WQ0008489_Monitoring - 12-2020_20210122

CW-59A COMPLLA.1"+TCE REPORT FORM Pennit # Wa Qex.1109
(Submit one each monitoring period with GW-59 forms.)
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
If the answer to question 4 is "NO", skip to section 8.
"YFrS" individually with consti[uent�s) and concentration(s)
If the answer to question 4 is list the affected wells
exceeding standards in the space p
i rovided 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 B.
5 is "YES". list in the space provided below, each well with constituent(s) exceeding
If the answer to question
standards, ooncentration(s) reporter, 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 bound ry?
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 "Nib'; 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 surrou Ong this facil►ty. Failure to do so may subiedt the permittee to a Nonce of Violation,
fines andlorpenXItips. �.
n
� z
ND
ar
g
The person completing this portion (G W-59A) of the hilt itoring report should sign below and submit this
form with G W-59 forms for required wells to the address provided at the top of the current G W-59 form.
�_.;....:..9'%�L....._.:....:t-'�::..:i�.
?" �.a: " ' �th t the3atib ''f6' "a 'n,iiVas-'evaluated?an"ci.' `. nfo. ' ati''`ii, iteii .
i(• r a�IcOled9e ?,
/
`r p~F.° .orrm 1 a
or Z�
Signa a of P ittee (or Authonzed Agent) ate
GW-59A 12/82003

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
P/ease Print Clearly or
Facility Name:
Permit Name (if dl
Facility Address:
SUBMIT FORM
Co
'APER ONLY
Contact Person: 3-0S'�7-pff F. SAO(� Telephone#: t5ZZcj 21_. 7 2.2 ,
Well Location/Site Name: pl �(J� Woof). rr)j,)-pp No. of wells to be sampled: qe�
Well Depth: 1 q, 2-1
Screened Interval: 12, L4
Depth to Water Level: 4,35
Measuring Point is 3.0
Gallons of water pumped/bal
from Permit): nn
ft. Well Diameter: 2-- in.
ft. to I ` .2 ft.
ft. below measuring point.
ft. above land surface,
d before sampling:_ 2.,0
WELL WAS DRY.
time of sampling, Check here
Date sample col
DA
PE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedlation: Infiltration Gallery
(Spray Reid Remedlation:
_ Rotary Distributor _ Land Application of Sludge
Water Source Heat Pump
Other
mt � niglL (Total VOC Concentration)
ant mglL (Total VOC Concentration)
Removal
(A
FIELD ANALYS IS: pH Specific Conductance uMhos Date sampleanalyzed:
Temp. °C Odor Appearance Laboratory Name: A) C
Certification No. p
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified YES NO.)
NOTE: Values should reflect dissolved and colloidal concentrations.
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal L
/loom]
Nitrate (NO3) as N p,p(p
mg/I
Coliform: MF Total
/loom]
Phosphorus: Total as P 1,31
mg/I
(Note: Use MPNmethod for highly turbldsamples)
Orthophosphate
mg/1
Dissolved Solids: Total a �.� I
mg/1
A 1- Aluminum
mg/1
pH (when analyzed) ,(o
units
Ba - Barium
mg/I
TOC p , Sn
mg/I
Ca - Calcium
mg/I
Chloride 1 3
mg/l
Cd - Cadmium
mg/I
Arsenic
mg/I
_ Chromium: Total
mg/I
Grease and Oils
mgll
Cu - Copper
mg/I
Phenol
mg/l
Fe - Iron
mg/1
Sulfate
mg/1
Hg - Mercury
mg/1
Specific Conductance
uMhos
K- Potassium
mg/1
Total Ammonia
mg/1
Mg - Magnesium
mg/I
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese
mg/1
TKN as N
mg/I
Rev. 11 /2005
Ni - Nickel m9/1
Pb - Lead mg/I
Zn - Zinc mg/1
Other (Specify Compounds and Concentration Units)
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Report Attached? Yes_(I) No (0)
VOC : method #
method #=
method #=
method #=

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
l
FACILITY INFORMATION Please Print Clearly or Type
PERMIT NoEXPIRATION DATE:
Facility Name: PIN�I W 0o O S 4J W TP
_
Non -Discharge 060 jAq jL UIC
i��
Permit Name (If differ COC�V Q F y&
�—
NPDES
.nt):
Facility Address: /� D. An X 10
(e,n.t) Z7 5'
TYPE OF PERMITTED OPERATION BEING MONITORED
County p[
We p
`✓ Lagoon Remedlation: Inflitralion Gallery
Contact Person: In -SF F. SF�10LZ)E
vt
Telephone#:(2.S7AZ(.-2.2Z-4_
vSpray Reld _Remediation:
-Ply-
Well Location/Site Name: i ) —r p
No. of wells to be sampled:
Rotary Distributor Land Application of Sludge
m °
Water Source Heat Pump
Well Identification Number (from Permit): OOZ `
If WELL WAS DRY
other.
Well Depth: ft. Well Diameter: in.
at time of sampling, Check here
For Remediation System Influent/Effluent Only {Attach Lab Reports.)
Screened Interval: 12,0 ft. to O ft.
Sample is from system:
Depth to Water Level:3r"1p ft. below measuring point:
❑ Influent E3ffluent
Influent mgn.. (Totalvoc concentration)
Effluent- ng/L (Taal voc concentration)
Measuring Point is _ ft. above land surface.
Relative M.P. Elevation in ft.
voc Removal
Gallons of water pumped/balled before sam ling: D
Date sam le collected: U2= I L
FIELD ANALYSIS; pH Specific Conductance
uMhos
Date sample analyzed: Z. o
C
Temp. °C Odor
Appearance
Laboratory Name: U /p0 -
Certification No. Co
PARAMETERS (Samples for metals were collected unfiltered - YES NO and field acidified
YES NO:)
NOTE: Values should reflect dissolved and colloidal concentrations.
mg/I
COD mg/l
Nitrite (NO2) as N
mgA NI - Nickel
Coliform: MF Fecal L / /100mi
Nitrate (NO3) as N 0.6 1+
mg/I Pb - Lead mg/I
Coliform: MF Total Mooml
Phosphorus: Total as P_ p, 0P mg/I Zn - Zinc mg/I `
(Note: Use MPN method for highly turbid samples)
S �( mg/l
Orthophosphate
A 1- Aluminum
mg/I -
mg/l Other (Specify Compounds and Concentration Units)
Dissolved Solids: Total F
pH'(when analyzed) . 5 units
Bat - Barium
►ng/I
TOC , `? A mg/l
Ca - Calcium
mg/I
Chloride mgll.
Cd - Cadmium
mg/I
Arsenic m /1
Chromium: Total
mg/1
Grease and Oils m /l
mg/I
Cu - Copper
Fe - Iron
mg(I
mg/I ORGANICS: (by GC, GC/MS, HPLC)
Phenol
Sulfate mg/I
Hg - Mercury
mg/l (Specify test and method #. ATTACH LAB REPORT.)
Specific Conductance uMhos•
K - Potassium
mg/I Report Attached? Yes_(I) No (0)
_
Total Ammonia L p d 4 mg/I
Mg - Magnesium
mg/I VOC ; method #=
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese
mg/I method #=
-vnr-- KI mn/I
-- method #=
Rev. 1112005

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
'nnt Cleany or type
cilityName: PIIULkf W(Y)ASAA) U)TP
rmlt Name (if different): CDUA;u OF d j fu
cilityAddress: pry'6-y (Oil _
JRl1/i �vi"L�i � t.�" 2rXJ �vu��y 1711y
Ct bee i �
Contact Person *:T sgeM I=. SAICILt=p— Telephone#: (^05,2 92L.-2 2,2-%
Weil Locatlon/Site Name: PJAZO No, of wells to be sampled:
m .rm
Well Identification Number (from Permit): p0 It WELL WAS DRY
Well Depth: /qr" ft. Weil Diameter: 3, in. at time of sampling, Check here
Screened interval: It. to Aft. Sample !s from system:
Depth to Water Level: t� ft. below measuring point. ❑ influent Offluent
Measuring Point is ft, above land surface, Relative M.P. Elevation In ft.
Gallons of water pum ed/balled before sampling: Zi. D Date sample collected: / 2
ERMIT No. 1114 onl) S V g? EXPIRATION DATE:
on -Discharge I J pnO IN 99 UIC
POES t'
YPE OF PERMITTED OPERATION BEING MONITORED
f/ Lagoon _Remedlation:Inflitration.Gallery
t,/ Spray Feld _Remediatiom
Rotary Distributor _Land Application of Sludge
Water Source Heat Pump
Other.
-or Remediation System Influent/Effluent Only (Attach Lab Reports.)
nfluent ng/L (Total VOC Concentration)
9fiuent mg/L (Total VOC Concentration)
/OC Removal %
d� 2
FIELD ANALYSIS: pH . O Specific Conductance
uMhos
bate sample analyze :
C
Temp. °C Odor
Appearance
Laboratory
Name:
L r�
Certification
No.
PARAMETERS (Samples for metals were collected unfiltered
YES NO and field acidified -
YES
NO.)
NOTE: Values should reflect dissolved and colloidal concentrations.
mg/1
COD
mg/I
Nitrite (NO2) as N
mg/I
Ni -Nickel
Coliform: MF Fecal 5
/100ml
Nitrate (NO3) as N 0.51b
mg/l
Pb - Lead mg/I
mgli
Coliform: MF Total
/100ml
Phosphorus: Total as P 4 0. (3!+
mg/I
Zn -Zinc
(Note: Use MPN method for hlghly turbid samples)
`7 S
mg/I
Orthophosphate
A I- Aluminum
mg/I
mg/I
- -
Other (Specify Compounds and Concentration Units)
Dissolved Solids: Total
PH (when analyzed) D
units
Be - Barium
mg/1
TOC [ K�
mg/I
Ca-- Calcium
mg/l
-
Chloride 10
mg/I
Cd- Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/I
mg/I
Cu - Copper
Fe - Iron
mg/I
mg/I
ORGANICS: (by GC, GC/MS, HPLC)
Phenol
mg/I
Hg - Mercury
mgll
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate
Specific Conductance
uMhos
K- Potassium
mg/I
Report Attached? Yes (1)'No (0)
Total Ammonia L p, ep�f
mg/I
Mg - Magnesium
mg/I
VOC : method #=
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese
mg/I
method #=
: method #_
TKN as N
. m9/l
: method #=
Rev. 11 /2005

SUBMIT FORM ON YELLOW PAPER ONLY
FACILITY INFORMATION - . Please Print Clearly or Type "PERMIT
No. RAT DATE:
Facility Name: P(N�Y ( oba
1
LAAJTP
Non•Dlscharge lllC
Permit Name (if differ n : pUIU
NPDES
Facility Address: -u• O
(stre.p
c�t,lJR
ty Coun(•{ E
YQ
TYPE OF PERMITTED OPERATION BEING MONITORED
� � °T 8
p
Lagoon Remediaton: Infiltration Gallery
e
�sffContact Person`. 3Q5Ci� F. SAOL�Q
Telephone#: ��^��
Spray Feld _Remediation:
Land Application of sludge
Well Location/Site Name:._rlN a/ lt�bptlS
t4,W TP
No. of wells to be sampled:
Rotary Distributor
Water Source Heat Pump
Well Identification Number (from Permit): CIO
if WELL WAS DRY
Other:
Well Depth: Well Diameter
jn.
at time of samPlln9 Check here
For System Influent/Effluent Only (Attach tab Reports)
Screened Interval: 3 ft. to `S ft.
Sample !s iipm system:
❑went [&ffluent
Remediation
Influentrrg1L(TotalVocconcentration)
Depth to Water Level:5":0o ft. below measuring point.
Effluent mg1L (Total voc concentration)
Measuring Point is 3 ft. above land surface.
Relativ§'M.P.`Elevation in ft.
1'
voc Removal / '
Gallons of water pumpedlbailed before sampling:
Date sample collected:
FIELD ANALYSIS: pH ' Specific Conductance
°C
Umhos
Date sample analyzed:
Laboratory Name: N) '
Temp. Odor
-
Appearance
Certification No.
PARAMETERS (Samples for metals were collected unfiltered YES NO and'field acidified
YES NO.)
NOTE: Values should reflect dissolved and colloidal concentrations,
mg/l
COD
mg/I
Nitrite (NO2) as N
mg/l Ni - Nickel
mg/I
Coliform: MF Fecal q
/1 ooml
Nitrate (NO3) as N (�� 6
mg/l Pb -Lead
mg/l
Coliform: MF Total
/100m1
Phosphorus: Total as P O.O%
rn9/I Zn -Zinc
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mgll
mg/I Other (Specify Compounds and Concentration Units)
Dissolved Solids: Total
mg/I
A I- Aluminum
mg/l
pH (when analyzed) I
units
Ba - Barium
mg/l
TOC 1 r etc
mg/l
Ca - Calcium
Chloride
mg/I
Cd - Cadmium
m9/I
Arsenic
mg/l
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu -Copper
mg/I -
mg/I ORGANICS: (by GC, GC/MS, HPLC)
Phenol
mg/I
Fe -Iron
mg/I (Specify test and method #. ATTACH LAB REPORT.)
Sulfate
mg/1Fe
uMhos
-Mercury
K - Potassium
mg/I Report Attached? Yes (1) No (�)
Speolfic Conductance
mg/l
Mg - Magnesium
mg/I VOC : method #_
Total Ammonia (' Q
(Ammonia Nitrogen; NH3 as N: Ammonia Nitrogen, Total)
Mn - Manganese
mg/l :method #_
; method #=
TKN as N
mg/1
method #_
® using approved methods of analysis by. a ivorin uat onna uvvu (iul ii-Py �` uv � �u .0 , .• r : � : - _ _ _. _ _
GW-59
Rev. 11 /2005

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:•
COMPLIANCE REPORT FORM
or
Name:
Name (if t
Address:
act Person: Seel-i S14 f) Lan Telephone#: q 26— ZZ.Z 44
Locatlon/Site Name: PIJV421 Wp(,)nq 'I,() (A) TiP- No. of wells to be sampled:
m a°n
Identification Number (from Permit): If WELL WAS DRY
Well Depth: IS ft. Well Diameter: 2 in.
Screened interval: ft. to JC-ft.
Depth to Water Level: q It. below measuring point.
Measuring Point is—LLOA ft. above land surfs5,
Gallons of water pumped/bafled before sampling: jo
pH ­6--, 1— Specific G
Temp. aC Odor
at time of sampiing, Check here
Sample Is from system:
❑ Influent [
Relative M.P. Elevation In
Date sample collected:
uMho
Appearance
i OF PERMITTED OPERATION BEING MONITORED
_Lagoon Remedlatlon: inflitration Gallery
—Spray Feld _ Remediation:
—Rotary Distributor _ Land Application of Sludge
—Water Source Heat Pump
Other.
Remediation System Influent/Effluent Only (Attach Lab Reports.)
nt rrg/L (Total VOC Concentration)
tnt mg/L (Total VOC Concentration)
Removal/6
Date sample analyzed:
Laboratory Name: = INC,
Certification No. in
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified YES NO.)
NOTE: Values should reflect dissolved and colloidal concentrations.
COD
mg/I
Nitrite (NO2) as N
mgA
Coliform: MF Fecal
L /
/100ml
Nitrate (NO3) as N O , L� Z
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P o,07
mgA
(Nate: Use MPNmethod for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total
2 Z
mg/I
A i- Aluminum
mg/I
pH (when analyzed)
g ; (
units
Ba - Barium
mg/I
TOC
/ (o. Z L(
mg/I
Ca - Calcium
mgA
Chloride
mgA
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mgA
Grease and Oils
mg/1
Cu - Copper
mgA
Ni - Nickel mg/I
Pb - Lead mgA
Zn - Zinc mg/I
Other (Specify Compounds and Concentration Units)
Phenol
mg/I
Fe - Iron
mg/I
ORGANICS: (by GC, GC/MS, HPLC)
Sulfate
mg/I
Hg - Mercury
mgA
(Specify test and method #. ATTACH LAB REPORT.)
Specific Conductance
uMhos
K - Potassium
mg/1
Report Attached? Yes (1) No (0)
Total Ammonia 0 4
mg/I
Mg - Magnesium
mg/I
VOC : method #=
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese
mgA
: method #=
TKN as N
mg/I
: method #=
method #=
GW-59
Rev. 11 /2005
I CnAV OF HUE
nE
emu ee ldl\Authorized Agen me
Signature of rmttte (or Authorized Agent)
OI'//9 /Z

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
or
Facility Name:
Permit Name (If c
Facility Address:
SUBMIT FORM ON YELLOW PAPER ONLY
•v/ %v..ma1 %cry/ J
Contact Person: to utpa Telephone#: S2a C12J-- 2-12- f
Well Location/Site Name: r/(J/=Y l i)[]o�S No, of wells to be sampled: 11
m.snn)
Well Identification Number (from Permit): Oole if WELL WAS DRY
Well Depth: [ S ft. Well Diameter: 2, in. at time of sampling, Check here .
Screened Interval: 3 ft. to Is' ft. Sample is from system:
Depth to Water Level: 3,(05' ft. below measuring point. ❑ Influent fnuent Influent ng1L (Total VOC copcentration)
Measurin Point IS Effluent mglL (Total VOC Concentratlon)
g 3 ft. above land surface. Relative M.P. Elevation In ft. VOC Removal
Gallons of water pumped/balled before earn ling: . 3 Date sample collected' l
FIELD ANALYSISd pH !S,t7 Specific Conductance uMhos " Date sample analyzed: '�
Temp. °C Odor Appearance Laboratory Name:
Certification No.
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified YES NO.)
NOTE: Values should reflect dissolved and colloidal concentrations.
COD mg/I Nitrite (NO2) as N mg/I Ni - Nickel
Coliform: MF Fecal 4 /100ml Nitrate (NO3) as N Z,6�{ mg/1 Pb - Lead
Coliform: MF Total /100ml Phosphorus: Total as P co,O�J, mg/I Zn Zinc
h
WG cloosgg9 EXPIRATION DATE:
L4Q oa[ 2%4g4 UIC
YPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedlation: Infiitretlon Gallery
1/ Spray Fleig Remedlation:
Rotary Distributor _Land Application of Sludge
Water Source Heat Pump
Other,
mg/I
mg1I
mg/I
(Note: Use MPN method for highly turbid samples)
`f 6
Orthophosphate
Dissolved Solids: Total
mg/I
A I- Aluminum
mg/I
Other (Specify Compounds and Concentration Units)
pH (when analyzed) 376
units
Be -,Barium
mgll
TOC , j R
mg/I.:.
Ca - Calcium
mg/I
Chloride q
mad
Cd - Cadmium
mg/l
Arsenic
mg/I
Chromium: Total
mg/l
Grease and Oils
mg/I
Cu - Copper
mg/i
Phenol
mg/l
Fe - Iron
mg/I
ORGANICS: (by GC, GC/MS, HPLC)
Sulfate
mg/I
Hg - Mercury
mg/I
(Specify test and method #. ATTACH LAB REPORT.)
Specific Conductance
uMhos
K - Potassium
mg/I
Report Attached? Yes (1); Nci (0)
Total Ammonia O,p $
mg/I
Mg - Magnesium
mg/I
VOC : method #=
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese
mg/I
: method #=
TKN as N
mg/I
: method #=
O/ Z f
GW-59 Signaturqy
Perm a (or Authorized Agent) (Date)
Rev. 1112005

_SUBMIT FORMON YELLOWPAPER •
GROUNDW-"Ijgr
.x�•,�,,�c �S'o c r A !l"tV{ { _
Ell
ffiMail original and
CO t0QUALITY.OORt4�t
'.
'
.Aw+. GY'+"'i. �;
��� .A. • �' - . ,'; 6+,,fit^ .
. ...._-...... _ __.._. _ . --'—"—Please all .—— -
yor
PIN 1/0. • • •i.r
a e I i ere
FacllityAddress:
Arj ^ C.
$$S'
County J� �'tiL
TYPE OF PERMITTED OPERATION BEING MONITORED
a e ! a
Lagoon Remediatlon: Inflitration Gallery
Contact Person: —J�C= pht ram, 10C-,p
Telephone#: ZS2)qA. -Z,7 2-4
[% Spray Flair, Remediation:
Welf Location/Site Name: 1pU�JS
W LoTP
No, of wells o be sampled:
Rotary Distributor _Land Application of Sludge
Water Source Heat Pump
other.
Well Identification Number (from Permit): 007 If WELL WAS DRY
Well Depth: � ft. Well Diameter:_�In.
at time of samplin, Check here g
For Remediation System Influent/Effluent Only (Attach Lab Reports)
Screened interval: ft. to IS' ft, Sample is from system:
Depth to Water Level:3.65' ft. below measuring point.
❑ influent Dffluent
influent rrg/L (TotalVOC concentration)
Measuring Point is ft, above land surface.
Relative M.P. Elevation In ft,
Effluent mglL (rout voc concentration)
Gallons of water pumped/balled before sampling:-
6 •3
Date sample collected:
VOC Removal /
FIELD ANALYSIS: pH 54-Specific Conductance
uMhos
Date sample analyzed:
Temp. °C Odor
Appearance
Laboratory Name: G V IROYMCA) TINC
Certification No. O
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified
YES NO.)
NOTE: Values should reflect dissolved and colloidal concentrations.
Cob
mg/1
Nitrite (NO2) as IN
mg/I Ni - Nickel mg/I
Coliform: MF Fecal
/100m1
Nitrate (NO3) as N �O �>
mg/1 Pb - Lead mg/l
Coliform: MF Total
/100ml
Phosphorus: Total as P C Ong - mg/I Zn - Zinc mg/I
(Note: Use MPN method fa highly lurbldraemples)
Dissolved Solids: Total S ;t 4
-
mg/1
Orthophosphate
A I- Aluminum
mg/i
mg/I Other (Specify Compounds and Concentration Units)
PH (when analyzed) S, 3
units
Be - Barium
mgli
TOC 1 l R .�
rq it
Ca - Calcium
mg/l
Chloride g
mg/I
Cd - Cadmium
mg/I
_
Arsenic
_
mg)1
Chromium: Total
mgll
Grease and Oils
_
mg/1
Cu - Copper
mg/I
Phenol
mg/i
Fe - iron
mg/1 ORGANICS: (by GC, GC/MS, HPLC)
Sulfate
mg/i
Hg - Mercury
mg/I (Specify test and method #. ATTACH LAB REPORT.)
Specific Conductance
uMhos
K - Potassium__
mg/I Report Attached? Yes (1) No (0)
Total Ammonia C�. `l
mg/I
Mg - Magnesium
mg/I VOC : method #=
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese
mgll method #=
TKN as N
mg/I
: method #=
method #=
Rev. 11 /2005