WQ0002428_Monitoring - 11-2020_20210108 (2)

GW-59A COMPLIANCE REPORT FORM Permit # kJO 000 ZL/ 2 $
(Submit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due. ( /z 3t z ) 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.)? ff 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 constituent(s) and concentration(s)
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, concentration(s) repotted, and sample collection date for each occurrence (for the last two years).
6
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 maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe 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 Noffce of Violation,
fines, and/or penalties.
Z
z � w
w m
p c�CA
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 informationsubmitted in this `
report (Compliance Report GW-59A) is true and complete to the best of my knowledge.
Sio ture of Permittee (or Authorized Agent) Dafte
GW-59A 12/8/2003

SUBMIT FORM ON YELLOW PAPER ONLY
0 •
DEPARTMENT OF ENVIRONMENT &NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0002428 Expiration Date: ;
Facility Name: Mountaire/Mt. Vernon
Non -Discharge X UIC
Permit Name (if different): A4 00,v 1 41 k r
FRAM s
/JC-
NPDES Other
Facility Address: 175 Foust Road
TYPE OF PERMITTED OPERATION BEING MONITORED
Siler City "' NC
27344 County Chatham
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Doug Goodwin
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Mt. Vernon
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
(from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MWJu<
1$
Date sample collected: 11/03/20
FIELD ANALYSES:
WAS
Well Depth: 26.5 ft.
Well Diameter: 2 in.
pH oo400: 6.92 units Temp. 000lo: 17.7 °C
DRY at
Depth to Water Level 82546: 10.6
p ft. below measuring point Screened Interval: ft. to
_ft.
Spec. Cond. 000sa: µ Mhos
time of
sampling,
Measuring Point is 4 ft. above land surface
Relative M.P. Elevation: ft.
Odor 000m:
check
Volume of water pumped/bailed before sampling:
5.00
gallons
Appearance
here: ❑
Samples for metals were collected unfiltered: ❑ YES
0 NO and field acidified: ❑ YES ■❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11/03-09/2020
Laboratory Name: Cameron Testing
Services
Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N oo615
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 6.43
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):
issolved Solids:Total 70300 391
mg/L
Al -Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.00
mg/L
Ca - Calcium 00916
mg/L
Chloride oos4o 36.2
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total o1o34
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 000ss
µMhos
K - Potassium 00937
mg/L
VOC 78732: method # 8260B
Total Ammonia oo610 <0.100
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 Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
J%OUjt4S W IAA cuEgy_ A AtjAGfk
Permittee (or Authorized Agent) Name and Title - Please print or type

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
�16117
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0002428 Expiration Date: k,
Facility Name: Mountaire/Mt. Vernon
Non -Discharge X UIC
Permit Name (if different): Ap U1J`rjr2E
FR2'.S
/A/ C
NPDES Other
Facility Address: 175 Foust Road
TYPE OF PERMITTED OPERATION BEING MONITORED
Siler City "''`'" NC
27344 County Chatham
El Lagoon ❑Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Doug Goodwin
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Mt. Vernon
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-2
Date sample collected: 11/03/20
FIELD ANALYSES:
WAS
Well Depth: 16 ft.
Well Diameter: 4 in.
pH 00000: 6.78 units Temp. 000lo: 18.6 °C
DRY at
Depth to Water Level 82546: 3.8
p ft. below measuring point Screened Interval: ft. to
_ft. Spec. Cond. 000sa: µ Mhos
time of
sampling,
Measuring Point is 1 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085:
check
Volume of water pumped/bailed before sampling:
10
gallons
Appearance
here: ❑
Samples for metals were collected unfiltered: ❑ YES
H NO and field acidified: ❑ YES ® NO
LABORATORY INFORMATION
Date sample analyzed: 11103-09n0
Laboratory Name: Cameron Testing Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 <0.050
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):
issolved Solids:Total 70300 180
mg/L
All -Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oo68o <1.00
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 11.6
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 78732: method # 8260B
Total Ammonia oo610 < 0.100
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 Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
DOUGLAS W GOODY414 #ATCHEfZY MA,4JArnE2
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59
Rev. 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
�11617
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Cleady or Type
PERMIT Number: W00002428 Expiration Date:
Facility Name: Mountaire/Mt. Vernon
Non -Discharge X UIC
Permit Name (if different): AA a wu TR r ¢ E
Fi! QM S
/^1C
NPDES Other
Facility Address: 175 Foust Road
TYPE OF PERMITTED OPERATION BEING MONITORED
Siler City iSlreet) NC
27344
County Chatham
❑Lagoon ❑Remediation: Infiltration Gallery
(Staley
(Lp)
❑■ Spray Field El Remediation:
Contact Person: Doug Goodwin
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Mt. Vernon
No. of wells to be sampled:
4
❑ Water Source Heat Pump ❑ Other:
from Perrnil
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-3
Date sample collected: 11/03/20 FIELD ANALYSES:
WAS
Well Depth: 15 ft.
Well Diameter: 4
in. pH 00000: 6.91 units Temp. 000lo: 17.9 °C
DRY at
Depth to Water Level 82546: 6.9 ft. below measuring point
Screened Interval:
ft. to _ft. Spec. Cond. 00094: µ Mhos
time of
sampling,
Measuring Point is 1 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085:
check
Volume of water pumped/bailed before sampling:
8.50
gallons
Appearance
here:
Samples for metals were collected unfiltered: ❑ YES ❑■
NO and field acidified: ❑ YES
® NO
LABORATORY INFORMATION
Date sample analyzed: 11/03-09/20
Laboratory Name: Cameron Testing Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 1.60
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):
issolved Solids:Total 70300 150
mg/L
All -Aluminum oilo5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.00
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 8.13
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total olo34
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 78732: method # 8260B
Total Ammonia 00610 < 0.100
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 Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
_b4UG(.4t W. 601$-1Wtri 141gTcuF)e�, MAdA6EZ
Pennittee (or Authorized Agent) Name and Title - Please print or type

SUBMIT FORM ON YELLOW PAPER ONLY
�.
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0002428 Expiration Date:
Facility Name: Mountaire/Mt. Vernon
Non -Discharge X UIC
Permit Name (if different):
NPDES Other
Facility Address: 175 Foust Road
TYPE OF PERMITTED OPERATION BEING MONITORED
Siler City ''` "" NC
27344 County Chatham
❑ Lagoon ❑ Remediation: Infiltration Gallery
(a+y) (State)
(" '
❑■ Spray Field ❑ Remediation:
Contact Person: Doug Goodwin
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Mt. Vernon
No. of wells to be sampled:
4
❑ Water Source Heat Pump ❑ Other:
(from Permd)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-4
Date sample collected: 11/03/20 FIELD ANALYSES:
WAS
Well Depth: 17 ft.
Well Diameter: 4
in. pH 000lo: 6.81 units Temp. 000lo: 17.9 °C
DRY at
Depth to Water Level szsas: 6.4 ft. below measuring point Screened Interval:
ft. to _ft. Spec. Cond. 000sa: µMhos
time ofsampling,
Measuring Point is 1 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085:
check
Volume of water pumped/bailed before sampling:
16
gallons
Appearance
here: ❑
Samples for metals were collected unfiltered: ❑ YES
N NO and field acidified: ❑ YES
(] NO
LABORATORY INFORMATION
Date sample analyzed: 11/03-09/20
Laboratory Name: Cameron Testing Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L Pb - Lead o1os1 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 2.22
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):
issolved Solids:Total 70300 234
mg/L
Al -Aluminum oilo5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.00
mg/L
Ca - Calcium 00916
mg/L
Chloride oos4o 9.61
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total o1o34
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) 0 No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method # 8260B
Total Ammonia oo610 < 0.100
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen, NH3as N. Ammonia Nitrogen, Total)
Mn - Manganese olo55
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%
_b`006LAS W. 4040114+r/ 1149G9/FreY /'0r4nl66E2
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.2/2010