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Home My WebLink AboutWQ0011360_Monitoring - 11-2020_20210105GW-59A COMPLIANCE REPORT FORM Permit � 3 (Subndt one each Yronitoying perlad with GW-59 fortes.) 1 Enter date monitoring results were due. Will this monitoring report (GW-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 NO 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? -YES 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 c nshtuentfs) and concentra on(s) exceeding standards in the space provided below: ``(� S-. -, 0�] �0 CA1rJ— SDI tin %`A, tht,J S' V� 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, co wentration(s) reported, and sample collecti n date for each occyrrence (for the last two years). ��--�1-1c� �►-�-a� s,t �n;�$ r\-kc\ 5-,r)3 ��-�-ao -�-ao SAS 3-X\k-19 S�(19 sip 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 haying at the review and compliance boundaries surrounding this facility. Failure to do so may subject the permittee to a Notice of Violation fines, and/or penalties. :j _ ' � 8 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. I hereby acknowledge that the above information was evaluated and the information submitted in this report (Compliance Report GW9 �!�,#m--omptete to the best of my knowledge. AS CX Signature of Pe iftee (or Authorized Agent) Date GW-59A 12/812003 i ��o6 cal It-57-18 3 caL 3-1�a0 s121, 3-/C-ao sil . S- ll _ \t- fl - « 8, c s - r� - 11- tl� s, 9 8 - 3 -141- l9 sS 0 1- -- ----- -- - -lq-M s,a8 M. - ao ' Cato tl-�s S'Cl 3 - - --- � SUBMIT FORM ON YELLOW PAPER ONLY 151PARTMMNT OF ENVIRONMENTAL QUALITY • DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM " ' oft MAIDS16M1=1111OMNTER,RALEIGH,NO27a99-1617 FACILITY INFORMATION PleasePnntClea yorrype PERMIT Number 3�OExpiration Date: rj Facility Name: �� q��CG► O c� T Non -Discharge UIC Permit Name (if different): NPDES Other Facility Address: TYPE OF PERMITTED OPERATION BEING MONITORED C 4Z,-2 "-.`:�; C. County KC'3g oon ❑Remediation: Infiltration Gallery " wn 'Spray Field ❑Remediation: \ Contact Person: Telephone#:ql�`a lJ—' i�� ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: -JeXNv on No. of wells to be sampled: ❑ Water Source Heat Pump ❑ Other: from Permit SAMPLING INFORMATION yam' `\ WELL ID NUMBER (from P r it): 1' \W ^ Date sample collected: — olQ FIELD ANALYSES: If WELL WAS ift. / �(� 80C DRY at Well Depth: Well Diameter: in. pH 00400:15i'd units Temp. 000lo: Depth to Water Level s25as: p ��Sft. below measuring point Screened Interval: ft. to ft. Spec. Cond. 000sa: µ Mhos time of Measuring Point is a.s ft. above land surface Relative M.P. Elevation: ft. Odor 000e5: Ul sampling, check Volume of water pumped/bailed before sampling: gallons Appearance � here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: ❑■ YES ❑ NO LABORATORY INFORMATION Date sample analyzed: Laboratory Name: j 0 cl�_e r` Certification No. PARAMETERS NOTE: Values stfould reflect cKsolved andtolloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 S Cal /100mL Nitrate (NO3) as N o0620 (o ` , mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 . mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): Dissolved Sollds:Total 70300 mg/L Al -Aluminum o1105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium 00916 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 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total) Mn - Manganese 01055 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: mg/L Effluent Total VOCs: mg/L VOC Removal% SUBMIT FORM ON YELLOW PAPER ONLY 440AOF ENVIRONMIIIINTAL QUALITY DIV, OF WATER RE80URCE8 GROUNDWATER QUALITY MONITORING: IMIMOItMA'PION P001111IlwalNg UNIT COMPLIANCE REPORT FORM °� �.46iy MAlt,ORVicscENTaR,RALEIGH,NO27090.1617 FACILITY INFORMATION \ CPleasePrint ClearlyorType PERMIT Number: (ration Date: Q — Q �� Facility Name: O�C�(�\ VO�II\T\ �� Non -Discharge U I C Permit Name (if different): NPDES Other Facility Address: TYPE OF PERMITTED OPERATION BEING MONITORED �Vh o'� County 43"Cagoon ❑Remediation: Infiltration Gallery t,.It,� I;'(Cite;) Contact Person: u e k � Telephone#:��`OlU-3�3� y Field ❑Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: No. of wells to be sampled: �� ❑ Water Source Heat Pump ❑ Other: from Permit SAMPLING INFORMATION ,\ 1 WELL ID NUMBER (from P rmit): 1, \W — a Date sample collected: \_�' o Q FIELD ANALYSES: If WELL WAS Well Depth: ft. Well Diameter: � in. //�� pH o0aoa5', 4units Temp. 00010. V � °C DRY at Depth to Water Level 825as: ft. below measuring point Screened Interval: ft. to ft. Spec. Cond. 00094: µMhos time of sampling, Measuring Point is a , ft. above land surface C Relative M.P. Elevation: ft. Odor 000e5: Q check Volume of water pumped/bailed before sampling: V gallons Appearance here: ❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: ❑■ YES ❑ NO LABORATORY INFORMATION _ — O I1-111, —Q,D �(w\ ql ' Date sample analyzed: 1 — �$ . O — Laboratory Name: � r, Certification No. PARAMETERS NOTE: Values should ref( ct dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 rng/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 at h /100mL Nitrate (NO3) as N 00620 S3 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 Q. 3 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300mg/L Al -Aluminum o1105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium oogls mg/L Chloride oosao� S 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 oo937 mg/L VOC 7873 method # Total Ammonia ooslo < C) a mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L , method # TKN as N 00525 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 OIrAR N k�l!I�NVIK M�!NTH► QIJAUTY -DIV OFWATER RNSOURCIS GROUNDWATER QUALITY MONITORING: 111000MtNNA"1` ONiPROCtIIRIIIIIIIIIING UNIT COMPLIANCE REPORT FORM 4�II IIII�II(�Ir��tVltxY CINI�, INgI»tGIH, Nv7ope•ts�� FACILITY INFORMATION r\TyPe Please Pri; ClZ:1 PER MIT Number i 6(5xpiration Date: - - Facility Name: cLk 22 Z CXAX OY1 Non -Discharge UIC Permit Name (if different: NPDES Other Facility Address: TYPE OF PERMITTED OPERATION BEING MONITORED County &L-agoon ❑ Remediation: Infiltration Gallery y Field ❑ Remediation: Contact Person: 1 Telephone#:910-a1&3"Qi - ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: No, of wells to be sampled: _� ❑ Water Source Heat Pump ❑ Other: from Permit SAMPLING INFORMATION WELL ID NUMBER (from er It): ��- Date sample collected: - �- FIELD ANALYSES: If WELL WAS Well Depth: ft. Well Diameter: in. pH 00400: S units Temp. 000io: °C DRY at Depth to Water Level e25as:.s, aft. below measuring point Screened Interval: ft. to Spec. Cond. oo sa: µMhos time of Measuring Point is 1S ft. above land surface Volume S _ft. Relative M.P. Elevation: ft. Odor 00085: sampling, check of water pumped/bailed before sampling: gallons Appearance id here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: ■❑ YES ❑ NO LABORATORY INFORMATION k �- Date sample analyzed: - - k^ - j - - - O 1 Laboratory Name: Es7w\ r(jC Certification No. 11tty--' PARAMETERS NOTE: Values should reflec dissolved and' colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o5i ug/L Coliform: MF Fecal 31616 C, /100mL Nitrate (NO3) as N 00620 3 mg/L Zn - Zinc 01092 mg/L Coliform: IMF Total 31504 /100mL Phosphorus: Total as P 00555 \ j mg/L (Note: Use MPN method for highly turbid samples) issolved Solids:Total 5 S Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): 70300 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC oosso mg/L Ca - Calcium oogis mg/L _ Chloride oosso- 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 oosso mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00525 mg/L Ni - Nickel 01067 ug/L method # t-or Kemealat(on Systems only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% SUBMIT FORM ON YELLOW PAPER ONLY PIEPARTNIIMNT OF i1NVIRONMENTAL QUALITY • DIV« OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: 1NMdItINATIONM01IOCMt111I1/1NOUNIT COMPLIANCE REPORT FORM aair NlAll. I�I�viawlr cibINIElt, RAIIIOH, NG.II1t1991b17 FACILITY INFORMATION Please nyorType PERMIT Number ()Q3q_6piration Date: Q — _PnntCle Facility Name: �� h�e� `.�( (��'� l O C1 Non -Discharge UIC Permit Name (if diffe ent): NPDES Other Facility Address: TYPE OF PERMITTED OPERATION BEING MONITORED AJ C County agoon ❑ Remediation: Infiltration Gallery ay Field El Remediation: Contact Person: ei ee �, I Telephone#:910 Ala- 3161+ ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name. $ " e Q No. of wells to be sampled: —,.U'_ ❑ Water Source Heat Pump ❑ Other: from Penult SAMPLING INFORMATION WELL ID NUMBER Permit):W— S Date — �0 FIELD ANALYSES: If WELL WAS (from Well Depth: �ft. sample collected:1\, Well Diameter: in. pH 00400: r, l units Temp. 00010: 191 1 °C DRY at Depth to Water Level 825as:�_ft. below measuring point Screened interval: ft. to _ft. Spec. Cond. oosao: µMhos time of Measuring Point is a, s ft. above land surface Relative M.P. Elevation: ft. Odor 000s5: C� sampling, check `(\ Volume of water pumped/balled before sampling: gallons Appearance here:❑ Samples for metals were collected unfiltered: N YES ❑ NO and field acidified: 0 YES ❑ NO LABORATORY INFORMATION — — ) k 1— I I _ O Date sample analyzed: — — Rch �\—S—0 11—Q—ac) Laboratory Name: \\� (�jC Certification No. PARAMETERS NOTE: Values should reflect dissolved andlcolioidal concentrations. COD 00335 mg/L Nitrite (NO2) as N oo615 rug/L Pb - Lead 01051 ug/L Coliform: MF Fecal sisis�/100mL Nitrate (NO3) as N ooszo�—s mg/L Zn -Zinc oios2 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 Olt mg/L (Note: Use MPN method for highly turbid samples) issolved Solids:Total Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): 70300 mg/L Al -Aluminum oiio5 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium oogis mg/L Chloride oosao c 3 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 00610 4::::� Q y d mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total) Mn -Manganese oioss ug/L ,method # TKN as N 00625 mg/L Ni - Nickel 01057 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: M IPA(kTMO OPINVRO MNNTA( OVAIITY-DIV OF WATER RESOURCES INMOkdIIATIk�NM ORit'D�IS>ltINQ UNIT' COMPLIANCE REPORT FORM „. ` II+ i M lividi CINTIRt Rill.f�i�ii�l, N4 27094+1017 FACILITY INFORMATION Please Prin�tClearlyorType PERMIT Number (Sxpiration Date: — — Facility Name: �I lee ��Tl Q(\ Non -Discharge UIC Permit Name (if different): NPDES Other Facility Address: ' TYPE OF PERMITTED OPERATION BEING MONITORED t.+AJ C County _ 9? agoon ❑Remediation: Infiltration Gallery ®'Spray Field ❑ Remediation: Contact Person: \_\C 11 v Telephone#: �lb'`� (.� -�- 3 434 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: u 0. No. of wells to be sampled: �� El water Source Heat Pump ❑Other: from Permit SAMPLING INFORMATION /^ WELL ID NUMBER (from Permit): ~��" \p l' r� Date �� T oISJ If WELL WAS sample collected: Well Depth: ft. Well Diameter: FIELD ANALYSES: (p °C DRY at ' in. pH ooaoo: units Temp. 000lo: Depth to Water Level 82546: 2L ft. below measuring point Screened Interval: ft. to Spec. Cond. 00094: µMhos time of Measuring Point is ��ft. above land surface Volume of water before 11� _ft. Relative M.P. Elevation: ft. Odor 00085: `11\ sampling, check pumped/bailed sampling: gallons Appearance I; O� here:❑ Samples for metals were collected unfiltered: ❑0 YES ❑ NO and field acidified: K YES ❑ NO LABORATORY INFORMATION Date sample analyzed: — — — l' —' (�— 6— �^ ` `I_ ,, _ �j Laboratory Name: lU (b _ Certification No. PARAMETERS NOTE: Values should reflect di solved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead 01051 ug/L _ Coliform: MF Fecal 31616 , ,�� /100mL Nitrate (NO3) as N 00620 a `� S mg/L Zn - Zinc 01092 mg/L Coliform: IMF Total 31504 /100mL Phosphorus: Total as P 00665 Q� (� mg/L (Note: Use MPN method for highly turbid samples) issolved Solids:Total Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): 70300 mg/L Al -Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC omm mg/L Ca - Calcium oo916 mg/L Chloride 00940 s 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 00610 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total) Mn - Manganese o1o55 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remealatlon Systems only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% uai Permittee (or th ized Agent) Name and Title - Please print or type GW-59 Rev.06-07-2018 Of (Date)