WQ0004972_Monitoring - 11-2020_20210215 (2)

SUBMIT FORM ON YELLOW PAPER ONLY
Mai) Original
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
and 1 copy to:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, INC 27699.1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0004972 Expiration Date.
Facility Name: Forest Lake ELS
Non -Discharge UIC
Permit Name (if different):
NPDES Other
Facility Address: 192 Thousand Trails Drive
TYPE OF PERMITTED OPERATION BEING MONITORED
Advance °°"`' NC
27006
County Davie
❑ Lagoon ❑ Remediation: Infiltration Gallery
© Spray Field ❑ Remediation:
Contact Person: Tracy Overdurf
Telephone#:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
(from Permitt
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-4
Date sample collected:
11/19/2020
FIELD ANALYSES:
WAS
Well Depth: 46.00 ft.
Well Diameter:
2 in.
pH 00400: 6.59 units Temp. 000lo: 17.0 °C
DRY at
Dept to Water Level 41.99 ft. below pleasuring
point
Screened Interval:
ft. to _ft,
Spec. Cond. 00094: ftMhos
time of
sampling,
Measuring Point is ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085:
check
Volume of water pumped/bailed before sampling:
1.25-Dry
gallons
Appearance
here:❑
Samples for metals were collected unfiltered: ❑ YES ❑
NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11/20-12/05/2020
Laboratory Name: Pace Analytical
Certification No. 40,12 & 633
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 <1.0
/100mL
Nitrate (NO3) as N 00620
<0.30 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 Solids:Total 70300
mg/L
Al - Aluminum ollo5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
_
TOC 00680 <1.0
mg/L
Ca - Calcium 00916
mg/L
FE� 1 2021
Chloride 00940 3.7
mg/L
Cd - Cadmium 01027
uglL
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
DWR iF(` olil
Grease and Oils 00552
mg/L
Cu - Copper o1042
V V ill mg/L
ORGANic1MR9R WWM"9 UN(7
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #ACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900 °
L 'ug/L
Lab Report Attached? Yes (1) ❑ No (0)
Specific Conductance 00095
ftMhos
K - Potassium 00937
mg/L
VOC 78732: method # 8260
Total Ammonia 00610
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen: NH -,as N, Ammonia Nitrogen, Total)
Mn - Manganese 01o55
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%
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
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
MIN
Permittee (or Authorized Aaent) Name and Title - Please onnt or Ivoe
Permittee (or Authorized Aueutl (Date)
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
and 1 copy to:
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: WQ0004972 Expiration Date:
Facility Name: Forest Lake ELS
Non -Discharge UIC
Permit Name (if different):
NPDES Other
Facility Address: 192 Thousand Trails Drive
TYPE OF PERMITTED OPERATION BEING MONITORED
Advance h INC 27006
County Davie
❑ Lagoon ❑ Remediation: Infiltration Gallery
© Spray Field ❑ Remediation:
Contact Person: Tracy Overdurf
Telephone#:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
(from Permiq
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-3
Date sample collected:
11/19/2020 FIELD ANALYSES:
WAS
Well Depth: 19.10 ft.
Well Diameter:
2 in. pH 00400: 6.55 units Temp. 000lo: 16.8 oC
DRY at
Dept to Water Level 8.60 ft. below
measuring point
Screened Interval:
ft. to ft. Spec. Cond. 00094: pMhos
time of
u
sampling,
Measuring Point is ft. above land
surface
Relative M.P. Elevation:
ft. Odor 00085:
check
Volume of water pumped/bailed before sampling:
2.75-Dry
gallons
Appearance
here:❑
Samples for metals were collected unfiltered:
❑ YES ❑
NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11/20-12/05/2020
Laboratory Name: Pace Analytical Certification No. 40,12 & 633
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 <1.0
/100mL
Nitrate (NO,,) as N 00620
7.4 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
mg/L
Al - Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.0
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 27.7
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 # ACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
fT
ug/L Lab Report Attached? Yes (1) =No (0)
Specific Conductance 00095
ItMhos
K - Potassium 00937
mg/L VOC 78732: method # 8260
Total Ammonia 00610
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen: NH, as N: Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L , method #
TKN as N 0062.5
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%
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
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
Permittee (or Authorized Aoenl) Name and Title - Please print or tvoe Signature of Permittee (or Authorized Aaen6 (Datei
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
and 1 copy to:
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: WQ0004972 Expiration Date:
Facility Name: Forest Lake ELS
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 192 Thousand Trails Drive
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Advance NC 27006 County Davie
© Spray Field ❑ Remediation:
Contact Person: Tracy Overdurf
Telephone#:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
tirom Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-2
Date sample collected:
11/19/2020
FIELD ANALYSES:
WAS
Well Depth: 39.00 ft.
Well Diameter:
2 in.
pH 00400: 6.82 units Temp. 000lo: 16.5 °C
DRY at
Dept to Water Level 34.44 ft. below measuring point
Screened Interval:
ft. to _ft.
Spec. Cond. 00094: pMhos
time of
sampling,
Measuring Point is ft. above land surface
Relative M.P. Elevation:
ft.
Odor 000m:
check
Volume of water pumped/bailed before sampling:
1.50-Dry
gallons
Appearance
here:
Samples for metals were collected unfiltered:
❑ YES ❑
NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11/20-12/05/2020
Laboratory Name: Pace Analytical
Certification No. 40,12 & 633
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L Pb - Lead o1051 ug/L
Coliform: MF Fecal 31616 1.0
/100mL
Nitrate (NO3) as N 00620
1.0 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 Solids:Total 70300
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.0
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 5.1
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) 0 No (0)
Specific Conductance 00095
ttMhos
K - Potassium 00937
mg/L VOC 78732: method # 8260
Total Ammonia 00610
mg/L
Mg - Magnesium 00927
mg/L
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: mg/L Effluent Total VOCs:
mg/L VOC Removal%
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 submitting false information, including the possibility of fines and imprisonment for knowing violations.
&CU.A Nt--( wLC10Vf_r1
Perrnitlee (or Authorized Aaent) Name and Title - Please orinl or lvoe
Sianature of Permittee for Authorized
(Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
and 1 copy to:
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: W00004972 Expiration Date:
Facility Name: Forest Lake ELS
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 192 Thousand Trails Drive
TYPE OF PERMITTED OPERATION BEING MONITORED
Advance ' NC 27006
County Davie
❑ Lagoon ❑ Remediation: Infiltration Gallery
© Spray Field ❑ Remediation:
Contact Person: Tracy Overdurf
Telephone#:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled:
4
❑ Water Source Heat Pump ❑ Other:
from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-1
Date sample collected:
11/19/2020
FIELD ANALYSES:
WAS
Well Depth: 90.00 ft.
Well Diameter:
2 in.
pH 00400: 6,54 units Temp. o0olo: 17.0 °C
DRY at
Dept to Water Level 64.61 ft. below
measuring point
Screened Interval:
ft. to
ft. Spec. Cond. 00094: ItMhos
time of
sampling,
Measuring Point is ft. above land
surface
Relative M.P. Elevation:
ft.
Odor 000a5:
check
Volume of water pumped/bailed before sampling:
5.00-Dry
gallons
Appearance
here:❑
Samples for metals were collected unfiltered:
❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11/20-12/05/2020
Laboratory Name: Pace Analytical
Certification No. 40,12 & 633
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 1.0
/100mL
Nitrate (NO3) as N 00620
<0.30 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
mg/L
Al - Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oosso 3.3
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 1.5
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 LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
1#.XATTACH
Lab Report Attached? u Yes (1) ❑ No (0)
Specific Conductance 00095
ItMhos
K - Potassium 00937
mg/L
VOC 76732: method # 8260
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 Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs:
mg/L VOC Removal%
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
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
13,,O,/1-. / v Gam` (
Permittee for Authorized Aoentl Name and Title - Please Drint or tvoe Signature of Permittee f Authorized Anent)
(Date)
GW-59 Rev.2/2010