gallery (State) (zip) P'Spray Field ❑ Remediation: Contact Person: G� �L�'`. C' Telephone#: 3 -� l� - 3`Y�� Rotary Distributor El Land Application of Sludge Well Location/Site Name: VN-\itAl — Sp ('rti i e k(A No. of wells to be sampled: ❑ Water Source Heat Pump ❑ Other: (from Permit) SAMPLING INFORMATION (, pl, ��' ' 3 ` _ If WELL WAS WELL ID NUMBER (from Pe mit): Date sample collected: -U FIELD ANALYSES: � L�, °C DRY at Well Depth: J�ft. Well Diameter: in. pH 0oao0: , units Temp. 000lo:/�+ "J Depth to Water Level ersas:ft. below measuring point Screened Interval: ft. to _ft. Spec. Cond. 00094: µMhos time ofsampling, Measuring Point is ft. above land surface Relative M.P. Elevation: ft. Odor 00085: ' f1 check Volume of water pumped/bailed before sampling: / 6 gallons Appearance lxn W f\ %I—, here: ❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Sr\- O /�---�� t C7_\ ': `II �N( Date sample analyzed:..3- j-1013-��;3 1613-`19,1-fit Laboratory Name: t O ( , Certification No. I / PARAMETERS NOTE: Values should reflect d ssolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o51 ug/L Coliform: MF Fecal 31616 �;;, I /100mL Nitrate (NO3) as N 00620 U c �, mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 "� L/ mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 , mg/L Ca - Calcium 00916 mg/L Chloride 00940 v 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 # Total Ammonia 00610 l mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen, NH3 as N, Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L , method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # GW-59 Rev.05-02-2017 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 Phone: 919.807.6306 FACILITY INFORMATION Please Print Clearly or Type lr PERMIT Number: ,'UJJ'Elration Date: y `' Facility Name: T� Non -Discharge UIC Permit Name (if different): NPDES Other F c ' lity Addresg , 'T �r d G` TYPE OF PERMITTED OPERATION BEING MONITORED \ (street) Ck County (.q ) ;1 Lagoon ❑ Remediation: Infiltration Gallery (State) (zip) �G��(� IF / j {[ C U-8pray Field El Remediation: Contact Person: Cl, l\ Telephone#: 1 ��J /� ❑Rotary Distributor El Land Application of Sludge Well Location/Site Name: fq,�4 No. of wells to be sampled: ElWater Source Heat Pump ❑Other: (from ermil) SAMPLING INFORMATION �7/. i) l�/ I� Date collected: V FIELD ANALYSES: If WELL WAS WELL ID NUMBER (from Permit): sample Well Diameter: in. iL -� units Temp. 000lo: °C 00400: DRY at Well Depth: ft. pH , time of ^ Depth to Water Level 82546: > >S ft. below measuring point Screened Interval: ft. to _ft. ho Spec. Cond. 0009a: µ Mhos sampling, Measuring Point is ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check Volume of water pumped/bailed before sampling: �r gallons Appearance 4 ,� u r f ( here: ❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION '3 9-ao 1 (` Date sample analyzed- �� 3 j 1 �3' �� 3 " 1 Laboratory Name: (\ \1 ((� 0 C, 1 \ �' ((� Certification No. PARAMETERS NOTE: Values should refle t dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1051 uglL Coliform: MF Fecal 31616 C /100mL Nitrate (NO,) as N 00620 mg/L Zn Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 ' i mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): r issolved Solids:Total 70300 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 t mg/L Ca - Calcium 00916 mg/L Chloride 00940 r7 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 # Total Ammonia 00610 < ji, mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen, NH3as N; Ammonia Nitrogen, Total) Mn - Manganese o1o55 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% and Title - Please GW-59 Rev.05-02-2017 Signature of Permittee (or Authorized Agent) 16-` a p 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 Phone: 919.807.6306 FACILITY INFORMATION i PleasePnntCl`arlyorType / II 7 ► �tSl1 PERMIT Numbe 'pfl�91�xpiration Date: UIC Facility Name: r 0 Hi t1 ►'f 1, Non -Discharge Permit Name (if different): NPDES Other Face' Addres : � Ci TYPE OF PERMITTED OPERATION BEING MONITORED i j (street) C 1A County TQ y ► Z-Lagoon ❑ Remediation: Infiltration Gallery (city) (zip) LSpray Field ❑ Remediation: m I �j f(S_tate) Contact Person: ` Cv- l� l c1 y\ r/� t u Q Telephone#: (�/'� t�' l J ❑Rotary Distributor El Land Application of Sludge Well Location/Site Name: M (A) " eJ rA 1 . No. of wells to be sampled: El water Source Heat Pump ElOther: (from Permit) SAMPLING INFORMATION WELL ID NUMBER (from Permit): Date sample collected: 3 - FIELD ANALYSES: r� If WELL WAS Well Depth: 151 ft. Well Diameter: 9N in. pH 00400S units Temp. 00010: i 4 °C DRY at Depth to Water Level 82546: � 1 ft. below measuring point Screened Interval: ft. to _ft. Spec. Cond. 00094: µ Mhos time of sampling, Measuring Point is ft. above land surfaceRelative M.P. Elevation: ft. Odor 000e5: check Volume of water pumped/bailed before sampling: A( allons Appearance F0 here:❑ Samples for metals were collected unfiltered: ❑ YES NO and field acidified: ElYES ElNO LABORATORY INFORMATION - t - 16 - I ) 3 - / 613 - �� Laboratory Name: U 1 �C�� (�(\ Certification No. Date sample analyzed I I ) S ► dissolved PARAMETERS NOTE: Vali6es�d refleof and c6lioidal concentrations. COD 00335 mg/L Nitrite (NOZ) as N 00615 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31515 /100mL Nitrate (NO3) as N oos20 I- mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 mg/L (Note: Use WIN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 V mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC omm 1 a mg/L Ca - Calcium 00916 mg/L Chloride 00940 S 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 # Total Ammonia 00610 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total) Mn - Manganese o1o55 ug/L , method # TKN as N 00525 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% Permitlee (or Authorized Agent) Name and Title - Please dr nt or type Signature of Permitlee (or Authorized Agent) GW-59 Rev.05-02-2017 SUBMIT FORM ON YELLOW PAPER ONLY DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1817 MAIL SERVICE CENTER, RALEIGH, NC 27899.1617 Phone: 919.807.6306 T t Clearly Please Print or Type FACILITY INFORMATION � PERMIT Number(t,, 671ffxpiration Date: y Name: Facility Non -Discharge UIC Permit Name (if different): NPDES Other Fa ility Add r ss: T c TYPE OF PERMITTED OPERATION BEING MONITORED n ), G� (s`feB`) County ( I ® Lagoon ❑ Remediation: Infiltration Gallery (city) (State) (zip /, ce 7 %3-1 E] Spray Field ❑ Remediation: Contact Person: Q Telephone#: U ' j El Rotary Distributor ❑Land Application of Sludge Well Location/Site Name: N,[) ,r't I� No. of wells to be sampled: q ❑ Water Source Heat Pump ❑ Other: (from Permit) SAMPLING INFORMATION If WELL WAS WELL ID NUMBER (from Permit): (" 1 " Date sample collected: Jy FIELD ANALYSES: Well Depth: �ft. Well Diameter: in. pH o0a00:v i � units Temp. 000lo: r� °C DRY at Depth to Water Level 82546: f 1 ft. below measuring point Screened Interval: ft. to _ft. Spec. Cond. 00094: µ Mhos time of sampling, Measuring Point is ft. above land surfaceJ Relative M.P. Elevation: ft. Odor 00085: ��( Gl I� check Volume of water pumped/bailed before sampling: / 0 gallons Appearance - f O(cl f i .G 1 here: ❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO, LABORATORY INFORMATION ,- "] - - ff rJ Date sample analyze ro ��3 - ! �0 13 -1 �� Laboratory Name: (� I �C �' Certification No. PARAMETERS NO VMould resolved a6d colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N oo615 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 .� C r /100mL Nitrate (NO3) as N 00620 Q mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 1 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 / mg/L Al - Aluminum o11os mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC omm t mg/L Ca - Calcium 00916 mg/L Chloride 00940y, l 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 # 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% Permitted (or Authorized Agent) Name and Title - Please print or type GW-59 Rev.05-02-2017 Signature of Permittee (or Authorized Agent) � _ 1-11 a� v (Date)