WQ0034102_Monitoring - 11-2020_20210126

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION
Facility Name:
Permit Name (if different):_
Facility Address:
Contact Person:±
Well Location/ Site Name:
x
Please Print Clearly or Type
County , ne—
Telephone #: lg - `7.-
No. of Wells to be Sampled:
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth:.. ft. Well Diameter: ern. Check One: ❑ Influent (9$�
Screened Interval: ft. to ft.
Depth to Water Level; (a El Effluent99_�, below measuring point. � }
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling:Date sample collected: 41- wo
Field analysis: pH , Specific ConductaMhos
Temp. li,2 °C, Odor Ie Appearance _
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non-DischargeU I C
NPDES
LYPE-OF PERMIJIED OPERATION BEING MONITORED
Lagoon
Spray Field
Rotary Distributor
Other:
Remediation: Infiltration Gallery
Remedialion:
Land Application of Sludge
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name:
Certification No.
PEA TE (Samples for metals were collected unfiltered YES
NO and field acidified
COD
mg/I
/1 Cam!
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
L '20 mg/1
Coliform: MF Fecal 0
Coliform: MF Total
/100m1
Phosphorus: Total as
P mg/I
(Note: Use MPN method for highly turbid sa ies)
Dissolved Solids: Total <,1 (
Orthophosphate
mg/l
pH (when analyzed)
mg/I
units
Al - Aluminum
Ba - Barium
mg/f
mg/l
2 t
TOCmg/l
mg/1
Ca - Calcium
Cd -Cadmium
mg/I
9
mg/l
Chloride
Arsenic
Grease and Oils
mg/1
Chromium: Total
mg/l
Phenol
mg/l
Cu - Copper
mg/l
Sulfate
mg/l
mg/I
Fe - Iron
Hg -Mercury
mg/l
mg/I
Specific Conductance
Total Ammonia
uMhos
K - Potassium
mg/l
TKN as N
mg/I
Mg - Magnesium
mg/l
mg/I
Mn - Manganese
mg/l
YES NO)
Ni - Nickel
mg/1
Pb - Lead__
mg/l
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Deport Attached? Yes -(I) No - (0)
VOC - method # _ 7- �r0 F
: method #
method It
C -�-- /Q P q
Permittee (or Authorized Agent) Name and Title - P ebse print or type
�W-s9
FIev. 0312000

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY IWORMATION Please Print Clearly or Type
Facility Name:
Permit Name (if different):
Facility Address:
Contact Person: E&As
Well Location/ Site Name:
a County ,J ne-
Telephone C _.. I9 - `7:'
_ No, of Wells to be Sampled:
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: _ --- &2 0 _ ft. Well Diameter: 2 in. Check One: ❑ Influent (98)
Screened Interval: ft. to ft. ❑ Effluent (99)
Depth to Water Level: - _ft. below measuring point.
Measuring Point (M.P.) is: ft. above land sumaRelative M.P. Elevation in ft.:
c .
Gallons of water pumped/bailed before sampling., Date sample collected:
Field analysis: pH ( - 0 , Specific Conductance uMhos
-- Temp. 1-74 °C, Odor 6 0r75' Appearance _ . ,-A j F_
DEPARTMENT OF ENVIRONMENT A NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge —ULC-014 A UIC
NPDES
TYPE OF PEAMITrED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field
Rotary Distributor
Other:
Rernediation:
Land Application of Sludge
NQTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name: —
Certification No.
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified
COD mg/1 Nitrite (NO2) as N mg
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total /100mI Phosphorus: Total as P 4-CL 9 m /I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/l
PH (when analyzed)
units
TOC
mg/I
Chloride__. I q �
mg/l
Arsenic
mg/l
Crease and Oils
mg/1
Phenol
mg/I
Sulfate
mg/l
Specific Conductance uMhos
Total Ammonia to
mg/I
TKN as N
mg/l
Orthophosphate
mg/1
Al -Aluminum
mg/1
Ba - Barium
mg/l
Ca •- Calcium
mgh
Cd - Cadmium
mg/1
Chromium: Total
mg/l
Cu - Copper
mg/1
Fe - Iron
mg/1
Hg - Mercury
mg/I
K - Potassium
mg/l
Mg - Magnesium
mg/1
Mn - Manganese
mg/1
YES NO)
Ni - Nickel mg/l
Pb - Lead - mg/l
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS. (GC,GC/MS,HPLC)
(Specify test and method #. Attach tab report.)
Report Attached? Yes (1) No (0}
VOC method # =
method # =
: method # =
v+ iypu
GW-59
Rev. 03/2000
;iranature of Permittee (or Authorized Annnt)
(Da

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Prinf Clearly or Type
Facility Name: r7 ylW
Permit Name (if different):
Well Location/ Site Name:
County 4- T
'telephone #: -- - q m- :,,'3 V�
No. of Wells to be Sampled: „T
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: ft. Weil Diameter: in. Check One: ❑ influent (96)
Screened Interval: -�---- ft. to ft. ❑Effluent (99}
Depth to Water Level: C ft. below measuring point.
Measuring Point (M.P.) is:-. r ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: . Lam- Date sample collected: / / �Z©cv
Field analysis: pH -3 � 2- , Specific Co ductance uMhos
Temp. LL °C, Odor 0/7 e Appearance LLr'dR
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1536 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge -WO 005 ,La UIC
NPDES
TYE!E OE PERMITTED OPERATION BEING MONITORED
Lagoon Rernediation: infiltration Gallery
✓ Spray Field Rernediallon:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name:
Certification No.
f'_. ARIA T-E (Samples for metals were collected unfiltered YES NO and field acidified
COD mg/1 Nitrite (NO2) as N mg/1
Coliform: MF Fecal /10(}ml Nitrate (1103) as N mg/1
Coliform: MF Total 4�_ 1 /1norni Phngnhnri TnfaI n,, P / r-) . C-) mnA
(Note: Use MPN method for highly turbid samples}
Dissolved Solids: Total -' mg/l
pH TOCwhen analyzed) units
mg/l
Chloride C)E Ll mg/1
Arsenic mg/l
Grease and Oils mg/I
Phenol mg/I
Sulfate mg/1
Specific Conductance uMhos
Total Ammonia -'- 0 mg/I
TICN as N mg/I
GW-59
Rov. 03/2-000
Orthophosphate
mg/1
Al - Aluminum
mg/l
Ba - Barium
mg/l
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/l
Hg - Mercury
mg/l
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mall
YES NO)
Ni - Nickel
mg/i
Pb - Lead_
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes —(I) No (0)
VOC method # = (0
method # =
method #
fi armiliee or Authorized Agent) Name and Title -Please print r rypa
Signature of Permitlee {o'r Authorized Agent) (Dale)

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORTH!
FA IL TY INFORMATION
Facility Name:
Permit Name (if different): -
Facility Address:
Contact Person:!
Well Location/ Site Name:
Fil
U
Please Print Clearly or Type
County _G.1►_0ne_
T•_.
Telephone #: _ GI t '7-
No. of Wells to be Sampled:
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: / q• ••, ^—ft. Well Diameter: In. Check One; ❑ Influent (98)
Screened Interval: ft. to ft. ❑ Effluent (99)
Depth to Water Level: ft. below measuring point.
Measuring Point (M.P.) is:-z2` ft. above land surface. Relative M.P. Elevation in ft,:
Gallons of water pumped/bailed before sampling: Date sample collected: --Zap-a
Field analysis: pH Z , Specific Con - uctance uMhos
Temp. _ L Z• -C, Odor Appearance (26g 4
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 NEAR, SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge_ I�IG_1�3'%- UiG
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
✓ Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
N TE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name:
Certification No.
PACERS (Samples for metals were collected unfiltered YES NO and field acidified
COD
mg/I
/10om1
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
Coliform: MF Fecal G
Coliform: MF Total
/100ml
Phosphorus: Total as P 0 ._ �:)
mg/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total G I 6D
Orthophosphate
mg/I
� HOwhen analyZd)
mg/I
units
Al - Aluminum
Ba -Barium
mg/I
mg/l
mg/I
Ca - Calcium
mg/I
Chloride
Arsenic
mg/I
Cd - Cadmium
mg/1
Grease and Oils
mg/1
mg/l
Chromium: Total
Cu - Copper
mg/I
mg/I
Phenol
Sulfate
mg/i
Fe - Iron
mg/I
Specific Conductance
mg/1
uMhos
Hg - Mercury
K - Potassium
mg/I
mg/1
Total Ammonia /_j 0
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
YES NO)
Ni - Nickel
mg/I
Pb - Lead_ _�....
_ mg/l
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method C Attach lab report.)
Report Attached? Yes (1) No
VOC method P3
method #
_ method #
- .NEW 1 _
Poll it Uf lypt:
rCyyIYy^�03
�ry //��/�/�
� ev. /2000
M

Analytical Testing Parameters
Client Sample ID NlAiV;4°.G!ab
Sample Matrix: ,x,o, itcriE� {xii
Collected By:
Lab Sample ID: IEvK 23 -C;1
1-1106ress
Collection Date: 11'16i2ft20
9:48
Field Parameters
Result
RL
Units
Dilution
N
Note Prepared
Analyzed
Analyst
NA
Depth
20.0
0.0830
ft
1
Depth to Water Surface
6.00
11/16/20 0948
imp
Gallons purged
ft
1
1V16120 0948
JMP
7.0
gal
1
11/16/20 0948
JMP
SM 2550 B-2010
Temperature, Field
18
0.1
°C
1
11/16/20 0948
JMP
SM 4500-H+ B-2011
pH, Field Test
5.2
1.0
S U
1
11/16120 0948
JMP
Microbiology
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
SM 9222 D-2006
Coliform, Fecal
<1.0
1.0
per 100ml-
1
11/16/20 1443
11117/20 1354
NOT
Inorganics Total
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
EPA 300.0, Rv. 2.1 (1993)
Chloride as CL
10.4
1.00
mg1L
4
11/17/20 1318
11/17120 1318
JDW
Nitrate as N
1.41
0.200
mg/L
4
11/17/20 1318
11/17/20 1318
JDW
SM 2540 C-2011
Total Dissolved Solids
<50.0
50.0
mg/L
1
11/18/20 1322
MT
SM 4500-NH3 G-2011
Ammonia as N
<0.200
0.200
mg1L
1
11/24/20 1651
11124120 1651
JDW
SM 4500-P F-2011
Phosphorus, Total
<0.20
0.20
mglL
1
1112312o 1241
11/23/20 1241
JDW
Analyses Subcontracted to: Microbac
Laboratories Inc., -
Marietta, OH
Inorganics Total
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
SM 5310 C-2011
Total Organic Carbon - TOC
2.30
1.00
mg/L
1
11/23/20 1751
11124/20 1159
DiH
Volatile Organic Compounds by
GCMS
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
EPA 8260E
Acetone
<5.00
5.00
uglL
1
11/25/20 1832
EEA
Nflcr bac L. abo�-a1
2592 Hope Mills Rd I Fayetteville,
NC 28306 1910.864.1920 p I www.microbac.com
Page 3 of 33

*MICROBAC:
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOK0231
!lent Sample ID: �M',V F�2. Grah
Sample Matrix: klnniioring iA'eil
Collected By: 1 oythr
;s
Lab Sample Ib: K€� 02:?`..0
Collection Date: 11/1612020 10:44
S
Field Parameters
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
NA
Depth
20.0
0.0830
ft
1
Depth to Water Surface
8.00
11/16120 1044
JMI'
Gallons purged
ft
1
11/16/20 1044
JMP
6.0
gal
1
11/16/20 1044
JMP
SM 2550 B-2010
Temperature, Field
17
0.1
°C
1
11/16/20 1044
JMP
SM 4500-H+ B-2011
pH, Field Test
6.8
1.0
S.U.
1
11/16/20 1044
JMP
Microbiology
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
SM 9222 D-2006
Coliform, Fecal
<1.0
1.0
per 100mL
1
11/16/20 1443
11/17120 1354
MT
Inorganics Total
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
EPA 300.0, Rv. 2.1 (1993)
Chloride as CL
17.3
1.00
mglL
1
Nitrate as N
1111712o 1405
11/17/20 1405
JDW
<0.200
0.200
mg/L
1
11/17/20 141)5
1111712o 1405
JDW
SM 2540 C-2011
Total Dissolved Solids
156
100
mg/L
2
11I18120 1322
MT
SM 4500-NH3 G-2011
Ammonia as N
10.4
5.14
mg(L
26
11t24120 1934
11/24/20 1934
JDW
SM 4500-P F-2011
Phosphorus, Total
<0.20
0,20
mglL
1
11/23/20 1245
11/23/20 1245
JDW
Analyses Subcontracted to: Microbac Laboratories Inc., -
Marietta, OH
Inorganics Total
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
SM 5310 C-2011
Total Organic Carbon - TOC
5.24
1.00
mg/L
1
11/23/20 1751
11/24/20 1221
DIH
Volatile organic Compounds by
Result
RL
Units
Dilution
Note Prepared
Analyzed
GCMS
Analyst
EPA 8260B
Acetone
<5.00
5.00
ug/L
1
Benzene
11125120 1901
EEA
Bromobenzene
<1.00
1.00
uglL
1
11/25120 1901
EEA
<1.00
1.00
uglL
1
11125l20 1901
EEA
2592 Hope Mills Rd I Fayetteville,
NC 28306 j 910.864..1920 p I www.microbac.com
Page 6 of 33

-V,MICROBAC'
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOK0231
Client Sample ID: %V42,, Grab
Sample Matrix: (vloniiv;ing'+4`eli
Lab SampleID:
Collected B t�or
- DvKOKt-',231-03
Collection Date: 111 6!2020
!(1-29
Field Parameters
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
NA
Depth
15.0
0.0830
ft
1
Depth to Water Surface
6.00
11/16/20 1029
JMP
Gallons purged
ft
1
11/16120 1029
JMP
5.0
gal
1
11116I20 1029
JMP
SM 2550 B-2010
TemPorature, Field
18
0.1
oC
1
11/16/20 1029
JMP
SM 4500-H+ B-2011
PH, Field Test
6.4
1.0
S.U.
1
11116/20 1029
JMP
Microbiology
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
SM 9222 D-2006
Coliform, Fecal
<1.0
1.0
per 100mL
1
11/16/20 1443
11/17/20 1354
NIT
Inorganics Total
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
EPA 300.0, Rv. 2.1 (1993)
Chloride as CL
13.1
1.00
mg/L
1
Nitrate as N
11/17/20 1420
11117/20 1420
JDW
<0.200
0.200
mg/L
1
11/17/20 1420
11/17120 1420
JDVV
SM 2540 C-2011
Total Dissolved Solids
<100
100
mg/L
2
11118120 1322
MT
SM 4500-NH3 G-201t
Ammonia as N
<0.2CO
0.200
mg/L
1
11/24/20 1702
11/24/20 1702
JDW
SM 4500-P F-2011
Phosphorus, Total
0.85
0.20
mg1L
1
11/23/20 1246
11123120 1246
JDW
Analyses Subcontracted to:
Microbac Laboratories Inc., - Marietta, OH
Inorganics Total
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
SM 5310 C-2011
Total Organic Carbon - TOC
2.17
1.00
mg/L
1
1112312o 1751
11/24/20 1242
DIH
Volatile Organic Compounds by
GCM$
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
EPA 8260B
Acetone
<5.00
5.00
uglL
1
Benzene
11/25/20 1931
EEA
<1.00
1.00
uglL
1
Bromobenzene
<1.00
1.00
11125Y20 1931
LEA
ug/L
1
11/25120 1931
LEA
Mmro
a L 4 1 3 t9i
2592 Hope
Mills Rd I Fayetteville,
NC 28306 1 910.864.1920 P I WWW.microbac.com
Page 9 of 33

VMICROBAC.'
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOK0231
Client Sample ID: MW 94, Grab
Sample Matrix: Mon4Qnng Wei!
Collected By: ?o",
ress
Lab Sample ID:KOK-.2.3 -04
_
Collection Date: 11;161202(.1 101�5,
�
Field Parameters
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
NA
Depth
18.0
0.0830
ft
1
11/16/20 1016
imp
Depth to Water Surface
5.00
ft
1
11/16/20 1016
imp
Gallons purged
7.0
gal
1
11116f20 1016
imp
SM 2550 B-2010
Temperature, Field
18
0.1
°C
1
11/16/20 1016
imp
SM 4500-H+ B-2011
pH, Field Test
6.2
1.0
S.U.
1
11116120 1016
JMP
Microbiology
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
SM 9222 0-2006
Coliform, Fecal
<1.0
1.0
per 100mL
1
11/16/20 1443
1111V20 1354
MT
Inorganics Total
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
EPA 300.0, Rv. 2.1 (1993)
Chloride as CL
23.0
1.00
mg/L
1
11/17/20 1435
11/17/20 1435
JDN!
Nitrate as N
<0.200
0.200
mg/L
1
11/17/20 1435
11/17/20 1435
JIM
SM 2540 C-2011
Total Dissolved Solids
<100
100
mg/L
2
11118/20 1322
MT
SM 4500-NH3 G-2011
Ammonia as N
<0.200
0.200
mg/L
1
11/24/20 1704
11/24/20 1704
JDW
SM 4500-P F-2011
Phosphorus, Total
0.37
0.20
mg/L
1
11/23120 1248
11/23120 1248
JDW
Analyses Subcontracted to: Microbac
Laboratories Inc., -
Marietta, OH
Inorganics Total
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
SM 5310 C-2011
Total Organic Carbon - TOC
3.98
1.00
mg/L
1
11/23/20 1751
11/24/20 1302
DIf1
Volatile Organic Compounds by
Result
RL
Units
Dilution
Note Prepared
Analyzed
Analyst
GCMS
EPA 8260B
Acetone
<5.00
5.00
ug1L
1
11/25/20 2001
EEA
Benzene
<1.00
1.00
uglL
1
Bromobenzene
<1.00
1.00??
ug/L
1
11/25/20 2001
ELA
11/25/20 2001
EFA
2592 Hope Mills Rd I Fayetteville, INC 28306 1910.864.1920 p I
www.microbac.com
Page 12 O# 33

G-59A CONIPLIANCE REPORTFORM Perini8 1t;I 1k o 0 3 Lf 10
(Srobnde one each aa�ra�tit+�rara� period d s iih Gif-59 fO�°a��s
j
Enter date monitoring results were due. Will 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
co
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
NO
identification plate, area overgrown, etc.)? If the answer is "Yes". contact tlae Regivrzat Offic'e fnr gttidarace.
4
Are any monitored constituents equal to or above the established standards?
- E 5
NO
If the answer to question 4 is "NO", skip to section B.
If the answer to question 4 is "YES" fist the affected wells individually with constituent(s) and concentration(s)
i
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, concentrations) reported, and sample collection date for each occurrence (for the last two years)
(
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
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 may be 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 the waste disposal system is having at the review and compliance
boundaries surrounding this facility. Failure to do so may subject the Permittee to a Notice of Violation
fines, and/orpenalties.
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.
4abab, ""i attii;ornraedge that tit able iti€brrgattsri *a ic evaluated;'and the rnftrt rtat�att subttaFtterl. t tFt
t ep r r r F pt�rt 1 59 j rs th e a i vrrrplet to tfae:; es,t .f try kndiririedge:'
_-
_
\Agent)
Signature of Permittee (or Authorized IDate
GW-59A I Z `8 2003