WI0400065_Staff Report for the Oliphant Residencer_20210721

North Carolina Department of Environmental Quality - Division of Water Resources
WQROS REGIONAL STAFF REPORT FOR
UIC Program Support
Date: 07/20/2021
To: Shristi Shresta
Central Office Reviewer
Permit No. WI0400065
County: Guilford
Permittee/Applicant: Mark and Christel Oliphant
Facility Name: 1259 Elon Place
I. GENERAL INFORMATION
1. This application is (check all that apply): ❑ New ® Renewal
❑ Minor Modification ['Major Modification
a. Date of Inspection: 05/25/2021
b. Person contacted and contact information: Mark Oliphant [phone]
c. Site visit conducted by: Jim Gonsiewski
d. Inspection Report Printed from RIMS attached: ® Yes ❑ No.
e. Physical Address of Site including zip code: 1259 Elon Place High Point, NC 27263
f. Driving Directions if rural site and/or no physical address:
g. Latitude: 35.949422 Longitude: 79.946114
Source of Lat/Long & Accuracy (i.e., Google Earth, GPS, etc.):Google Earth
II. DESCRIPTION OF INJECTION WELL(S) AND FACILITY
1. Type of injection system:
® Geothermal Heating/Cooling Water Return
❑ In situ Groundwater Remediation
❑ Non -Discharge Groundwater Remediation
['Other (Specify:
2. For Geothermal Water Return Well(s) only
a. For existing geothermal system only:
Were samples collected from Influent/Effluent sampling ports? ® Yes ❑ No.
Provide well construction information from well tag: Well installed 1/14/04. Total depth 220' Yield
was listed as 12 GPM
b. Does existing or proposed system use same well for water source and injection? ® Yes ❑ No
If No, please provide source/supply well construction info (i.e., depth, date drilled, well contractor,
etc.) and attached map and sketch location of supply well in relation to injection well and any other
features in Section IV of this Staff Report.
3. Are there any potential pollution sources that may affect injection? ❑ Yes ® No
What is/are the pollution source(s)?
What is the distance of the injection well(s) from the pollution source(s)?
4. What is the minimum distance of proposed injection wells from the property boundary?
5. Quality of drainage at site: ® Good ❑ Adequate ['Poor
6. Flooding potential of site: ® Low ❑ Moderate ❑ High
WQROS Staff Report Rev. 4/15/2016 Page 1

Signature of WQROS Regional Supervisor:
7/20/2021
Date:
7. For Groundwater Remediation Injection Systems only, is the proposed and/or existing groundwater monitoring
program (number of wells, frequency of monitoring, monitoring parameters, etc.) adequate? ❑ Yes ❑ No.
If No, attach map of existing monitoring well network if applicable and recommend any changes to the
groundwater -monitoring program.
8. Does the map included in the Application reasonably represent the actual site (property lines, wells, surface
drainage)? ❑ Yes ❑ No. If No, or no map, please attach a sketch of the site. Show property boundaries,
buildings, wells, potential pollution sources, roads, approximate scale, and north arrow.
9. For Non -Discharge Groundwater Remediation systems only (i.e., permits with WQ prefix):
a. Are the treatment facilities adequate for the type of waste and disposal system? ❑ Yes ❑ No ❑ N/A.
If No, please explain:
b. Are the site conditions (soils, topography, depth to water table, etc.) consistent with what was reported by
the soil scientist and/or Professional Engineer? ❑ Yes ❑ No ❑ N/A. If no, please explain:
III. EVALUATION AND RECOMMENDATIONS
1. Do you foresee any problems with issuance/renewal of this permit? ❑ Yes ® No. If Yes, explain.
2. List any items that you would like WQROS Central Office to obtain through an additional information request.
Make sure that you provide a reason for each item:
Item
Reason
3. List specific special conditions or compliance schedules that you recommend to be included in the permit when
issued. Make sure that you provide a reason for each special condition:
Condition
Reason
4. Recommendation
❑ Deny. If Deny, please state reasons:
❑ Hold pending receipt and review of additional information by Regional Office
❑ Issue upon receipt of needed additional information
® Issue DocuSpnedby:
5. Signature of Report Preparer(s): "� a01 t-Wrki
E197B68F179D45F... DocuSi9ned by:
c
oti ?. 5Mat1'
145B49E225C94EA...
WQROS Staff Report Rev. 4/15/2016
Page 2

IV. ADDITIONAL REGIONAL STAFF REVIEW COMMENTS/ATTACHMENTS (Optional /If Needed)
The well was approximately 100-feet from the residence. A photograph of the well follows below along with a
photograph of the well tag. The influent line is on the left while the effluent line is on the right. Laboratory data
from the sampling of the influent and effluent on May 25, 2021 is attached.
View of the injection well.
WQROS Staff Report Rev. 4/15/2016
Page 3

View of the well tag.
WQROS Staff Report Rev. 4/15/2016
Page 4

AC85162 North Carolina Division of Water Resources Water Sciences Secfon Laboratory Results
Loc. Descr.:
County:
Region:
River Basin
Emergency
COC Yes/No
OLIPHANT RESIDENCE 1259 ELON PLACE
Guilford Collector: J GONSIENSKI VisitlD
Winston-Salem Report To WSRO Location ID: WSRO NLC
CPF Collect Date: 05125/2021 Priority ROUTINE
Collect Time: 14:35 Sample Matrix: GROUNDWATER
Sample Depth Loc. Type: Water Supply
Final Report
Sample ID: AC85162
PO Number #
Date Received: 05/26/2021
Time Received: 08:15
Labworks LoginlD TASCENZO1
Delivery Method NC Courier
Final Report Date: 7/13/21
Report Print Date: 07114/2021
If this report is labeled preliminary report, the results have not been validated. Do not use for Regulatory purposes.
CAS # Analyte Name
Sample temperature at receipt by lab
PQL
Result/
Qualifier
LAB
0.9
Units
°C
Method Analysis
Reference Date Validated by
5/26/21 MSWIFT
Coliform, MF Fecal in liquid
1
MIC
1 B2,Q1 CFU/100m1 SM 9222 D-1997 5/26/21 JJURGEVICH
Coliform, MF Total in liquid
1 1 Q1
CFU/100m1 SM 9222 B-1997 5/26/21 JJURGEVICH
7664-41-7
NH3 as N in liquid
0.02
NUT
0.02 U
mg/L as N
EPA 350.1 REV 2 5/27/21 ALWILLIAMS
14797-55-8 Nitrate as N in liquid
0.02 0.37 mg/L as N
EPA 353 2 REV 2 5/27/21 ALWILLIAMS
14797-65-0 Nitrite as N in liquid
0.01 0.01 U mg/L as N
EPA 353.2 REV 2 5/27/21 ALWILLIAMS
E701177
NO2+NO3 as N in liquid
0.02 0.37 mg/L as N
EPA 353.2 REV 2 5/27/21 ALWILLIAMS
24959-67-9 Bromide
0.4
WET
0.4 U
mg/L
EPA 300.0 rev2.1 6/16/21 ALWILLIAMS
16887-00-6 Chloride
1.0 4.6 mg/L EPA 300.0 rev2.1 6/16/21 ALWILLIAMS
16984-48-8 Fluoride
0.4 0.4 U mg/L
EPA 300.0 rev2.1 6/16/21 ALWILLIAMS
14808-79-8 Sulfate
2.0 5.7 mg/L EPA 300.0 rev2.1 6/16/21 ALWILLIAMS
Total Dissolved Solids in liquid
12 221 mg/L SM 2540 C-1997 5/26/21 ALWILLIAMS
7440-22-4 Ag by ICPMS
MET
1.0 1.0 U ug/L EPA 200.8 Rev5 4
6/15/21 JJURGEVICH
7429-90-5 Al by ICP
50 110
ug/L EPA200.7 Rev4.4
6/15/21 JJURGEVICH
7440-36-0 Antimony by ICPMS
10 10 U
ug/L
EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7440-38-2
As by ICPMS
2.0 2.0 U ug/L EPA 200.8 Rev5 4 6/15/21 JJURGEVICH
7440-38-3
BabyICP
10 19 ug/L EPA 200.7 Rev4 4
6/15/21 JJURGEVICH
7440-41-7
Be by ICP
5.0 5.0 U
ug/L EPA 200.7 Rev4.4
6/15/21 JJURGEVICH
7440-70-2 Ca by ICP
0.10
49 mg/L
EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7440-43-9 Cd by ICPMS
0.50 0.50 U
ug/L EPA 200 8 Rev5.4
6/15/21 JJURGEVICH
7440-48-4 Cobalt by ICP
50 50 U
ug/L
EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7440-47-3 Cr by ICPMS
5.0 5.0 U ug/L EPA 200.8Rev5.4 6/15/21 JJURGEVICH
7440-50-8 Cu by ICPMS
2.0 43 ug/L EPA 200.8 Rev5 4 6/15/21 JJURGEVICH
7439-89-6 Fe by ICP
50 130
ug/L
EPA 200.7 Rev4 4 6/15/21 JJURGEVICH
7440-09-7 K by ICP
0.10 2.3 mg/L EPA200.7 Rev4.4 6/15/21 JJURGEVICH
7439-93-2 Li ICP
25 25 U ug/L EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7439-95-4 Mg by ICP
0.10
9.2 mg/L
EPA 200.7 Rev4 4 6/15/21 JJURGEVICH
7439-96-5 Mn by I C P
10 19 ug/L EPA 200 7 Rev4 4 6/15/21 JJURGEVICH
7439-98-7
Mo by ICPMS
10 10 U ug/L EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7440-23-5
Na by ICP
0.10 11
mg/L
EPA 200.7 Rev4 4 6/15/21 JJURGEVICH
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 (919) 7333908
"Not Detected" or"U" does not indicate the sample is analyte free but that the analyte is not detected at or above the PQL.
Page 1 of 3

WC 1n`D(t , Ga6oratorySection Resurts/Sample Comments/Qua(ier(Definitions
Sample ID: AC85162
CAS # Analyte Name
7440-02-0
Ni by ICPMS
PQL
2.0
Result/
Qualifier
2.5
Method
Units Reference
ug/L EPA 200.8 Rev5.4
Analysis,
Date Validated by
6/15/21 JJURGEVICH
7439-92-1
Pb by ICPMS
2.0
2.0 U
ug/L
EPA 200.8 Rev5 4 6/15/21 JJURGEVICH
7782-49-2 Se by ICPMS
1.0 1.0 U ug/L EPA200.8Rev5.4 6/15/21 JJURGEVICH
7440-28-0
Thallium (TI) ICPMS
2.0 2.0 U ug/L EPA200.8 Rev5.4 6/15/21 JJURGEVICH
7440-62-2 V by ICP
10
10 U
ug/L
EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7440-66-6 Zn by ICPMS
10
26
ug/L
EPA 200 8 Rev5 4 6/15/21 JJURGEVICH
Sample Comments
MIC:Fecal Coliform-B2-Counts from all filters = 0.
MIC:Fecal Coliform-Q1-Sample exceeded holding time prior to receipt at lab.
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the PQL.
Page 2 of 3

WC rDW& La&oratorySection gOsutts/Sample Comments/QuafifierrDefi'nitions
Sample ID: AC85162
CAS # Analvte Name
PQL
Result/
Qualifier
Units
Method
Reference
Analysis
Date
Validated by
NCDEQ-WSS-Chemistry Lab Data Qualifiers
Al The reported value is an average, where at least one result is qualified with a "U". The PQL is used for the qualified result(S) to calc
B 1 Coliform-Countable membranes with less than 20 colonies. Reported value is estimated or is a total of the counts on all filters repor
B2 Coliform-Counts from all filters were zero. The value reported is based on the number of colonies per 100 ml that would have been
B3 Coliform-Countable membranes with more than 60 or 80 colonies. The value reported is calculated using the count from the smalle:
B4 Coliform-Filters have counts of both >60 or 80 and <20. Reported value is estimated or is a total of the counts on all filters reported
B5 Coliform-Too many colonies were present; too numerous to count (TNTC). TNTC is generally defined as >150 colonies.
B6 Coliform-Estimated Value. Blank contamination evident.
B7 Coliform-Many non-coliform or non-enterococcus colonies or interfering non-coliform or non-enterococcus growth present. In this cc
BB1 MPN-No wells or tubes gave a positive reaction. Value based upon the appropriate MPN Index and reported as a less than "<" valu
BB2 MPN-All wells or tubes gave positive reactions. Value based upon the MPN Index and reported as a greater than ">" value.
C Total residual chlorine was present in sample upon receipt in the laboratory; value is estimated.
G1 BOD-The dissolved oxygen (DO) depletion of the dilution water blank exceeded 0.2 mg/L.
G2 BOD-The bacterial seed controls did not meet the requirement of a DO depletion of at least 2.0 mg/L and/or a DO residual of at lea:
G3 BOD-No sample dilution met the requirement of a DO depletion of at least 2.0 mg/L and/or a DO residual of at least 1.0 mg/L.
G4 BOD-Evidence of toxicity. This is generally characterized by a significant increase in the BOD value as the sample concentration de
G5 BOD-The glucose/ glutamic acid standard exceeded the range of 198 ± 30.5 mg/L.
G7 BOD-Less than 1 mg/L DO remained for all dilutions set. The reported value is an estimated greater than value and is calculated foi
G8 BOD-Oxygen usage is less than 2 mg/L for all dilutions set. The reported value is an estimated less than value and is calculated for
G9 BOD-The DO depletion of the dilution water blank produced a negative value.
J1 Surrogate recovery limits have been exceeded.
J10 Unidentified peak; estimated value.
J11 The reported value is determined by a one -point estimation rather than against a regression equation. The estimated concentration
J12 The calibration verification did not meet the calibration acceptance criterion for field parameters.
J2 The reported value failed to meet the established quality control criteria for either precision or accuracy.
J3 The sample matrix interfered with the ability to make any accurate determination.
J4 The data is questionable because of improper laboratory or field protocols (e.g., composite sample was collected instead of grab, p
J5 Temperature limits exceeded (samples frozen or >6°C) during transport or not verifiable (e.g., no temperature blank provided): non-
J6 The laboratory analysis was from an unpreserved or improperly chemically preserved sample. The data may not be accurate.
J7 This qualifier is used to identify analyte concentration exceeding the upper calibration range of the analytical instrument/method. Th
J8 Temperature limits exceeded (samples frozen or >6°C) during storage, the data may not be accurate.
J9 The reported value is determined by a one -point estimation rather than against a regression equation. The estimated concentration
M Sample and duplicate results are "out of control". The sample is non -homogenous (e.g., VOA soil). The reported value is the lower
N1 Presumptive evidence and estimated value. The component has been tentatively identified base on mass spectral library.
N2 There is an indication that the analyte is present, but quality control requirements for confirmation were not met (i.e., presence of
N3 This code shall be used if the level is too low to permit accurate quantification, but the estimated concentration is less than the labo
N4 This code shall be used if the level is too low to permit accurate quantification, but the estimated concentration is less than the labo
N5 The component has been tentatively identified based on a retention time standard.
P Elevated PQL* due to matrix interference and/or sample dilution.
Q1 Holding time exceeded prior to receipt by lab.
Q2 Holding time exceeded following receipt by lab.
S Not enough sample provided to prepare and/or analyze a method -required matrix spike (MS) and/or matrix spike duplicate (MSD).
U Indicates that the analyte was analyzed for but not detected above the reported practical quantitation limit*. The number value repo
U, J6 The laboratory analysis was from an unpreserved or improperly chemically preserved sample. The data may not be accurate.
UU Indicates that the analyte was not detected by a screen analysis. The number value was determined by a one -point estimation at tt
✓ Indicates the analyte was detected in both the sample and the associated method blank. Note: The value in the blank shall not be s
X1 Sample not screened for this compound.
X2 Sampled, but analysis lost or not performed -field error.
X3 Sampled, but analysis lost or not performed -lab error.
Y Elevated PQL* due to insufficient sample size.
Z1 Inability to analyze the sample.
Z2 Questions concerning data reliability.
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the PQL.
Page 3 of 3

AC85163 North Carolina Division of Water Resources Water Sciences Section Laboratory Results
Loc. Descr.: OLIPHANT RESIDENCE 1259 ELON PLACE
County: Guilford Collector: J GONSIENSKI VisitID
Region: Winston-Salem Report To WSRO Location ID: WSRO NLC
River Basin CPF Collect Date: 05/25/2021 Priority ROUTINE
Emergency Collect Time: 14:20 Sample Matrix: GROUNDWATER
COC Yes/No Sample Depth Loc. Type: Water Supply
Final Report
If this report is labeled preliminary report, the results have not been validated.
CAS # Analyte Name
Sample temperature at receipt by lab
PQL
Result/
Qualifier
LAB
0.9
Sample ID: AC85163
PO Number #
Date Received: 05/25/2021
Time Received: 08_15
Labworks LoginlD TASCENZOI
Delivery Method NC Courier
Final Report Date: 7/13/21
Report Print Date: 07/14/2021
Do not use for Regulatory purposes.
Units
oC
Method Analysis
Reference Date Validated by
5/26/21 MSWIFT
Coliform, MF Fecal in liquid
1
MIC
1 B2,Q1
CFU/100m1 SM 9222 D-1997 5/26/21 JJURGEVICH
Coliform, MF Total in liquid
1 1 B2,Q1
CFU/100m1 SM 9222 B-1997 5/26/21 JJURGEVICH
7664-41-7 NH3 as N in liquid
0.02
NUT
0.02 U
mg/LasN EPA 350.1 REV2
5/27/21 ALWILLIAMS
14797-55-8 Nitrate as N in liquid
0.02 0.37
mg/L as N EPA 3532 REV 2
5/27/21 ALWILLIAMS
14797-65-0 Nitrite as N in liquid
0.01 0.01 U
mg/L as N EPA 353.2 REV 2
5/27/21 ALWILLIAMS
E701177
NO2+NO3 as N in liquid
0.02 0.37
mg/L as N EPA 353.2 REV 2
5/27/21 ALWILLIAMS
24959-67-9 Bromide
0.4
WET
0.4 U
mg/L EPA 300.0 rev2.1
6/16/21 ALWILLIAMS
16887-00-6 Chloride
1.0 4.6 mg/L EPA 300.0 rev2.1
6/16/21 ALWILLIAMS
16984-48-8 Fluoride
0.4 0.4 U mg/L EPA 300.0 rev2.1
6/16/21 ALWILLIAMS
14808-79-8 Sulfate
2.0 5.7
mg/L EPA 300.0 rev2.1
6/16/21 ALWILLIAMS
Total Dissolved Solids in liquid
12 211 mg/L SM 2540 C-1997
5/26/21 ALWILLIAMS
7440-22-4 Ag by ICPMS
1.0
MET
1.0 U
ug/L
EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7429-90-5 Al by ICP
50 170 ug/L
EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7440-36-0 Antimony by ICPMS
10 10 U ug/L
EPA 200.8 Rev5 4 6/15/21 JJURGEVICH
7440-38-2 As by ICPMS
2.0 2.0 U
ug/L
EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7440-38-3 Ba by ICP
10 20
ug/L
EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7440-41-7
Be by ICP
5.0 5.0 U ug/L EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7440-70-2 Ca by ICP
0.10 50 mg/L EPA 200.7 Rev4.4
6/15/21 JJURGEVICH
7440-43-9 Cd by ICPMS
0.50 0.50 U
ug/L EPA 200.8 Rev5.4
6/15/21 JJURGEVICH
7440-48-4 Cobalt by ICP
50 50 U
ug/L
EPA 200 7 Rev4 4 6/15/21 JJURGEVICH
7440-47-3 Cr by ICPMS
5.0 5.0 U ug/L
EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7440-50-8 Cu by ICPMS
2.0 43
ug/L
EPA 200.8 Rev5 4 6/15/21 JJURGEVICH
7439-89-6
Fe by ICP
50 220
ug/L EPA 200.7 Rev4 4
6/15/21 JJURGEVICH
7440-09-7 K by ICP
0.10 2.4
mg/L
EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7439-93-2 Li ICP
25 25 U ug/L EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7439-95-4
Mg by ICP
0.10 9,5 mg/L EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7439-96-5
Mn by ICP
10 27 ug/L
EPA 200.7 Rev4.4 6/15/21 JJURGEVICH
7439-98-7
Mo by ICPMS
10 10 U ug/L EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7440-23-5
Na by ICP
0.10 12 mg/L EPA 200.7 Rev4.4
6/15/21 JJURGEVICH
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the PQL.
Page 1 of 3

NC (D41R1, Laboratory Section R suits/Sampee Comments/Quafifier(Definitions
Sample ID: AC85163
CAS # Analyte Name
7440-02-0 Ni by ICPMS
PQL
2.0
Result/
Qualifier
2.6
Units
ug/L
Method Analysis
Reference Date Validated by
EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7439-92-1
Pb by ICPMS
20
2.7
uglL
EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7782-49-2 Se by ICPMS
1 .0 1.0 U ug/L EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7440-28-0 Thallium (TI) ICPMS
2.0
2.0 U
ug/L
EPA 200.8 Rev5.4 6/15/21 JJURGEVICH
7440-62-2 V by ICP
10
10 U
ug/L
EPA200.7 Rev4.4 6/15/21 JJURGEVICH
7440-66-6 Zn by ICPMS
10
27
ug/L
EPA200.8 Rev5.4 6/15/21 JJURGEVICH
Sample Comments
MIC:Fecal Coliform-B2-Counts from all filters = 0.
MIC:Fecal Coliform-Ql-Sample exceeded holding time prior to receipt at lab.
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the PQL.
Page 2 of 3

NC rD'W& La6oratoryy Section Results/Samp1 Comments/Quarifier(Definitions
Sample ID: AC85163
CAS # Analyte Name
PQL
Result/
Qualifier
Units
Method
Reference
Analysis
Date
Validated by
NCDEQ-WSS-Chemistry Lab Data Qualifiers
Al The reported value is an average, where at least one result is qualified with a "U". The PQL is used for the qualified result(S) to call
B1 Coliform-Countable membranes with less than 20 colonies. Reported value is estimated or is a total of the counts on all filters repor
B2 Coliform-Counts from all filters were zero. The value reported is based on the number of colonies per 100 ml that would have been
B3 Coliform-Countable membranes with more than 60 or 80 colonies. The value reported is calculated using the count from the smalle:
B4 Coliform-Filters have counts of both >60 or 80 and <20. Reported value is estimated or is a total of the counts on all filters reported
B5 Coliform-Too many colonies were present; too numerous to count (TNTC). TNTC is generally defined as >150 colonies.
B6 Coliform-Estimated Value. Blank contamination evident.
B7 Coliform-Many non-coliform or non-enterococcus colonies or interfering non-coliform or non-enterococcus growth present. In this cc
BB1 MPN-No wells or tubes gave a positive reaction. Value based upon the appropriate MPN Index and reported as a less than "<" valu.
BB2 MPN-All wells or tubes gave positive reactions. Value based upon the MPN Index and reported as a greater than ">" value.
C Total residual chlorine was present in sample upon receipt in the laboratory; value is estimated.
G1 BOD-The dissolved oxygen (DO) depletion of the dilution water blank exceeded 0.2 mg/L.
G2 BOD-The bacterial seed controls did not meet the requirement of a DO depletion of at least 2.0 mg/L and/or a DO residual of at lea:
G3 BOD-No sample dilution met the requirement of a DO depletion of at least 2.0 mg/L and/or a DO residual of at least 1.0 mg/L.
G4 BOD-Evidence of toxicity. This is generally characterized by a significant increase in the BOD value as the sample concentration de
G5 BOD-The glucose/ glutamic acid standard exceeded the range of 198 ± 30.5 mg/L.
G7 BOD-Less than 1 mg/L DO remained for all dilutions set. The reported value is an estimated greater than value and is calculated foi
G8 BOD-Oxygen usage is less than 2 mg/L for all dilutions set. The reported value is an estimated less than value and is calculated for
G9 BOD-The DO depletion of the dilution water blank produced a negative value.
J1 Surrogate recovery limits have been exceeded.
J10 Unidentified peak; estimated value.
J11 The reported value is determined by a one -point estimation rather than against a regression equation. The estimated concentration
J12 The calibration verification did not meet the calibration acceptance criterion for field parameters.
J2 The reported value failed to meet the established quality control criteria for either precision or accuracy.
J3 The sample matrix interfered with the ability to make any accurate determination.
J4 The data is questionable because of improper laboratory or field protocols (e.g., composite sample was collected instead of grab, p
J5 Temperature limits exceeded (samples frozen or >6°C) during transport or not verifiable (e.g., no temperature blank provided): non-
J6 The laboratory analysis was from an unpreserved or improperly chemically preserved sample. The data may not be accurate.
J7 This qualifier is used to identify analyte concentration exceeding the upper calibration range of the analytical instrument/method. Th
J8 Temperature limits exceeded (samples frozen or >6°C) during storage, the data may not be accurate.
J9 The reported value is determined by a one -point estimation rather than against a regression equation. The estimated concentration
M Sample and duplicate results are "out of control". The sample is non -homogenous (e.g., VOA soil). The reported value is the lower
N1 Presumptive evidence and estimated value. The component has been tentatively identified base on mass spectral library.
N2 There is an indication that the analyte is present, but quality control requirements for confirmation were not met (i.e., presence of e
N3 This code shall be used if the level is too low to permit accurate quantification, but the estimated concentration is less than the labo
N4 This code shall be used if the level is too low to permit accurate quantification, but the estimated concentration is less than the labo
N5 The component has been tentatively identified based on a retention time standard.
P Elevated PQL* due to matrix interference and/or sample dilution.
Q1 Holding time exceeded prior to receipt by lab.
Q2 Holding time exceeded following receipt by lab.
S Not enough sample provided to prepare and/or analyze a method -required matrix spike (MS) and/or matrix spike duplicate (MSD).
U Indicates that the analyte was analyzed for but not detected above the reported practical quantitation limit*. The number value repo
U, J6 The laboratory analysis was from an unpreserved or improperly chemically preserved sample. The data may not be accurate.
UU Indicates that the analyte was not detected by a screen analysis. The number value was determined by a one -point estimation at tt
✓ Indicates the analyte was detected in both the sample and the associated method blank. Note: The value in the blank shall not be s
X1 Sample not screened for this compound.
X2 Sampled, but analysis lost or not performed -field error.
X3 Sampled, but analysis lost or not performed -lab error.
Y Elevated PQL* due to insufficient sample size.
Z1 Inability to analyze the sample.
Z2 Questions concerning data reliability.
WSS Chemistry Laboratory» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone]
"Not Detected" or "U" does not indicate the sample is analyte free but that the analyte is not detected at or above the PQL.
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Compliance Inspection Report
Permit: WI0400065 Effective: 08/08/16 Expiration: 07/31/21 Owner : Mark L Oliphant
SOC: Effective: Expiration: Facility:- Mark and Christel Oliphant-SFR 5A7
County: Guilford 1259 Elon PI
Region: Winston-Salem
High Point NC 27263
Contact Person: Mark L Oliphant Title: Phone:
Directions to Facility:
From W-S take US 311S to exit 70 and turn R, take E Kivett Dr. —1.9mi turn R, the property is at the end of Elon Place
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 05/25/2021 Entry Time 01:30PM
Exit Time: 03:05PM
Primary Inspector: Jim J Gonsiewski Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Sampling
Permit Inspection Type: Injection Heating/Cooling Water Return Well
Facility Status: El Compliant Not Compliant
Question Areas:
Wells System Operations
(See attachment summary)
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Permit: WI0400065 Owner - Facility: Mark L Oliphant
Inspection Date: 05/25/2021 Inspection Type : Compliance Sampling
Reason for Visit: Routine
Inspection Summary:
The system at the Oliphant property was inspected on May 25, 2021. The system appeared to be in good working order
and, according to the property owner, has not had any operational problems. The influent and effluent lines at the well were
sampled.
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Permit: WI0400065 Owner - Facility: Mark L Oliphant
Inspection Date: 05/25/2021 Inspection Type : Compliance Sampling
Reason for Visit: Routine
System Operation
Is same well used as source well and injection well?
Is injection well capable of assimilating injected fluid?
Injection flow rate at time of inspection (gpm)
Has system owner/operator noticed any abnormalities (turbidity, air in system, poor heating/cooling, etc) in
system operation?
Comment on system operation
Is system operation and construction consistent with that described in application?
Describe inconsistencies between application and observed operation/construction
According to the owner the system has been operating well. No inconsistencies noted in the well or system.
Comment:
Yes No NA NE
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