WQ0000185_Monitoring - 05-2021_20210725 (2)

DWR - NonDischarge Monitoring Report Submittal
NORTH CAROLINA
Ertrlranmerttat Quaffty
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0000185
Name of Facility:* Ocean Sands WWTP
Month:* May Year:* 2021
Report Information
Type* Upload Document*
Revised-GW-59 Revised GW- 285.69KB
59_07232021072348.pdf
FDF a,y
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter:* Rod Holley
Signature:
ee
Date of submittal: 7/25/2021
This will be filled in automatically
Initial Review
Reviewer: Mokashi, Poorva

Is the project number correct?* WQ0000185
Is the monitoring report C' Yes C No
accepted?*
Regional Office* Washington
Accepted Date: 8/9/2021

GW-59A COMPLIANCE REPORT FORM Permit# !t)A 0°co l 'c
(Submit one each monitoring period with GU/9 forms.)
1 Enter date monitoring results were due.(5/'5)/ZI ) Will this monitoring report(GW-59 and GW-59A) YES
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 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 8
identification plate,area overgrown,etc.)?1 f the answer is "Yes",contact the Regional Office for guidance.
4 Are any monitored constituents equal to or above the established standards? OD 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 standards in the space provided below:
5 For the constituents identified in question 4 above,have standards been exceeded previously for the YES1 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
stands ps, oncentration(s)reported,and sample collection date for each occurrence(for the last two years).
t�S f0'1'4
6 Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES SIZ
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 ES 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"NO",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 surrounding this facility. Failure to do so may subject the permittee to a Notice of Violation,
fines,and/or penalties. a
°146-1 v 4D F . Si /004A
6I�
nn 4,d AI c'G�s,S 1 s�, f)- t%air e,/al 11144
8 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.
4)11 6/z9/./
Signature of Permittee(or Aut¢orized Agent) Date
GW-59A 12/8/2993

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and I copy fo DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH NC 21699 1617 Phone:;(918).733-3229
FACILITY INFORMATION Please Print clearly or Type PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla .5iF t) NC 27927 Count
y Currituck El Lagoon El Remediation: Infiltration Gallery
lea,,, (Srac lz:PI ❑ Spray Field 0 Remediation:
Contact Person: Rod Holley Telephone#:[phone] 0 Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ElWater Source Heat Pump ElOther: Infiltration
(Ram Permit) ,r
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW4 Date sample collected:5/7/21 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:6.82 units Temp.o0010: 18.0 °C DRY at
Mhos time of
Depth to Water Level 82546:9.2 ft.below measuring point Screened Interval: 12 ft. to 17 fit. Spec.Cond.00094: u sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: sulfur check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance clear here:❑
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: 0 YES 0 NO
LABORATORY INFORMATION
Date sample analyzed:4/8/21 Laboratory Name: Enviro Chem 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 ug!L
Coliform: MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 0,41 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 3i504 /100mL Phosphorus:Total as P 00665 4.83 mg/L
(Note: Use MPN method far highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 644 mg/L Al-Aluminum sites mg/L
pH(Lab)00403 6.82 units Ba-Barium moor ug/L
TOC 00680 4.7 mg/L Ca-Calcium o0916 rnglL
Chloride 00940182 mglL Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug!L
Grease and Oils 00552 mglL Cu-Copper o1042 mg/L ORGANICS:(by GC,GC/MS, HPLC)
Phenol 32730 uglL Fe-Iron of 045 uglL (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 'Athos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia oa610 0.9 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 uglL ,method#
TI<N 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 certifthat,;to the best of myknowledge and belief the Information submitted in.his re pod is true,accurate and complete.arm)that theaborato analytical data was produced using ap,roved methods of analysis bya
R P � Yl P P ys
WM-certified laboratory. I ant aware that there are significant mottles for submitting':false information,including the possibi€ty',of fines and imprisonment for knowinguipfations
9 P
Rod Holley Wastewater Superintendent Trainee iZ £ 114 6/29/21
Permtttee(or Authorised Agent)Name and Title-Please print or type Signature of Permittee(or Autho'r7d Agent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT S NATURAL.RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM and t oOpY t0 1617MAIL SERVICE CENTER RALEIGH,NC 27699 1617 Phone:[phone]
FACILITY INFORMATION Please Print Cloaffy or Type PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla is:,``i NC 27927 Count
y Currituck 0 Lagoon 0 Remediation:infiltration Gallery
te,iy; t'`i"' izpi ❑ Spray Field ❑Remediation:
Contact Person: Rod Holley Telephone#:[phone] 0 Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 0 Water Source Heat Pump IN Other: Infiltration
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW5 Date sample collected:5/7/21 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 In. pH 00400:6.57 units Temp.onto: 18.1 °C DRY at
Depth to Water Level 62s46:5.0 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: Athos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Semi-clear here:❑
Samples for metals were collected unfiltered: [OYES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: 5/7/21 Laboratory Name: Enviro Chem Certification No, 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N oes15<0.02 mg/L Pb-Lead 01051 u9/L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 0.16 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 2.17 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 250 mg/L Al-Aluminum o1105 mg/L
pH(Lab)oo4as 6.57 units Ba-Barium 01007 uglL
TOG 00680 8.1 mg/L Ca-Calcium o0Bt6 mg/L
Chloride 00940 14 mgiL Cd-Cadmium o1a27 uglL
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 ug1L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 uglL Lab Report Attached? 0 Yes(1) 0 No(0)
Specific Conductance 00095 Mhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610 0.9 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NH3ee 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:certif Matto the best of knowledge:and belief the information submitted in this od is two..accurate and complete.and that the laboratory'anal cal data was produced using approved methods of analysis b a
Y Y pP Ya P 9 P .,. Y Y
DIN rtified la re significant false information, of imprisonment c
Qce..._ bnratnry i am aware Mat there are lg nt penalties for
P submitting _.._rm n,lwactudln9,tkie'-possrblldyo pdimp.....cmmnnt:for)fnnwumgYi4latons .-. .... . .... . ..
Rod Holley Wastewater Superintendent Trainee A, 14. J it 6/29/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorizedent) (Date)
GW-59 Rev.212010 ff

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OFENVIRONMENT&"NATURALiRESOURCES
GROUNDWATER QUALITY MONITORING; DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
and I co; py to
COMPLIANCE REPORT FORM 1617 MAIL SERVICEC ER RALEIGti NO27699-1617 Phone:(919)733,3221
FACILITY INFORMATION Please Print Clewlyor Type PERMIT Number: WQ0000195 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla i`_''recq NC 27927 County Currituck ❑ Lagoon 0 Remediation: Infiltration Gallery
c11„ sa„E�a Zr,: ❑ Spray Field ❑Remediation:
Contact Person: Rod Halley Telephone#:[phone] 0 Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 0 Water Source Heat Pump ®Other: Infiltration
(from Panes)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW6 Date sample collected:517/21 FIELD ANALYSES: WAS
Well Depth: 17.6 ft, Well Diameter: 3 In. pH 00400:6.82 units Temp.00010: 18.4 °C DRY at
Depth to Water Level 82546:6.1 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Clear here:❑
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: 0 YES 0 NO
LABORATORY INFORMATION
Date sample analyzed: 5/7/21 Laboratory Name: Enviro Chem 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 ug/L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N o0620 4.07 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P o066s 3.05 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 397 mg/L Al-Aluminum o1105 mg/L
pH(Lab)00403 6.82 units Ba-Barium 01007 ug/L
TOC 00680 3.5 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 58 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium:Total 01034 ug1L
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 ug1L Lab Report Attached? 0 Yes(1) ❑ No(0)
Specific Conductance 00095 i.tMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610<•2 mg/L Mg-Magnesium 00927 _mg/L ,method#
(Ammonia Nitrogen;NH3 as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug1L 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 certi that'to thnand :.the m fo ur te
best of m .knowled e. n nnatton submitted tn.this report is.trtre,.aec ate_and.com leis.ardthaY the iaborato anal cal'data was Produced a raved methods of analysis bya
fS` Y g . ppr1 Yb P 9 PP y
OW] c 'fled laboratory.'Q sdo . am aware tiialihere,aresi ntflca penalties for.Isub elfin false infnrrrtation include the ssibi6t of" lines and imprisonmentr' otatrons
1... 9 n1 P:.... .._ m... g .:....... n9 h Pp. ......Y 3okrsovr'in9 vt .. ..
Rod Holley Wastewater Superintendent Trainee 6Z Jr. 6/29/21
Petmitlee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Ag nt) (Date)
GW-59 Rev,2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEP43 TMENT Of ENVIRONMENT&NATURAL RESOURCES c '
GROUNDWATER QUALITY MONITORING: D MSION OF WATER QUALrfY-1NFOORMATION PROCESSING uNrr
and 1 copy to
COMPLIANCE REPORT FORM teJ7 MAIL SERVICE CENTER,RALEIGH NC 27699115.17 Phone:[phone].
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0000165 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other .
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (sir°eii NC 27927 Count
y Currituck El Lagoon ❑Remediation:Infiltration Gallery
, is:atoi (Zu” ❑ Spray Field ❑Remediation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump ®Other: Infiltration
1rrom Permit)
SAMPLING INFORMATION if WELL
WELL ID NUMBER(from Permit): MW7 Date sample collected:5/7/21 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00460:6.22 units Temp.00o10: 17.9 °C DRY at
Depth to Water Level 82546:4.2 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point Is 2 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Semi-Clear here:❑
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: 0 YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: 517/21 Laboratory Name: Enviro Chem 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 ug!L
Coliform:MF Fecal 31616<1 1100mL Nitrate(NO3)as N 00620 0.95 mg/L Zn-Zinc 01092 mglL
Coliform:MF Total 31504 1100mL Phosphorus:Total as P 00665 0.47 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 252 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 6.22 -units Ba-Barium 01007 ug/L
TOC 00680 6.9 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 36 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) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610<.2 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NHsas 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: mglL Effluent Total VOCs: mg/L VOC Removal%
Ei ,i I cerfr that, the bestof mykn6sr�[edae"arid.behef the nfnririafion.stibrnii submitted in tYrs:re report is true accurate and complete.antl'$hat theabnrata :analytical'data was produced usingapproved methods ofanalysisb a
.:, fY tPmp !'YP pP eh Y
D1NQ certified laboratory..1 am aware,mat:there are si9nifiicant penalties for;submitting`false'informatiQn,lnclading 1he'Passsb iYof fines_.,and imprisonment for knowing violations.
,:... .. �.:
Rod Holley Wastewater Superintendent Trainee g. ►j ,1 6/29/21
Permlttee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized gent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY '
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM and 1 copy to
is ' .. ..:1617 MAIL SERVICE CENTER,RALE(GH NC 27699 4B17 Phone:(919)733e9221,
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ00001B5 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla i`"`e`3 NC 27927 Count
y Cunituck 0 Lagoon 0 Remediation:infiltration Gallery
cEiy; s"t`` IT) ❑ Spray Field ❑Remediation:
Contact Person: Rod Holley Telephone#:[phone] 0 Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump ❑s Other: Infiltration
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW9 Date sample collected:5/7/21 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:6.77 units Temp.00010: 16.6 °C DRY at
Depth to Water Level 82546:6.2 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Semi-Clear here:❑
Samples for metals were collected unfiltered: ®YES 0 NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: 5/7/21 Laboratory Name: Enviro Chem 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 ug/L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 2.29 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 2.12 mg/L
(Nate: Use MPN method far highly turbid sampled Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 383 mg/L AI-Aluminum o1105 mg/L
pH(Lab)00403 6.77 units Ba-Barium 01007 ug/L
TOC 00680 15.5 _mg/L Ca-Calcium 00916 mg/L
Chloride 00940 37 _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 ot045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 -mg/L Hg-Mercury moo ug/L Lab Report Attached? 0 Yes(1) 0 No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 0os10<.2 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;Nt13as 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%
t certi€ythat,to the best of myknowledge and belief,the information submitted in this report is:true,'accurate,and,com complete,and>that the:laborato analytical data was.produced usingapproved methods of analysis bya P laboratory Yh Pp Y
DWQ-certified iaborato:" .I.am.aware Thal there are'si significant a allies or;subs itiing'false:information including the: i il:t,of fines and imprisonment_.. fY _:. 9 pP �.._.submitting p n9Possb...y __.. p rmentfor�ncnamg
Rod Holley Wastewater Superintendent Trainee ,ev 11 - P 6/29/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee for Autlloriz Agent) (Date)
GW-59 Rev.2/2010