WQ0007144_Monitoring - 03-2021_20210409 (3)

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0007144
Name of Facility:* Camp Seafarer
Month:* March
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
GW-59
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Year:* 2021
Upload Document*
Non -Discharge Reports 807.69KB
March 2021.pdf
FDF Only
GW-59 March 2021.pdf 406.45KB
FDF only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-7, NDAR-2, NDMLR, GW-59).
[e-mail]
Stanley Eudy
4/9/2021
This will be filled in &Aormtically

Initial Review
Reviewer: Williams, Kendall
Is the project number correct?* WQ0007144
Is the monitoring report r Yes r No
accepted?*
Regional Office* Washington
Accepted Date: 4/9/2021

SUBMIT FORM ON YELLOW PAPER ONLY
.DE PARTMENT:OF ENVIRONMENTAL QUALITY DW ,OF WATER RESOURCES"
GROUNDWATER QUALITY MONITORING:
INFORM4rION PROCESSING UNIT
COMPLIANCE REPORT FORM
9617 MAIL SERVICECENTER, RALEIGH NC 27fi99 1647.": Phone.:919-8Dy-6306 ,
.:..
FACILITY INFORMATION Please PrfntClearly orType
PERMIT Number: ExpirationDate:
Facility Name: Camp Seafarer
Non -Discharge WQ0007144 UIC
NPDES ••• Other
Permit Name (if different): YMCA of the Triangle Area, INC.
Facility Address: 2744 Seafarer Rd Arapahoe NC
28510
TYPE OF PERMITTED OPERATION BEING MONITORED
2744 Seafarer Rd Arapahoe (S're�t)NC 28510
County Pamlico
Lagoon ❑ Remediation: Infiltration Gallery
(city) (state) czp)
© Spray Field © Remediation:
Contact Person: Mike Askew
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge "
Well Location/Site Name: Lagoon
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): We112
Date sample collected: 3I1T/ Al
FIELD ANALYSES:
WAS
Well Depth: 20 " ft.
Well Diameter: 2 in.
pH 00400: 6"Crunits Temp. 00010: � °C
DRY at
Depth to Water Level 82546: Q, 3 ft. below measuring point
Screened Interval: 10 ft. to
20 ft.
Spec. Cond. 00094: / i µMhos
time ofsampling,
Measuring Point is 1.9 fL above land surface
Relative M.P. Elevation: 24.2 ft.
Odor 00085: Yc
check
Volume of water pumped/bailed before sampiing: 7()1*kr
gallons
Appearance
here -
Samples for metals were collected unfiltered: ❑ YES ❑
NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Env 1 w l
Date sample analyzed: :31 1Y/4tr
LaboratoryName:
Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N oce15
mg/L
Pb - Lead o1o51 ug1L
Coliform: MF Fecal 3161s j /100mL
Nitrate (NO3) as N OCE20 < (�, Li 4.
mg/L
Zn - Zino 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P OCee5 G G mg/L
(Note: Use MPN method for highly turbidsamples)Orthophosphate
70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 ( mg/L
AI -Aluminum e11o5
mg/L
pH (Lab) 00403, units
Ba - Barium 01007
ug/L
TOC coseo mg/L
Ca - Calcium oosls
mg/L
Chloride 00940 mg/L
Cd - Cadmium 01D27
ug/L
Arsenic o1om ug/L
Chromium: Total 01034
ug1L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730 ug1L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate oo945 mg/L
Hg - Mercury 71900
ug1L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 C1 ° O �%^ mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonfa Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
uglL
method #
TKN as N 00625 mg/L
Ni - Nickel olos7
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
Mike Askew, Director of Facilities and Boating Operations
Permittee {or Authorized Agent) Name and Title - Please print or type
GW 59 Rev. 05-02-2017

SUBMIT FORM ON YELLOW PAPER ONLY
s .
D5 .ARTMENT DF ENVIRONMENTAL QuA1 ITY l7IV.;OF WATP-R RESOURCES
GROUNDWATER QUALITY MONITORING:
'
INFORMATION;PROCE5SING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH NC �7699 1617 Rhone: 9i9-607 6306
FACILITY INFORMATION please Print Clearly or Type
PERMIT Number: Expiration Date: 3G l
Facility Name: Camp Seafarer
Non -Discharge WQ0007144 UIC
Permit Name (if different): YMCA of the Triange Area, INC.
NPDES Other
Facility Address: 2744 Seafarer Rd Arapahoe
NC 28510
TYPE OF PERMITTED OPERATION BEING MONITORED
2744 Seafarer Rd Arapahoe () NC 28510
County Pamlico
❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (a[alo) (zip)
:4 Spray Field ❑ Remediation:
Contact Person: Mike Askew
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Spray Field 3
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
3�/s�z/
If WELL
WAS
WELL ID NUMBER (from Permit): WELL 5
20
Date sample collected:
Well Diameter: 2
FIELD ANALYSES:
00400: 1164 units Temp. 00010: �G� °C
DRY at
Well Depth: ft,
In.
pH
'It, Mhos
time of
Depth to Water Level 62546: . 33 ft. below measuring point Screened lntervai: 10 ft. to 20
ft_ Spec. Cond. 00094:
sampling,
Measuring Point is 2•2 ft. above land surface
Relative M.P. Elevation: 27.7 ft.
Odor ooc85: pGY6-
check
Volume of water pumped/bailed before sampling: /0
gallons
Appearance s<4LVQY
here:❑
Samples for metals were collected unfiltered: El YES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION i
1
Date sample analyzed: '5115-/
a p
Laboratory Name: Enviroment 1,INC,
Certification No.
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00336 mg/L
Nitrite (NO2) as N o0615
mg1L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620 C Q P+
mg1L Zn -Zinc 01092 mg/L
- -----
Coliform: MF Total 31504 1100mL
Phosphorus: Total as P 00665< O , o t
mg/L
(Note; Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total70300 33 mglL
AI -Aluminum o11o5
mg/L
pH (Lab) 00403 �. units
Ba - Barium 01007
ug/L
TOC oo66o- mg1L
Ca - Calcium oo816
mg/L
Chloride 00040 rj mg/L
Cd - Cadmium o1o27
ug1L
Arsenic 01002 ug/L
Chromium: Total 01034
ug[L
Grease and Oils oo552 mg/L
Cu - Copper o1o42
mg/L
ORGANICS: (by GC, GC1MS, 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 0oo95 !_(Mhos
K - Potassium 00937
mgJL
VOC 7673 method #
Total Ammonia oo610 d G C�-mg/L
Mg - Magnesium oo927
mg/L
method #
(Ammonia Nitrogen; N%as N; Ammonia Nitrogen, Total)
Mn - Manganese o1055
ug1L , method #
TKN as N oo625 mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent I Otal VUL;s: . mgrt- vcn. xemovat 10
GW--59 Rev_ 05-02-2017

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OE ENVIRONMENTAL QUALITY DIV. ,OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
' t
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617Phone: [phone]
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: Expiration Date: 6 3C1
Facility Name: Camp Seafarer
Non -Discharge WQ0007144 U1C
Permit Name (if different): YMCA of the Triangle Area, INC.
NPDES Other
Facility Address: 2744 Seafarer Rd Arapahoe
NC 28510
TYPE OF PERMITTED OPERATION BEING MONITORED
2744 Seafarer Rd Arapahoe ( NC 28510
County Pamlico
❑ Lagoon ❑ Remediation: Infiltration Gallery
ply) (SEale} (Zip)
K Spray Field ❑Remediation:
Contact Person: Mike Askew
Telephone#, 252-249-1212
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Spray Field 3
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other.
(#rom Pertni4)
SAMPLING INFORMATION
,3 j`s
If WELL
WELL ID NUMBER (from Permit): Well 6
z 1
Date sample collected: l f
FIELD ANALYSES: J
Temp. 13, oC
WAS
DRY at
Well Depth: 20 ft.
Well Diameter: 2 in.
pH oo4o0:J,05units 000:0: I
��
time of
ft. below measurin Dint
Depth to Water Level 82546:L s g p
Screened Interval: 10 ft: to
20
p µMhos
ft. Sec. Gand. 0ooe4:
sampling,
Measuring Point is 2.75 ft. above land surface
Relative M.P. Elevation: 20.2 ft.
Odor a00a5: ,ICI
check
Volume of water pumped/bailed before sampling: f G
gallons
Appearance C/O te)"
here: El
Samples for metals were collected unfiltered: EYES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION / %
�r
Date sample analyzed: 13- -z
Laboratory Name: Enviroment 1,INC.
Certification No.
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 0061s
mg1L Pb - Lead o1051 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620 �G, o y.
mg/L Zn -Zinc o1o92 mg/L
Coliform: MF Total 31504 1100mL
Phosphorus: Total as P 00665 G: (
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate70507
mg1L Other (Specify Compounds and Concentration Units):
issolved Solids:Total70300 170 mg/L
AI -Aluminum ollo5
mg/L
pH (Lab) 00403 ' 97 units
Ba - Barium olo07
ug/L
TOC 0c6m mg/L
Ca - Calcium 00918
mg/L
Chloride 00940 2_6 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug1L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730 ug1L
Fe - Iron 01045
ug1L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg1L
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095 g!Mhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia oc610 < 0' O mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Tolal)
Mn - Manganese o9055
ug/L , method #
TKN as N oo625 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 VUL; Kemovalio
GW-59 Rev.05-02-2017

SUBMIT FORM ON YELLOW PAPER ONLY
AEPP RTMENT OF ENVIRONMENTAL QUALITY DIV.;OF WATER RESbl1RCE5
GROUNDWATER QUALITY MONITORING:
..
INFORMATIONPROCESSING u1aT
COMPLIANCE REPORT FORM
1817.MA1L SERVICE CENTER; RALI51G NC 17B95 1517 , Fhone .919 607-63US
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: Expiration Date: 3C! Z
Facility Name: Camp Seafarer
Non -Discharge WQ0007144 UIC
Permit Name (if different): YMCA OF THE Triangle Area, INC.
NPDES Other
Facility Address: 2744 Seafarer Rd Arapahoe
NC 28510
TYPE OF PERMITTED OPERATION BEING MONITORED
2744 Seafarer Rd Arapahoe [Street) NC 28510
County Pamlico
❑ Lagoon ❑ Remediation: Infiltration Gallery
(city) (Stale) (zip)
© Spray Field ❑ Remediation:
Contact Person: Mike Askew
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Spray Field 2
No. of wells to be sampled, 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
j
if WELL
WELL ID NUMBER (from Permit): WELL 7
Date sample collected: 31IS 1 Z/
FIELD ANALYSES:
WAS
Well Depth: 12 ft.
Well Diameter: 2 in.
pH 00400:✓' i 3 units Temp. 000lo: r�• °C
DRY at
Depth to Water Level 82546:: s� ft, below measuring point Screened Interval: 2 ft. to
12 ft.
Spec. Cord. 000e4: 1?'�, % pmhos
time of
sampling,
Measuring Point is 1 ft. above land surface
Relative M.P. Elevation: 25.8 ft.
Odor 000m: k
check
Volume of water pumpedfbailed before sampling: r0
gallons
Appearance
he re:
Samples for metals were collected unfiltered: ❑ YES
❑ YNO and field acidified: ❑ YES ❑ NO
LAI30RATORY INFORMATION
Date sample analyzed: 1 ��'�
Laboratory Name: Enviroment 1,1NC.
Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead 01o51 ug/L
Coliform: MF Fecal 31616 { , 1100mL
Nitrate (NO3) as N oosso < 0 , O
mg1L
Zn -Zinc 01092 mg/L
Coliform: MF Total 315o4� /100mL
Phosphorus: Total as P o0s65 O • l9 `-
mg/L
(Note: Use MPN method for Nghlytoretd samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
lb-0
issolved Solids:Total 70300 mg/L
AI - Aluminum o1105
mg/L
PH (Lab) 00403 S; units
Ba - Barium 01007
ug/L
TOC oosso mg/L
Ca - Calcium 00416
mg/L
Chloride 00940 mglL
Cd -Cadmium 01027
ugIL
Arsenic 01002 ug/L
Chromium: Total 01034
ug[L
Grease and oils oo5s2 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACK LAB REPORT.)
Sulfate 00245 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance coon AMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia oosso Oe G �{- mg1L
Mg - Magnesium oo927
mg/L.
method #
{Ammonia Nitrogen; NH3 as N: Ammonia Nitrogen, Total}
Mn - Manganese 01055
ug1L
method #
TKN as N oos25 mg/L
Ni - Nickel 01067
ug[L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOUS: mg/L v.ut: Kemovati°
GIN-59 Rev. 05-02-2017

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT;OR ENVIRONMENTAL QUALITY - ID) OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMATION ROCESST90UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTF-�i RALEIGH NC 27699 1617 ;Phone: [phone]
FACILITY INFORMATION Please Print CtearlyorType
PERMIT Number: Expiration Date:
Facility Name: Camp Seafarer
Non -Discharge WQ0007144 UIC
Permit Name (if different): YMCA of the Triangl Area, INC.
NPDES Other
Facility Address: 2744 Seafarer Rd Arapahoe
NC 28510
TYPE OF PERMITTED OPERATION BEING MONITORED
2744 Seafarer Rd Arapahoe `Street NC 28510
County Pamlico
❑ Lagoon ❑ Remediation: Infiltration Gallery
{City) (State) (Zip)
Spray Field El Remediation:
Contact Person: Mike Askew
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Spray Field 2
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
from Permit)
SAMPLING INFORMATION
/
If WELL
WELL ID NUMBER (from Permit): Well 8
Date sample collected: 3/� '
2
FIELD ANALYSES: �- 2
.2 °C
� Temp_ 00010: /
WAS
DRY at
Well Depth: 12 ft.
Well Diameter: in.
pH 00400: units ,
` � Mhos)
time of
Depth to Water Level 82546: c 6�ft. below measuring point
Screened Interval: 2 ft. to
12 ft_
Spec. Cond. 00094: ,,.7 ,
sampling,
Measuring Point is 1 ft. above land surface
Relative M.P. E[evation: 15.3 ft.
Odor 0008s: 1-61%.-4
check
Volume of water pumped/balled before sampling: +—OP r gallons
Appearance CLOK _
here: ❑
Samples for metals were collected unfiltered: ❑YES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
3/
Date sample analyzed:
Laboratory Name: Enviroment 1, INC.
Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N coels
mg/L
Pb - Lead olo51 ug/L
Co[iform: MF Fecal 31616 1100mL
Nitrate (NO3) as N 00620
mg/L
Zn - Zinc C1092 mg/L
Coliform: MF Total 31504 1100mL
Phosphorus: Total as P o0665 �Q®J J
mg/L
(Note: use MPN method for hightytutbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 6 mg/L
Al - Aluminum o1105
mg/L
pH (Lab) 00403`s units
Ba - i3arium 01007
ug/L
TOG oosso mg/L
Ca - Calcium oo9is
mg/L
Chloride 00940 1� mg/L
Cd - Cadmium olo27
ug1L
Arsenic 01002 ug/L
Chromium: Total D1034
ug/L
Grease and Oils 00552 mg1L
Cu - Copper o1o42
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #.'ATTACH LAB REPORT.)
Sulfate o0845 mg/L
Hg - Mercury 7190D
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance eoogs µMhos
K - Potassium C0937
mg/L
VOC 7873 , method #
Total Ammonia oo610 CSY mglL
Mg - Magnesium 00927
mg/L
method ##
(Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total)
Mn - Manganese 0105s
ug/L
method #
TKN as N oo625 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 vuu Kemovat io
GW-59 Rev.05-02-2017

GW-59A COMPLIANCE REPORT FORM Permit # WO OG V
(Suhrnit one each inoniioring_period 14th Gil'--59 fornes.)
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
N
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.)? Ifthe answer is "Yes", contact the Regional Officefor guidance.
4
Are any monitored constituents equal to or above the established standards?
NO
If the answer to question 4 is "NO" skip to section B.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentrations)
exceeding standards in the space pro idd, G
w'�q jJ C3 p H � +�I �' y�� ''ff
tvLj{ ( 1iL 6 1405 1,(>,— �'i1 5'0 [, S
5
For tho_corlstituenfs.ldenfifii_ed in question.4 ab_ av_e,.have standards been exceeded., previous[y_far t_he
Y
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.
If the answer to question 5 Is "YES", list in the space provided below, each well with constituents) exceeding
standards, concentration(s) reported, and sample collection date for each occurr, nce (for the last two years).
5' 4o,,-- PN 31r lAo 5�a71 q ja 1 lAu 5,131 1 ).�3r f,;& S" I c
w L > 6 40—M 311TIJ& S',�� 1 7/,Z/IXu 11.6.E 1 IJ-1311,20 5' t7t
� c 7 101- NY 30-Pu SUC 1 W /jc, S, $G 1 143/0r,
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
N
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 maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
N
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 da s• an evaluation may be
required to determine the impact the waste dis osal s stem is having at the review and com liance
boundaries surrounding this facility. Failure to do so ma sub"ect the permittee to a Notice of Violation
fines, and/or penalties„ Co xfl9 C lti)
Rec, /4>lY%3L
WALLS
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.
I hereby acknowledge that the above information was evaluated and the information submitted in this
report (Compliance Report GW-59A) is true and complete to the best of my knowledge.
r C {
40 -
Signature of Permittee or Authorized Agent) Date
i
GW-59A 12/8/2003