HomeMy WebLinkAboutWQ0023896_Monitoring - 09-2020_20201109 (2)GW-59A COMPLIANCE REPORT FORM
Permit # WQ0023896
(Submit one each monitoring period with GW -59 forms.) -
I
Enter date monitoring results were due. ( 1 Will this monitoring report (GW-59 and G A)
YES
NO
.
be submitted after the established due date?
X
2
Was any required information missing on the GW-59 report forms?
YES
O
'--+
X
IF the answer to question t or 2 is "YES'; list in the space provided below the weft identification number(s d
explain the problems encountered in obtaining the required information.
z
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.
X
4
_
Are any monitored constituents equal to or above the established st rds?
YES
NO
If the answer to question 4 is "NO", skip to section 8. p
x
If the answer to question 4 is "YES" list the affected wells individually co tituerjnd concentration(s)
exceeding standards in the space provided below.
`
9-10-2020 MW-1 pH 6.0 SULL LU
9-10-2020 MW-3 pH 5.8 SU , � Q2;
9-10-2020 MW-4 Fecal Coliform c
3 colonies/100 ml
a
LL
YES
NO
5
For the constituents identified in question 4 above, have standard en exceed previously for the
same constituent(s) in the same well(s) in the last two years?
+;
x
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, concentrations) reported, and sample collection date for each occurrence (for the last two years).
3-14-2019 MW-I pH 6.04 SU 12-6-2018 MW-3 pH 5.87 SU
6-11-2019 MW-1 pH 5.97 SU 3-14-2019 MW-3 pH 5.64 SU 6-12-2018 MW-3 7 SU
Fecal Coliform
9-13-2019 MW-I pH 5.74 SU 6-11-2019 MW-3 pH 5.48 SU 9-27-2018 MW-4 Fecal Coliform 2lo colonies/1 ru ml
12-10-2019 MW-1 pH 5.5 SU 9-13-2019 MW-3 pH 6.15 SU 12-6-2018 MW -4 Fecal Coliform 7 colonies/100 ml
3-13-2020 MW-1 H 5.9 SU 12- 6-11-2019 MW-4 Fecal Coliform 64 colonies/100 ml
F 10-2019 MW-3 pH 5.6 SU 12-10 2019 MW-4 Fecal Coliform l colonies/100 ml
6-12-2020 MW-1 pH 6.0 SU 3-13-2020 MW-3 pH 5.6 SU
6-12-2020 MW-4 Fecal Coliform I colonies/100 ml
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
X
If the answer is "YES", a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe improperly
located; contact the Regional Office.
See response in 7 below.
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 the waste disposal system is having at the review and compliance
boundaries surrounding this facility Failure to do so may subiect the permittee to a Notice of Violation
fines, andlor penalties. —
Larry Daw of UNC emailed Scott Vinson of DEQ on September 30, 2020 regarding results of groundwater sampling.
g
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
1 hereby acknowledge that the above information was evaluated and the information submitted In this
report (Compliance Report GW-59A) ue and complete to the best of my knowledge.
10 /20
ignatu f Permittee (or A orized Agent) Date
George . Battle, III Vice Chancellor of Institutional Integrity & Risk Management
G W-59.A 12/8/2003
SUBMIT FORM ON YELLOW PAPER ONLY
ROUNDWATER QUALITY MONITORING:
OMPLIANCE REPORT FORM
Name:
Name (if different):
Address:
act Person:
Location/Site Name:
Please Print Clearly or Type
UNC-CH BINGHAM FACILITY
1907 ORANGE CHAPEL CLOVER GARDEN ROAD
County ORANGE
LARRY DAW
DRIP IRRIGATION SITE
Telephone#: 919.96 2.6666
No. of wells to be sampled: 5
PERMIT Number: Expiration Date: 9/30/2020
Non -Discharge WQ0023896 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump R Other: Drip Irrigation
WELL ID NUMBER (from Permit): MW-1 Date sample collected: 9/10/2020
Well Depth: 38 ft. Well Diameter: 2 in.
Depth to Water Level 82546: 33 ft. below measuring point Screened Interval: 23 ft. to 38 ft.
Measuring Point is 2.5 ft. above land surface Relative M.P. Elevation: 522.8 ft.
Volume of water pumped/bailed before sampling: 5 gallons
,Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
FIELD ANALYSES:
pH 00400: 6 units
Spec. Cond. 00094:
Odor 00085:
Appearance
Date sample analyzed: 9-10, 11, 14, 16, 17-2020 Laboratory Name: ENVIRONMENTAL CHEMISTS, INC.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
0.03 mg/L
Coliform: MF Fecal 31616
<1
/100mL
Nitrate (NO3) as N 00620
0.73 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665
0.21 mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
issolved Solids:Total 70300
63
mg/L
Al -Aluminum olim
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680
<0.5
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940
<5
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
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
Total Ammonia 00610
<0.2
mg/L
Mg - Magnesium 00927
mg/L
(Ammonia Nitrogen; NH, as N, Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
Pb - Lead 01051
Zn - Zinc 01092
WAS
Temp. 000lc 183 °C DRY at
µMhos time of
None sampling,
check
Lt Tan/Mild Turbid here:❑
Certification No. 94
ug/L
mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) `� No (0)
VOC 7873 method # SM 6200C
method #
method #
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
GEORGE E. BATTLE, III VC OF INSTITUTIONAL INTEGRITY & RISK MGMT v
Permittee (or Authorized Agent) Name and Title - Please print or type Sign;e of Permittee (or guth6rized Agent)
GW-59 Rev.8/2013
0 / /J ,
SUBMIT FORM ON YELLOW PAPER ONLY
UNDWATER QUALITY MONITORING:
PLIANCE REPORT FORM
ILITY INFORMATION ['tease Nnnt dearly or type
lity Name: UNC-CH BINGHAM FACILITY
nit Name (if different):
lity Address: 1907 ORANGE CHAPEL CLOVER GARDEN ROAD
. r ; r.=, e
County ORANGE
act Person:
Location/Site Name:
LARRY DAW
DRIP IRRIGATION SITE
Telephone#: 919.962.6666
No. of wells to be sampled:
5
PERMIT Number:
Expiration Date: 9/30/2020
Non -Discharge WQ0023896
UIC
NPDES
Other
TYPE OF PERMITTED OPERATION
BEING MONITORED
❑ Lagoon
❑ Remediation: Infiltration Gallery
❑ Spray Field
❑ Remediation:
❑ Rotary Distributor
❑ Land Application of Sludge
❑ Water Source Heat Pump
0 Other: Drip Irrigation
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-3
Date sample collected: 9/10/2020
FIELD ANALYSES:
WAS
Well Depth: 39 ft.
Well Diameter: 2 in.
pH 00400: 5.8 units Temp. 0001c 20.9 °C
DRY at
Depth to Water Level 82546: 6.3 ft. below measuring point
Screened Interval: 19 ft. to 39 ft.
Spec. Cond. 000sa: µMhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: 497.11 ft.
Odor 00085: Mild Sulfur
check
Volume of water pumped/bailed before sampling. 5
gallons
Appearance Mostly Clear
here:
❑
SamDles for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES ❑ NO
Date sample analyzed:
9-10, 11, 14, 16, 17-2020
Laboratory Name:
ENVIRONMENTAL CHEMISTS, INC. Certification No. 94
PARAMETERS NOTE: Values
should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
<0.02 mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616
<1
/100mL
Nitrate (NO3) as N 00620
<0.02 mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665
0.11 mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300
59
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680
1.1
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940
<5
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) Ok No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method # SM 6200C
Total Ammonia 00610
<0.2
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH, 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%
GEORGE E. BATTLE, III VC OF INSTITUTIONAL INTEGRITY & RISK MGMT e -
Permittee (or Authorized Agent) Name and Title - Please print or type Signature ermittee (or Authori d ent) (Date)
GW-59 Rev.8/2013
SUBMIT FORM ON YELLOW PAPER ONLY
•
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIMSmOFWATER RESOURCES -INF'ORMATiONPROCESSING UNIT
COMPLIANCE REPORT FORM
1617MAIL SERVICE CENTER, RALEIgN,NC278884617 Phone:919-807.6306
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: Expiration Date: 9/30/2020
Facility Name: UNC-CH BINGHAM FACILITY
Non -Discharge WQ0023896 UIC
Permit Name (if different):
NPDES Other
Facility Address: 1907 ORANGE CHAPEL CLOVER GARDEN ROAD
TYPE OF PERMITTED OPERATION BEING MONITORED
h"l;_.
County ORANGE
❑ Lagoon Remediation: Infiltration Gallery
�`^`Y) ° -
❑ Spray Field ❑ Remediation:
Contact Person: LARRY DAW
Telephone#: 919.962.6666
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: DRIP IRRIGATION SITE
No. of wells to be sampled: 5
❑ Water Source Heat Pump X Other: Drip Irrigation
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-4
Date sample collected: 9/10/2020
FIELD ANALYSES:
WAS
Well Depth: 60 ft.
Well Diameter: 2 in.
pH 00400: 5.8 units Temp. 000ic 19 °C
DRY at
Depth to Water Level 82546: 19 ft. below measuring point Screened Interval: 25 ft. to
60 ft. Spec. Cond. 00094: E t Mhos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: 512.79 ft.
Odor 00085: None
check
Volume of water pumped/bailed before sampling: 5
gallons
Appearance Mostly Clear
here:❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 9-10, 11, 14, 16, 17-2020
Laboratory Name: ENVIRONMENTAL CHEMISTS, INC. Certification No. 94
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead o1051 ug/L
Coliform: MF Fecal 31616 3 /100mL
Nitrate (NO3) as N 00620 0.21
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 0.07
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 47 mg/L
Al -Aluminum 01105
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC 00680 1.3 mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 <5 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) 1 No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L VOC 7873 method # SM 6200C
Total Ammonia 00610 <0.2 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 /o
.1—
SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (if different):
Facility Address:
Contact Person:
Well Location/Site Name
f-lease f not weany or f ype
UNC-CH BINGHAM FACILITY
1907 ORANGE CHAPEL CLOVER GARDEN ROAD
"" 275�; County
LARRY DAW
DRIP IRRIGATION SITE
ORANGE
Telephone#: 919.96 2.66 66
No. of wells to be sampled: 5
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER RESOURCES •INFORMATION PROCESSING UNIT
1611 MAIL SERVICE CENTER, RALEIGH, NC 37890.1617 : Phone: 919.807.6306
PERMIT Number: Expiration Date: 9/30/2020
Non -Discharge W00023896 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor y❑ Land Application of Sludge
❑ Water Source Heat Pump Yy Other: Drip Irrigation
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-5
Date sample collected: 9/10/2020
FIELD ANALYSES:
WAS
Well Depth: 50 ft.
Well Diameter: 2 in.
pH 00400: 7.5 units Temp. 000lc 18.5 °C
DRY at
Depth to Water Level 82546: 15 ft. below measuring point
Screened Interval: 35 ft. to 50 ft.
Spec. Cond. 00094: (Mhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: 489.95 ft.
Odor 00085: None
check
Volume of water pumped/bailed before sampling: 5
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES ❑ NO
Date sample analyzed:
9-10, 11, 14, 16, 17-2020
Laboratory Name:
ENVIRONMENTAL CHEMISTS, INC. Certification No. 94
PARAMETERS NOTE: Values
should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
<0.02 mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616
<1
/100mL
Nitrate (NO3) as N 00620
<0.02 mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665
0.15 mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300
234
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680
1.1
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940
22
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 # SM 6200C
Total Ammonia 00610
<0.2
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%
GEORGE E. BATTLE, III VC OF INSTITUTIONAL INTEGRITY & RISK MGMT /Q'e�-f/ ol15S
Permittee (or Authorized Agent) Name and Title - Please print or type Signature Permittee (or Auth zed Agent) (Date)
GW-59 Rev.8/2013
SUBMIT FORM ON YELLOW PAPER ONLY
UNDWATER QUALITY MONITORING:
PLIANCE REPORT FORM
FACILITY INFORMATION weaset�nntcteartyorType
Facility Name: UNC-CH BINGHAM FACILITY
Permit Name (if different):
Facility Address: 1907 ORANGE CHAPEL CLOVER GARDEN ROAD
County ORANGE
IContact Person:
Well Location/Site Name
LARRY DAW
DRIP IRRIGATION SITE
Telephone#: 919.962.6666
No. of wells to be sampled:
5
PERMIT Number: Expiration Date: 9/30/2020
Non -Discharge WQ0023896 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump Q,Other: Drip Irrigation
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-6
Date sample collected:
9/10/2020
FIELD ANALYSES:
WAS
Well Depth: 51 ft.
Well Diameter:
2 in.
pH 00400: 6.6 units Temp. 0001c
21 1 °C
DRY at
Depth to Water Level 82546: 19 ft. below measuring point Screened Interval:
36 ft. to 51 ft.
Spec. Cond. 00094:
µMhos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
492.88 ft.
Odor 00085: None
check
Volume of water pumped/bailed before sampling: 5
gallons
Appearance Clear
here: ❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 9-10, 11, 14, 16, 17-2020
Laboratory Name:
ENVIRONMENTAL CHEMISTS, INC. Certification No.
94
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
<0.02 mg/L
Pb - Lead o1o51
ug/L
Coliform: MF Fecal 31616 <1 /100mL
Nitrate (NO3) as N 00620
<0.02 mg/L
Zn - Zinc 01092
mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665
0.16 mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 260 mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC 00680 1.2 mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 19 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) T� No (0)
pecific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method # SM 6200C
Total Ammonia 00610 <0.2
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%
GEORGE E. BATTLE, III VC OF INSTITUTIONAL INTEGRITY & RISK MGMT
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.8/2013