WQ0024577_Monitoring - 07-2020_20201006

SUBMIT FORM ON
PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
or
Ity Name: ---+
lit Name (if different):
Ity Address:
d
act Person:
Location/Site Name: I
County,
Telephone#:=s
No. of wells to be sampled: -
:rrvc i mrN I ur MVIRONMENT & NATURAL RESOURCES-
VISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
17 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
=RMIT Number' lC�cKU77Expiration
m-Discharge UIC
'DES Other
rPE O_F PERMITTED OPERATION BEING MONITORED
V' gon ❑ Remediation: Infiltration Gallery
Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
WELL ID NUMBER (from Permit): —
Well Depth: ft.
Date sample collected: 7 - ��
FIELD ANALYSES:
WELL
AS
Depth to Water Level
Well Diameter: in.
pH ooao0; units Temp. 000io: °C
at
e25ae:ft. below measuring point
Screened Interval: ft, to
ft. Spec. Cond. 0ooea: µMhos
[DRY
e of
Measuring Point Is � ft. above land surface
Relative M.P, Elevation: ft
Odor 000es:
mpling,
Volume of water pumped/bailed before sampling: gallons'eck
.Samples for metals were collected unfiltered: El YES El NO
and field acidified: ❑YES ❑ NO
Appearance
here:®
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: �.VlJi �PG��l .,K,r� , �' b/©
Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. uJ
COD 00336 mg/L Nitrite (NO,) as N D0615 n,na Ph - I Carl MnC1
U011TOrm: IVII- "Cal 31616 � %!3 I100mL Nitrate (NO3) as N oos2o L(�' mg/L Zn - Zinc o1092 mg/L
Conform: MF Total 31604 _ 'r
/100mL Phospho.I a;..TQ.taf.as, P ome5 .... .. .. L...r.
tNoie;" (lea i4ip15 me'Erod"tor ly samples) Orthophosphate 70507 (I
mg/L Other (Specify Compounds and Concentration Units): 1020
issoived Solids:Total 70300 ! mg/L Al - Aluminum 01105 mg/L
_. pH (Lab)..00403
UI)ItS Ba. 138rIUlT1 01007 ug/L
TOC oosao mg/L C.alciurn_0011e_�
-
Chlodde.00e4o`,, mg/L - Cd-Cadmium 01027 _.__ Ug/L....
Arsenicoiom ug/L Chromium: Totaloios4_._ _... .. ..._._ _
ug/L
Grease and Oils 00562 mg/L Cu - Copper 01042 mg/L ORGANICS: (by ��tZ^SECIi SSING _
Phenol 32730 uglL Fe - Iron 01045 I� �'��
ug/L (Specify test and method #. ATTACH REPORT.)
RT.)
RE
Sulfate oo945 mg/L H..g -
ref
pacific Conductance 00095 j.tMhos K - Potassium 00937 mg/L VOC 78732:
-Total Ammonia ooslo O method #
_- .. •..� . _ �.� ._mg/L Mg = Magns slum rna ±r r7glL method
(Ammonle Nitrogen; NH, as N; Ammonle NIGo@en, Tolsl� Mn -,Manganese1. 01066
.. ._ _ _ ug/L..... _ . method _
-TiFN�s N 00sz5 = mg7L '-19F-NF kel oios7 u
gli.
._..... _ , .method # _
For Remedinon'Systems Only -(Attach Lati Reports): In vent Total VOCs:
mg/L Effluent.Total VOCs: rng/L VOC Removal%

or
County
Telephone#: _ d
No. of wells to be sampled:
L ID NUMBER (from Permit): �
Depth: ¢ Date sample collected:
1 to Water Level 82546: Well Diameter: �ft. below measuring point in,
uring Point is �_ ft. above land surface Well
Interval: h. ie of water pumped/bailed before sampB9n : Relative M.P. Elevation:_ to "'-^-ft.
les for metals were collar+o,a ,...h.__ . ----_gallons -------
ft
VGRO.UNDWATER QUALITY MONITORING:SUBMIT FORM ON YELLOyy_ PAPER ONLY
MPLIANFORT FORM
Name: --C&
Name (if different):
Address: //I
act Person: r
Location/Site
UVISION OF WATER';•RVNmr:NT B NATURAL RESOURCES
4UALITY•INFORMATION PROCESSING UNIT
317 MAIL SERVICE CENTER, RALEIGH, NC 27690-1617 Phone: [phone]
ERMIT Number;,a ??Expiration Date:
on -Discharge
PDES UIC
Other
(PE OF PERMITTED OPERATION BEING MONITORED
&-Lagoon'
ElRemediat(on: Infiltration +❑'6pray Field Gallery
❑ Rotary Distributor El Remediation;
ate ❑Land Application of Sludge
FIELD ANALYSES: If WELL
PH 00400; units WAS
Temp, 00010, % -C DRY at
Spec. Cond. 000sa: µMhos time of
Odor 000ss: j` sampling,
"""gyp U YES (� NO Appearance check pate sample analyzed: here -
PARAMETERS Laboratory Name: `
NOTE: Values should reflect dissolved COD Dosesand colloidal canaentratlons Certification No.•°`.-
Coliform: MF Fecal 3161 mg/L Nltrlte (NO2) as N oosss ��— 'rAl i /,0
rnlifn nne T..._, _ . . /100ML Nitrate (NO;,) as N ons. mg/L Pb - Lead otos,
/100mL Phos ��"rgiL cn - zinc olosz ••���
Ir�om;.. use MPN rmrlud rormry ruArid g phorus; Total as P Doses -
n .-. _ _.._.. _ mg/L
Issolved Sollds:TOtal 70300 Orthophosphate 70507 - rng/L
pH (Lab) oo4D3 mg/L At - Aluminum o1105 mg/L Other (Specify Compounds and Concentration Units):
.. -
_ _ .units _
TO ooeso Ba Barium oioa mg/L
_ — Mg/L Ca Calcium __ ug/L
�TiCor e old 0940 - " - -- pg8is
_ _
_ mg/L, _ ..
Cd - Cadmium 91027- Arsenic olooz . . _ __...
_.. _..
Grease and Oils ooss2 ug/L Chromium: Total o1a34
Phenol 32730 mg/L Cu - Co u9/L
Copper o1042 -
Sulfate 00946 ug/L Fe - Iron 01046 rng/L ORGANICS: b
mg/L ug/L S (y GC, GC/MS, HPLC)
peciftc Conductance 000ss Hg - Mercury 719oo (Specify test and method #. ATTACH LAB REPORT.)
_ Total Ammonia oosj�—_ _ .µMhos K -Potassium Doss? ug/L Lab Report Attached?
(,lmmontoNitrogOn; Ntr,ua N; rlrtltiwm�"d Nlhoge -roiaq melt ._._.__. Mg Magnesium 0osz7 mg/L VOC 7a73z: ❑ Yes ( No (0)
nig/C..
method #1) ❑
Mn - Manganese 000ss .__. .. -
_ ECN_ ..
method # rng/L `- _ ug/L ... _
_--"11= rc a o1os7
For Remedlation Systems Only (Attach Lab Reports): _ od #�
Influent Total VOCs; ug/L
,method#
• .. mg/L Effluent Total VOCs: -
mg/L VOC Removal%
F ,�

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
COMPLIANCE REPORT FORM � DNISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
FACILITY INFORMATION Please Print Clearly or Type 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
Facility Name: �� �, ��, .� - r 2r�! / PERMIT Number: �c77Expiration Date:
Permit Name (if different). Non -Discharge UIC
Facility Address: 1� ;t��,f� NPDES Other
CJ"C/l/ <%cs oG? �� —�► r ' "' ,l�q y TYPE�F PERMITTED OPERATION BEING MONITORED
County—'1�G`'�/P LI La oon
r �.,/� ❑ Remediation: Infiltration Gallery
Contact Person: - ER Spray Field ❑ Remediation:
Telephone#: '
73b'- d? • " � ❑Rotary Distributor Land Application of Sludge
❑ Water
Well Location/Site Name:��� F�� No. of wells to be sampled: p _ .�_ Source Heat Pump ❑Other:
E ID NUMBER (from Permit): 3 Date sample collected: `7 —
�11 Depth: 2_? ft
O Well Diameter: e, in.
pth to Water Level 82546:-7, ft. below measuring point Screened Interval: ft. to ft.
asuring Point is ft. above land surface
Relative M.P. Elevation: ft,
ume of water pumped/bailed before sampling: gallons
'n les for metals were collected unfiltered ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
90RATr1RV IA1CnoKnn•rrr,u _
FIELD ANALYSES:
PH 00400: _6 units
Spec. Cond, 00094:
Odor 00085: 14
Appearance
Temp, 000lo I°C
µMhos
Date sample analyzed:
-
Laboratory Name:
�� "� s
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
Certification No.
COD o0335 mg/L
Coliform: MF Fecal 31616
Nitrite (NOZ) as N 00615
mg/L
Pb - Lead olos1
C / /100mL
Nitrate (NO3) as N 0062'
Q • mg/L
ug/L
Zn - Zinc 01092
Coliform: MF Total 31504 /100mL
(Nola: Use MPN method for highly turbid samples)
Phosphorus: Total as P oosss
f , C
m/L � g
mglL
lissolved Solids:Total 70300_� mg/L
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
pH (Lab) 00403
Al - Aluminum of im
mglL
units
Ba - Barium 01007
ug/L
TOC oo68o mg/L
Chloride 00940 �rt5 mg/L
Ca -Calcium 00916
mg/L
Cd - Cadmium 01027
uglL
Arsenic 01002 ug/L
Chromium: Total 01034
uglL
Grease and Oils 00552 mg/L
Cu C
Phenol 30 327
ug/L
opper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Sulfate 230
Fe -Iron oloas
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
pecific Conductance 00095
mg/L
µMhos
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Total Ammonia ooslo_�
mg/L
K - Potassium 00937
Mg
mg/L
VOC 76732: method #
(Ammonia Nitrogen, NH, as N, Ammonia Nitr gen, Total)
`
-Magnesium 00927
mg/L
method #
Mn - Manganese Gloss
ug/L
,
TKN as N ooszs
mg/L
Ni - Nickel 01067
method #
ug/L
• RfiffrZT110.. •
•
certify that, to the hest of riy knowledge and belief, the information submitted in this report is true. accurate. anc complete and that the lahn-atnn, e, .,...- ..._
DRY at
time of
sampling,
here: ❑