WQ0024003_Monitoring - 03-2021_20210423

Monitoring Report Submittal
............................................................................................................................................
Permit Number #* WQ0024003
Name of Facility:* Harvey Point Defense Testing Activity
Month:* March Year: 2021
Report Information
Type* Upload Document*
GW-59 ScanGW-59 March 2021.pdf 2.11 MB
FDF Only
NDMR, NDAR-1, NDAR-2, NDMLR Scan NDAR March 2021.pdf 1.96MB
FDF Cnly
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Dustin Combs
4/23/2021
This will be filled in autocratically

Reviewer:
Williams, Kendall
Is the project number correct?*
WQ0024003
Is the monitoring report
Yes r No
accepted?*
Regional Office*
Washington
Accepted Date: 4/23/2021

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1,_ of Q
Permit No.: W00024003
Facility Name: Harvey Point Defense Facility County: Perquimans Month: March
Year: 2021
PPI: 001
Flow Measuring Point: ❑influent DEfFluent ❑No flow generated
Parameter Monitoring Point: ❑influent REffluent ❑Groundwater Lowering ❑Surface water
Parameter Code 0
50050
00310
00940
31616
00610
00620
00400
00665
70295
00530
00600
00625
00630
0
i
m
F
0
C
O
ai
N
O
$
O
m
2
V
irs p
w
LL L)
p
E
a
..
CL
N
is s
Fo- w
0
i4 ? a
0 o
4)
+a c a
S a o
sn�
c
ig M
0�
z
t
r
w a�
oz
F-
�; m
zz
24-hr
hrs
GPD
mg1L
mg1L
#1100 mL
mg/L
mg/L
su
mg1L
mg[L
mg1L
I mg/L
mg/L
mg1L
1
07:30
4
12,600
2
07:30
4
10,198
3
07:30
4
11,028
4
07:30
4
7,750
5
07:30
4
4,647
<2
1
<0.2
36.9
7.21
2.27
<2.5
36.9
<0.5
36.9
6
4,647
7
4,647
8
07:30
4
6,224
9
07:30
4
7,126
10
07:30
4
5,188
11
07:30
4
5,778
121
07730
4
3,812
13
3,812
14
3,812
15
07:30
4
7,050
16
07:30
4
23,020
17
07:30
4
8,484
181
07:30
4
2,518
191
07:30
4
10,101
201
10,101
21
10,101
22
07:30
4
8,644
23
07:30
4
9,034
24
07:30
4
8,926
25
07:30
4
8,128
26
07:30
4
8,029
27
8,029
28
8,029
29
07:30
4
9,356
30
07:30
4
8,782
31
07:30
4
16,680
Average:
8,267
0.00
1.00
0.00
36.90
2.27
0.00
36.90
0.00
36.90
Daily Maximum:
23,020
2.00
1.00
0.20
36.90
7.21
2.27
2.50
36.90
0.50
36.90
Daily Minimum:
2,518
2.00
1.00
0.20
36.90
7.21
2.27
2.50
36.90
0.50
36.90
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
24,300
30
200
15
30
Daily Limit:
6-9
Sample Frequency:
Continuous
Monthly
3 x Year
Monthly
Monthty
Monthly
5 x Week
Monthly
3 x Year
Monthly

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page Z- of
Sampling Person(s) Certified Laboratories
Name: Dustin Combs Name: Environmental Chemists Inc.
Name: II Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? (]Compliant ❑Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Perm ittee Certification
ORC: Dustin B.Combs
Permittee: Harvey Point Defense Testing Activity
Certification No.: 1003645
Signing Official: Felicia A. Kraintz
Grade: III Phone Number: 252-562-2684
Signing Official's Title: Enviromental Safety Officer
Has th ORC changed since the previous NDMR? ❑Yes ONo
Phone Number: 252-426-4360 Permit Expiration: 3/31/2023
4 12Z)2j
Signature Date
Signature Date
By this signature, t certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page I of -A-
Permit No.: WQ0024003
Facility Name: Harvey Point Defense Testing Activity WWTP
County: Perquimans
Month: March
Year: 2021
Field Name:
1
Field Name:
2
Field Name:
3
Field Name:
4
Did irrigation occur
Area (acres):
1.46
Area (acres):
1.14
Area (acres):
1.38
Area (acres):
1.29
at this facility
Cover Crop:Cover
Crop:
P=
Cover Crop:
P�
Cover Crop:
P:
DYES ❑No
Hourly Rate (in):
0.5
Hourly Rate (in):
0.5
Hourly Rate (in):
0.5
Hourly Rate (in):
0.5
Annual Rate (in):
57.2
Annual Rate (in):
57.2
Annual Rate (in):
57.2
Annual Rate (in):
57.2
Weather
Freeboard
Field Irrigated?
EYES []NO
Field Irrigated?
EYES LINO
Field Irrigated?
DYES ONO
Field Irrigated?
DYES ❑NO
y
❑�o
oa
Ut`m„
c❑9
F
=CDV
y
CL
n_
(3
j -
❑ �a
'6
7
i=
°ofl
9
a
7Q
W
°
C°
J
E `
x °
=
J
'2
>
0
J
>7• C
x°
J
CL
7Q
E
v
o
�
5E a. `C
o
oMoa
_JE
or
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
PC
60
0
6,975
80
0.18
0.13
6,975
80
0.23
0.17
6,975
80
OA9
0,14
6,975
80
0.20
0.15
2
C
38
0
3,225
45
0.08
0.08
3,225
45
0.10
0.10
3,225
45
0.09
0.09
3,225
45
0.09
0.09
3
C
40
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
4
C
43
0
2,150
30
0.05
0.05
2,150
30
0.07
0.07
2,150
30
0.06
0.06
2,150
30
0.06
0.06
5
C
31
0
3.5
2,325
30
0.06
0.06
2,325
1 30
0.08
0.08
2,325
30
0.06
0.06
2,325
1 30
0.07
0.07
6
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
7
0
0
0
0,00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
8
C
29
0
1 0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
9
C
40
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
101
C
1 46
0
3,375
45
0,09
0.09
3,375
45
0.11
0.11
3,375
45
0,09
0.09
3,375
45
0.10
0.10
111
C
1 51
0
3,300
45
0.08
0.08
3,300
45
0.11
0.11
3,300
45
0.09
0,09
3,300
45
0.09
0.09
121
C
1 56
0
3.5
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
131
1
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0-00
0
0
0.00
0.00
14
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
15
C
41
0
0
0
0.00
0.00 1
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
16
R
37
1.25
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
17
CL
44
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0,00
0.00
0
0
0.00
0.00
18
CL
50
0
3,475
45
0.09
0.09
3,475
45
0.11
0A 1
3,475
45
0,09
0.09
3,475
45
0.10
0.10
19
CL
44
0.55
3.5
1,132
15
0.03
0.03
1,132
15
0.04
0.04
1,132
15
003
0.03
1,132
15
0.03
0.03
201
0
3,396
45
0.09
0.09
3,396
45
0.11
0.11
3,396
45
0.09
0.09
3,396
45
0,10
0.10
21
0
3,396
45
0.09
0.09
3,396
45
0.11
0.11
3,396
45
0.09
0.09
3,396
45
0.10
0.10
22
PC
47
0
3,225
45
0.08
0.08
3,225
45
0.10
0.10
3,225
45
0.09
0.09
3,225
45
0.09
0.09
23
CL
51
0.05
3,375
45
0.09
0.09
3,375
45
0.11
0,11
3,375
45
0.09
0.09
3,375
45
0.10
0.10
24
PC
61
0
3,425
45
0.09
0.09
3,425
45
0.11
0.11
3,425
45
0.09
0.09
3,425
45
0.10
0.10
25
C
56
0
3,150
45
0.08
0.08
3,150
45
0.10
0.10
3,150
45
0.08
0.08
3,150
45
0.09
0.09
261
C
65
0
3.5
3,575
45
0.09
0.09
3,575
45
0.12
0.12
3,575
45
0.10
0.10
3,575
45
0.10
0.10
271
0.35
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
28
0.2
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0,00
29
C
42
0
4,100
60
0.10
0.10
4,100
60
0.13
0.13
4,100
60
0.11
0.11
4,100
60
0.12
0.12
30
C
46
0
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
0
0
0.00
0.00
31
PC
59
1
3.5
31325
45
0.08
0.08
3,325
45
0.11
0.11
3,325
45
0.09
0.09
3,325
45
0.09
Monthly Loading:
56,924
1.44
27.57
56,924
1.84
34.50
56,924
1,52
29.00
56,924
t63
12 Month Floating Total {in}:

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 'a of a
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
(]Compliant ❑Nan -Compliant
[]Compliant ❑Non -Compliant
OComphant ❑Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? PCompliant ❑Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? OCompliant ❑Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
IOperator in Responsible Charge (ORC) Certification 11 Perm ittee Certification I
ORC: Dustin B. Combs
Certification No.: 1007989
Grade: SI Phone Number: 252-562-2684
Has the ORC changed since the previous NDAR-1? ❑yes ONO
� yl�
Signature
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
Permittee:
Harvey Point Defense Testing Activity
Signing Official: Felicia A. Kraintz
Signing Officials Title: Enviromental Safety Officer
Phone Number: 252-426-4360 Permit Exp.
1
3131 /23
Date Signature Date
certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance
with a system designed to assure that all qualified personnel property gathered and evaluated the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

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 Clearfy or Type
PERMIT Number: WQ0024003 Expiration Date: 3/31/2023
Facility Name: Harvey Point Defense Testing Activity
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 2835 Harvey Point Rd.
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Hertford (Street) N.C. 27944 County Perquimans
tQty) (State}
(Zip)
© Spray Field ❑ Remediation:
Contact Person: Dustin Combs
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: MW #1
No. of wells to be sampled: 3
❑ Water Source Heat Pump ❑ Other:
horn Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW#1
Date sample collected: 3/5/2021
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400: 6.20 units Temp. 000lo: 12 °C
DRY at
Depth to Water Level e2546:7 ft. below measuring paint Screened Interval: 2 ft.
to 20 ft. Spec. Cond. 00094: gMhos
time ofsampling,
Measuring Point is ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: none
check
Volume of water pumped/bailed before sampling:
8
gallons
Appearance Light Tan
here:❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/512021-3116/2021
Laboratory Name: Environmental Chemists Inc. Certification No. #94
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335
mg1L
Nitrite (NO2) as N 00615 0.41
mg/L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 a0.02
mglL Zn - Zinc 01092 mg/l
Coliform: MF Total 31504
I100mL
Phosphorus: Total as P 00665 0.7
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg1L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 160
mglL
Al -Aluminum of 105
mg1L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOO 0066o 4.2
mglL
Ca - Calcium oog16
mg/L
Chloride 00940 11
mg/L
Cd - Cadmium 01027
uglL
Arsenic 01002
uglL
Chromium: Total 01034
ug1L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC1MS, HPLC)
Phenol 32730
uglL
Fe - Iron 01045
uglL (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
uglL Lab Report Attached? ❑ Yes (1)[■ No (0)
pecific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia oo6lo <0•2
mglL
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
uglL , method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
RemediationFor Only r r•rts): Influent Total VOCs:•/L Effluent Total VOCs:• •
I certify that, to the best of my knowledge and belief, the information submitted in this report is true, accurate, and complete, and that the laboratory analytical data was produced using approved methods of analysis by a
DWQ-certified laboratory. I am aware that there are significant penalties for suhmilling false information, including the possibility of fines and imprlsonmenl for knowing violations.
Felicia j
A. • •! +
Permittee (or r '•NamePlease print or .• Sinnature of r • •-
GW-59 Rev. 212010

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: WQ0024003 Expiration Date: 3/31/2023
Facility Name: Harvey Point Defense Testing Activity
Non -Discharge X UIC
Permit Name (if different):
NPDES Other
Facility Address: 2835 Harvey Point Rd.
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Hertford (Street) N.C. 27944 County Perquimans
(City) (State)
(ZIP)
■ Spray Field El Remediation:
Contact Person: Dustin Combs
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: MW #2
No. of wells to be sampled: 3
❑ Water Source Heat Pump ❑ Other:
from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW#2
Date sample collected: 3/5/2021
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 0040n: 6.41 units Temp. 00o1o: 12 °C
DRY at
Depth to Water Level 82546:6 ft. below measuring point Screened Interval: 2 ft.
to 20 ft. Spec. Cond. Doosa: µMhos
time of
sampling,
Measuring Point is ft. above land surface
Relative M.P. Elevation:
ft. Odor 000as: None
check
Volume of water pumpedlhailed before sampling:
8
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed: 31512021-3/1812021
Laboratory Name: Environmental Chemists Inc. Certification No. #94
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead 01051 ug1L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 <0.02
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P oo665 0.12
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70,501
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 150
mg/L
All - Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOG 00680 15
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 41
mg1L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug1L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg1L ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730
ug1L
Fe - Iron o1045
ug1L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg1
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg1L VOC 78732: method #
Total Ammonia 00610 0.7
mg/L
Mg - Magnesium 00927
mglL method #
(Ammonia Nitrogen; NH, as N; 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:
Felicia A. Kraintz-Environmental Safety Officer HPDTA
Permittee (or Authorized Aqent) Name and Title - Please print or type
Totalmq/L Effluent •
iplete, and that the laboratory analytical data
possibility of fines and imprisonment for knc
mg/L VOC Removal%
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
�1617
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
MAIL SERVICE CENTER, RALEIGH, INC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0024003 Expiration Date: 3/31/2023
Facility Name: Harvey Point Defense Testing Activity
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 2835 Harvey Point Rd.
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Hertford (street) N.C. 27944 County Perquimans
(City) (state)
(zip)
❑■ Spray Field ❑ Remediation:
Contact Person. Dustin Combs
Telephone#!: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:MW #3
No, of wells to be sampled: 3
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW#3
Date sample collected: 3/5/2021
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400: 6.19 units Temp. 000lo: 12 °C
DRY at
Depth to Water Level 82546:7 ft. below measuring paint Screened Interval: 2 ft.
to 20 ft. Spec. Cond. 00094: µMhos
time ofSampling,
Measuring Point is ft, above land surface
Relative M.P. Elevation:
ft. Odor Ooo85: None
check
Volume of water pumped/bailed before sampling:
10
gallons
Appearance Light Tan
here:❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/512021-3118/2021
Laboratory Name: Environmental Chemists Inc. Certification No. #94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD omm
mglL
Nitrite (NO2) as N 00615 1.20
mg1L Pb - Lead o1o51 ug1L
Coliform: MF Fecal 31616 <1
/100ml-
Nitrate (NOA as N 00620 <0,02
mg1L Zn - Zinc 01092 mglL
Coliform: MF Total 31564
1100mL
Phosphorus: Total as P 00665 1.69
mg1L
(Note: use MPN method for Highly turbid samples)
Orthophosphate 70507
mglL Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 1090
mglL
Al - Aluminum o11o5
mglL
pH (Lab) 00403
units
Ba - Barium 01007
ug1L
TOC 0068o 25.8
mg1L
Ca - Calcium oo916
mglL
Chloride 00940 125
mglL
Cd - Cadmium 01027
uglL
Arsenic 01002
ug1L
Chromium: Total 01034
uglL
Grease and Oils 00552
mg1L
Cu - Copper 01042
mglL ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug1L
Fe - Iron 01045
uglL (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mglL
Hg - Mercury 71900
uglL Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mglL VOC 78732: method #
Total Ammonia 00610 0.5
mglL
Mg - Magnesium 00927
mg1L method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug1L , method #
TKN as N 00625
mglL
Ni - Nickel 01067
ug1L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mglL Effluent Total VOCs: mglL VOC Removal%
GW-59 Rev.212010

GW-59A COMPLIANCE REPORT FORM
Permit # VWU4100
(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(Na,
IF the answer to question I or 2 is "YES", list in the space provided below the well identification numbers) 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 constituent(s) and concentration(s)
exceeding 3Jbla� standards�Fi lthe
l��e pi�t}V7iI,-belo w�A`31r�1d�
lr;elll"(..off 5`�7 5`d4 y 3 5.�+3 574 5 l3 gt� 03' 6ic,
5 77 �� r q 4i .
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
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) 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
zy
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
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 Re Tonal Office within 90 da s• an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surroundina this facility, Failure to do so may subject the permittee to a Notice of Violation
fines, and/or penalties.
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.
Signature of Permittee (or Authorized Agent) Date
GW-59A 12/8/2003