HomeMy WebLinkAboutWQ0024577_Monitoring - 03-2020_20200506 (2)SUBMIT FORM ON
PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Pdnt Cleady or
,
Facility Name;��
Permit Name (if different):
Fai Address:R„�
Contact Person:
Well Location/Site Name: -1 110,cw ,`e
County
Telephone#: Mi- - /- T—
No. of wells to be sampled:
WELL ID NUMBER (from Permit): Date sample collected: =6
Weil Depth: 00;1 ft. Well Diameter: in.
Depth to Water Level 82546:,#.0 ft. below measuring point Screened Interval: ft. to ft.
Measuring Point is 3 ft. above land surface Relative M.P, Elevation: ft,
Volume of water pumped/balled before sampling: gallons
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES n NC)
;rRn I sera r Ur ENVIRONMENT & NATURAL RESOURCES
VISION OF WATER QUALITY4NFORMATION PROCESSING UNIT
17 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: (919) 733.3221
--RMIT Numberee/adm$77E:xpiration Date:
m-Discharge UIC
IDES Other
rPE Of PERMITTED OPERATION BEING MONITORED
ILag' pon ❑ Remediatlon: Infiltration Gallery
Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
FIELD ANALYSES: WAS
pH oomo: "units Temp. 000io: /J? °C DRY at
Spec. Cond. 00094: µMhos time of
Odor doom: N sampling,
Appearance check
here:
Date sample analyzed: LaboratoryName:
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
. ,
Certification No. L� u X-0
COD 00336 mg/L
Nitrite (NO0 as N oasis
MM/A
Ph - I earl nu.e, -
l:ourorm: IVil- 1-ecal 31616 /100mL
Nitrate (NO3) as N 00620 %� 4.7
-
mg/L
uyn.
Zn - Zinc oto92
. _.
Colfform: /1001nL
tNrm MF Total 3160a
`.., se�'APNiiie'Choi1'for g lyturbi sampiesl •�..,•,.
—
_ Phosph4.ruS;..Tpta).a&, t'Ala6ss -.,., Q..p
�L ..
mg/L
Issolved Solids.Total 70300 �r mg/L
Orthophosphate 70507
Al Aluminum
mg/L
Other (Specify Compounds and Concentration Units):
_
- of tos
mglL
oal
_ _
a ..... 3 r ds units Ba-- Barlum ot0o7 -_ ug/L
TOC ooseo m /gL _ Ca - Calcium nna;a
Chloride.00940, _:._...._ mg/L _ ...
___.. --Arsenic 01002-_ _. ___ ___ ... _
_ _ ag/L. .
Grease and Oils 00562
mg/L
Phenol 32730
^ ug/L
Sulfate oog45
m /L
Specific Conductance 000ss
:Mhos
--Total Ammonia ooslo 4 6�q-
'g/L
(AmroonlaNitrogen; N1-13asN; Amnx"a Mmuen, Total)—
as N Oosz
For Remediatlon'Systems OnIY7Attach Lab ki. )c O inf
d 0
x
Cd - Cadmium o1027 .... _ :.
. _...._ . ., , .... _ _ _ .._ ........_ ..
ug/L
Crom!um' Total 604 _ _
i
_ .
ug/L
Cu - Copper oto42
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Fe - Iron 01046
ug/L (Specify test and method #. ATTACH LAB REPORT.)
H9. MArmUYZ4,
. ._...„l-ab•Reparl,Atterehed'9"""f�"_'YLe"("f)...`❑.,.7N6.("gj._ ...._,� n ,_, ,..
K - Potassium 00937 mg/L VOC 78732: method #
g - Magnesit.rrn oosa7' nr 1L
a method #
a - Manganese otoss -- ug/L -,method #
—14! -Ncke 01067 ---
ug/L method #
lt. Total VOCs: mg/L Effluent Total VOCs:
r:..• --^----�---,---� mg/L VOC Removal%
AITPI I�PTRI�AS
MAY 21 2020
r
TER QUALITY MONITORING:
E REPORT FORM
Name: __&
Name (if different):
Address:
act Person: I
Location/Site
,L ID NUMBER— (f p rmlt):lT-��-�
Depth: ft Date sample collected:
1 to Water Level 8254e: Well Diameter:
ft. below measuring point in.
uring Point Is -�_ ft. above land surface Screened Interval; It. to —ft.
is of water pumped/bailed before sampling:
Relative M.P. Elevation:
les for metals were catiI.. ,....,..__ p..-- gallons ----ft'
or
SUBMIT FORM ON y LO " PAPER ONLY
Telephone#: I . - z
No, of well to be sampled:
=�nn�WtENT OF ENVIRONAgENT 8 NATURAL RESOURCES
"VISION OF WATER gUALiTY-INFORMATION PROCEgg�G UNIT
917 MAIL SERVICE CENTER, RALEIOH, NC 27899d817 Phone; (819) 733�3a21
on-DiERMIscharge
hargeNuma'GIpT r� ? 7 Expiration Date:_ d.
on -Discharge
PDES UIC
Other
(PE OF PERMITTED OPERATION BEING MONITORED
�I goon
❑ Remediation: Infiltration Gallery
r+-ray Field ❑ Remediation:
❑ Rotary Distributor
❑ .1 m.' e..�.___ . - Lend APPIIcatIon of Sludna
FIELD ANALYSES: If WEL
PH 00400: y, iiunits Temp, 00010: WAS
°C DRY at
Spec. Cond. 00094:
Odor 00085; 11Mhos time of
Appearansamppn
a�n,mea: U YES check
uate sample analyzed:---`" ❑ NO here:
PARAMETERS NOTE: Values should reflect dissolved and aolloLaboratory
ab concentrations.ry Name: '— I
COD oo335 �/•P��°?f=Nip" i
Coiiform: MF Fecal 31616 Certification No.
G m9 Nitrite (NOZ) as N oasis
/100mL Nitrate (NO,) as N onI mg/L Pb - Lead 01051
/100m1 Phosphorus: Total as P ooss6 n III cn - zinc o1092
LGee
;- Use MPN metlmd for N�lttxWmg/L
olids Total 7030oOrthophosphate 7oso7 mg/LpH (Lab) 00ao3 -- -. n9/sAI - Aluminum o11o5 MgL Other (Specify Compounds and Concentration Units);
- -
TOC oosso Ba Barium oioo�_�hor e ooTd 94o --- ______,_Ca - Calcium oo9tsmg/L Cd - Cadmium 01027 Arsenicolooz _ ug/L and Otis 00552 Chromium: Total 01034uglLmg/L Cu - Co henol 32730 ug/L Peer 01oa2m /L Sulfate 00945 Fe - Iron oio45 g ORGANICS: (by GC, GC/MS, HPLC)
uctance 0009s mg/LHg - Mercury 719oo ug/L (Specify test and method #. ATTACH__µMhosK -potassium 00937ug/l Lab Report Attached? LAB REPORT,)
mmonia o0510__. G.O.O�L� Nltrogon; IJt h uy N; 77- Nttr�en, To" , - mg/L VOC 78132: ❑ Yes (1) ❑ No (0)
------mg/L — - - Mg - Magnesium ooez7 _ . .
n�glL.. --
method*
Mn - Manganese otos5 - -- -
as_N_oosas - method #
For Remediation Systems Only (Attach Lab Reports); ug/L
Influent Total VOCs: method # _
'- •....._. m91L Effluent Total VOCs:
mg/L VOC Removal%
y-ao-ao
SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: DEPARTMENT OF ENVIRONMENT s NATURAL RESOURCES
COMPLIANCE REPORT FORM DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
1817 MAIL SERCE CENTER, RALEIGH, NC 27699-1617 Phone: (919) 733.3221
FACILITY INFORMATION Please Pnnr CleaAy or Type VI
rr ) PERMIT Number: �77Expiration Date:
Facility Name:
° Non -Discharge UICermit Name (if different). NPDES
=acility Address: �a ( Other
!u TYPEE F PERMITTED OPERATION BEING MONITORED
���'�� •l / �� 'Z 7 5 County /cur? L'7 La oon
;La ❑ Remediation: Infiltration Gallery
J �® Ll7 Spray Field ❑ Remediation:
,ontact Person: Telephone#: � y' . 7.K'_ awe_ ❑ Rotary Distributor Land Application of Sludge
'Veil Location/Site Name: 4�I �� q.,.�°i ��� No. of wells to be sampled: ❑
_ Water Source Heat Pump ❑ Other:
WELL ID NUMBER (from Permit): 3
Date sample collected:
p 3 '%� " �CI
FIELD ANALYSES:
If WELL
Well Depth: � ft.
Depth to Water Level 82546: 3,k ft. below measuring
Well Diameter: in.
pH 00400: units Temp. 000lo: °C
WAS
DRY at
MeasuringPoint is
� ft. above land surface
point Screened Interval: ft.
Relative
to ft.
---
Spec. Cond. 0009a: µMhos
time of
Volume of water pumped/bailed before sampling:
M.P. Elevation:
ft.
Odor 00085: �� °��
sampling,
check
les for metals were collected unfiltered: ❑YES
gallons
g
El NO and field acidified: ❑YES ❑ NO
Appearance
here: El
LABORATORY INFORMATION
Date sample analyzed:
Laboratory Name: �'�J���'��
�� '—
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
' 1
Certification No,
COD 00335 mg/L
Coliform: MF Fecal 31616 ` /100mL
Nitrite (NO,) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Nitrate (NO,) as N 00620 /�
mg/L
2n - Zinc olosz
Coliform: MF Total 31504 /100mL
(Note: Use MPN
Phosphorus: Total as P 00665 �♦� %, mg/L
mglL
method for highty turbid samples)
—
/
issolved Solids:Total 70300 (O
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403_ units
Ba - Barium 01007
TOC 00680 mg/L
Ca - Calcium 00916
ug/L
mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Phenol o 3z73
327
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
ug/L
Sulfate
Fe - Iron oloas
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
mg/L
pecific Conductance 00095 µMhos
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Total Ammonia oo6tt� V., O 4/ mg/L
K - Potassium 00937
Mg - Magnesium 00927
mg/L
VOC 76732: ,method #
(Ammonia Nitrogen, NH, as N; Ammonia Nitrogen, Total)
mg/L
method #
TKN as N 00625 mg/L
Mn - Manganese oio55
ug/L
method #
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%