WQ0040918_Monitoring - 07-2020_20200902

GW-59A COMPLLANCE REPORT FORM
Permit *V k00_ 0 9 1 `i?
(Submit orae each ym-r loyi3Ya Pea ;od v!M G-59 f orira.)
1
Enter date monitoring results were due. O Will this monitoring report (GW-59 and GW-59A)
YES
be submitted after the established due date
PNO'-,
2
Was any required information missing on the GW-59 report forms?
YES
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 or missing cap, missing
YES
NO
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?
S
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() and concentration(s)
exceeding standards in the ace provided below:
Mom; - \ C , a w As MQ -- a,y (( \\\C\ MIL— MW � 0
33 3
5
For the constituents identified in question 4 above, have standards been exceeded p. aviously 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, goncentration(s) re orted, and sample collection date for each o currence (for the l st two years).
IV � ��-
�_�_ ace G"O �(\:X-s -�-an r) r)-)-ao «,c� �-�-a s.o I ate
I
��'� MS/ 3_ �- a�
s,
Caw 3 Toc '1-• •1-• 0 33 �
Are the monitoring wells list d in section 5 located at or beyond the review boundary?
a- 3
`�-�
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" ng wells may be improperly
located; contact the Regional Office. \ �N0J38dRawO
7
Is the permittee implementing previously approved & a uired by the Division involving this
YES
NO
groundwater quality problem?4
If the answer to question 7 is "YES", describe those a ions 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 corn H
boundaries surrounding this facility. Failure to do so may subject the permittee to a Notic of lion
fines, and/or penalties.
'A wells Co
w - 3 70 C�i��.11
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 GW-59 form.
I hereby acknowledge that the above information was evaluated and the information submitted in fhis
report (Compliance Report GW 99A) is a complete to the best of my knovAedge.
10 -a o
Signature of Pe ittee (or Authorized Agent) (-k; Date
�,CA
aka
GW-59A 12/8/2003

SUBMIT FORM ON
PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
mease rnnr cieany or
Name:
Name (If different):
Address:. 4
Contact Person:
Well Location/Site Name:
County
Telephone#: t. I ) r '�YB
No. of wells to be sampled: _
Wok Ian 1%pauunulm
ll'1rP�9�T
PERMIT Number()j(piration Date: ZI- j,
Non -Discharge UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
t-Ca'goon ❑ Remedlation: Infiltration Gallery
III -Wray Field ❑ Remedlation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): ��� �"
r
Date sample ~ aC�J
FIELD ANALYSES:
If WELL
WAS
Well Depth: e ft.
collected:,)—
Well Diameter: 1-_ In.
pH o0a0o: t 6 units Temp. 000lo. i °C
DRY at
Depth to Water Level e25ae: I + . below measuring point
'' ft
Screened interval: ft. to ft.
Spec. Cond. 00094: µMhos
time
Measuring Point is ft. above land surface
Relative M.P. Elevation: ft.
Odor 000e5: "'61 T� �!'\ `„_�
sampling,
check
Volume of water pumped/balled before sampling: I(�) gallons
Appearance
here:®
Samples for metals were collected unfiltered: ® YES El NO
and field acidified: IN YES El NO
LABORATORY INFORMATION
Date sample analyzed: _ _,
� & 1"�(�� Laboratory Name:
Certification No.
PARAMETERS NOTE: Val ubs show d reflect fliss6lved and colloidal concentrations.
_
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Collform: MF Fecal 31616 V C7, /100mL
Nitrate (NO,) as N 00620 mg/L
Zn - Zinc 01092 m9 /L
Collform: MF Total 31504
/100mL
Phosphorus: Total as P oo665
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
Issolved Sollds:Total 70300
mg/L
Al -Aluminum 01105
mg/L
pH (Lab) 00403
units
Be - Barium 01007
ug/L
TOC omeo c; 7
mg/L
Ca - Calcium oogle
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
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 000e5
K - Potassium 00937
mg/L
VOC 7873 method #
_µMhos
Total Ammonia ooelo Q
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn -Manganese o1055
ug/L
,method #
TKN as N 00625
mg/L
NI - Nickel 01067
ug/L
method #
For Remedlation Systems Only (Attach Lab Reports): Influent Total VOCs: mp/L Effluent Total VOCs: mo/L VOC Ramnvnls/

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
or
Facility Name:
Permit Name (if d
Facility Address:.
act Person: :
Location/Site Name:
Telephone#: 91`'
No. of wells to be sampled:
PERMIT Number:( , \kO0(t I m `� '3r'F iration Date:
Non -Discharge UIC
V/"Ilylr LI- IIVI VI\IVIP I IVIV f
WELL ID NUMBER (from Permit): "" c Date sample collected: 6 " i� cc
Well Depth: ft. Well Diameter: 1U, in.
Depth to Water Level 8254e: ft. below measuring point Screened Interval: ft. to _ft.
Measuring Point is 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 ❑ NO
911r\Ilan nRgWWnv Fla
)99.d817
IDES Other
'PE OF PERMITTED OPERATION BEING MONITORED
Lagoon ❑ Remediation: Infiltration Gallery
ray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
If WELL
FIELD ANALYSES: WAS
'
pH ooaoa�� units Temp. 00010: , r;,`�C DRY at
Spec. Cond. 000sa: µMhos time ofsampling,
Odor 000s5:-�..\?l'"lwti check
Appearance;, here:
tAGUKAI UKT Irvl-UKMAI (Ury
Date sample analyzed: a - - (�' (t-
l l� ° 1- 4 - Laboratory Name:
j\�11� o3 A �0(\ Certification No.
PARAMETERS NOTE: Values should refract dlssolved a d colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N ooei5
mg/L
Pb - Lead 01051 ug/L
Collform: MF Fecal 31131E °� rv,�'
/100mL
Nitrate (NO3) as N 00620 , ti mg/L
Zn - Zinc 01092 mg/L
Collform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 E mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Sollds:Total 70300 `
mg/L
Al -Aluminum o1105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oomo (
mg/L
Ca - Calcium oosls
mg/L
Chloride 00940 ,,`;
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and 011s 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 ooslo <L c-
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 #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
mg/L Effluent Total VOCs:
mg/L VOC Removal%

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
'
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IVY'i'y�MM�1�iM(�NfIING�iNlT.
���� (,`11�;)���sN�!
COMPLIANCE REPORT FORMfi�itV�p°(�gpf
I►iIrrld�c�roae»�tf�r
FACILITY INFORMATION Please Print Clearly or Type
r r ; __ 4
�Gr�'��
^y.-
PERMIT Number: i) 4,Ooj f piration Date: i'
Facility Name: r , {� �t
r-���. �(�?C���
Non -Discharge UIC
Permit Name (If different):
NPDES Other
Facility Address: L� l-' _ 1�t �>
c]C'`C
TYPE OF PERMITTED OPERATION BEING MONITORED
C' . County
L-Cagoon ❑ Remedlatlon: Infiltration Gallery
°a�'�\ ',
CA� '•�
P�-Spray Field ❑ Remedlatlon:
Contact Person: C �I�
Telephone#:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled:
❑ Water Source Heat Pump ❑ Other:
from P emt
SAMPLING INFORMATION
WELL ID NUMBER Permit): \l\V Y
t r
Date
FIELD
If WELL
WAS
(from
Well Depth: ft.
sample collected:
Well Diameter: In.
ANALYSES: i
pH o040o;•��units Temp. 000lo: t �'� eC
DRY at
Depth to Water Level e2546: _ ft. below measuring point Screened Interval: ft. to
ft. Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point Is ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085: - >, 'L
check
check
Volume of water pumped/balled before sampling: . �`�
allons
Appearance kC-' �"
here:
Samples for metals were collected unfiltered: ® YES
NO and field acidified: ® YES ❑ NO
LABORATORY INFORM TION
Date sample analyzed. - r\-% '�' (bt - N_ t
— � SLaboratory Name: `\li It t aC`I��C_-i� \. Certification No.
PARAMETERS NOTE: Values should reflect diss Ived and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N oo615 mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 G, a /100mL
Nitrate (NO3) as N 00620 ` 1 '� mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P ooes5 mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 mg/L
Other (Specify Compounds and Concentration Units):
Issolved Solids:Total 70300 1 mg/L
Al - Aluminum 01105 mg/L
pH (Lab) 00403 units
Ba - Barium 01007 ug/L
TOC 00680 3') % -_5 mg/L
Ca - Calcium oogia mg/L
Chloride 00940 -f��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 000m µMhos
K - Potassium 00937 mg/L
VOC 7873 method #
Total Ammonia ooelo� mg/L
Mg - Magnesium 00927 mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn -Manganese o1055 uglL
,method #
TKN as N 00625 mg/L
NI - Nickel 01067 ug/L
method #
ror memeaiation Systems Only (Attacn Lap Reports): Influent Total VOCs: mta/L Effluent Total VOCs: ma/L VOC RPmnvalo/

SUBMIT FORM ON YELLOW PAPER ONLY
UNDWATER QUALITY MONITORING:
PLIANCE REPORT FORM
or
Facility Name:°
Permit Name (if different):
Facility Address` 4 Q
act Person:
Location/Site Name: XWk
County
Telephone#:' j 0 0 ,
R
k No. of wells to be sampled
Ir:rrr%t am mimuunuan
►e�p.1e47
PERMIT Number: (At,q 00� )C, xpiration Date: r 3
Non -Discharge` UIC
NPDES Other
TYPEOF PERMITTED OPERATION BEING MONITORED
Lagoon ❑ Remediatlon: Infiltration Gallery
91'Spray Field ❑ Remedlation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
anrvtrutvto IRrUMMA11VIV C� r
WELL ID NUMBER (from Permit): �� Date sample collected: r) — l� � . J
Well Depth: ft. Well Diameter: � In.
Depth to Water Level 82546: ' ft. below measuring point Screened Interval: ft. to ft.
Measuring Point Is ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/balled before sampling: I 0 gallons
Samples for metals were collected unfiltered: OMYES ❑ NO and field acidified: ® YES ❑ NO
FIELD ANALYSES:
pH 00400:1units Temp. 000lo: J } I I °C
Spec. Cond. 00094: µMhos
Odor 000ss:L ""
Appearance
If WELL
WAS
DRY at
time sampling,
check
here:
LABORATORY INFORMATION
Date sample analyzed: -• k, ( r -��1 -
V ri—' Laboratory
Name: i\ \)\` i,1C':Y�� is\
4oldal
Certification No.
PARAMETERS NOTE: Val es sh uld feflect d ssolved and concentrations.
COD 00335 mg/L
Nitrite (NO2) as N oo515 mg/L
Pb - Lead o1o51 u /L
g
Coliform: MF Fecal 31616 .�! �� t /100mL Nitrate (NO3) as N oos2o � � � � mg/L
Zn -Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 o mg/L
(Note: Use MPN method for highly turbid samples)
)issolved Solids:Total 70300 l3 '
Orthophosphate 70507 mg/L
Other (Specify Compounds and Concentration Units):
mg/L
Al -Aluminum o1105 mg/L
pH (Lab) 00403 units
Be - Barium 01007 ug/L
TOC omm 1 mg/L
Ca - Calcium oosle m9 /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
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 o0s10 i . mg/L
Mg - Magnesium 00927 mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese olom
9 ug/L
,method #
TKN as N 00625 mg/L
NI - Nickel 01067 ug/L
method #
For Remedlation Systems Only (Attach Lab Reports): Influent Total VOCs: ma/L Effluent Total VOCs: mn/i Vnc We.,,.,. 10