WQ0002829_Monitoring - 09-2021_20211022

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DWR - NonDischarge Monitoring Report Submittal y. •4 ..
NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0002829
Name of Facility:* KDHWWTP WWTP
Month:* September Year:* 2021
Report Information
Type* Upload Document*
GW-59 WQ0002829 GW59 SEP 2.16MB
21.pdf
PDF Only
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:* TINA GEE
Signature:
Date of submittal: 10/22/2021
This will be filled in automatically
Initial Review
...................
Reviewer: Mokashi, Poorva

Is the project number correct?* WQ0002829
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Accepted Date: 11/5/2021

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
and 1 copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 6/30/2022
Facility Name: KDHWWTP Non-Discharge WQ0002829 UIC
Permit Name(if different): NPDES Other
Facility Address: 801 W OCEAN BAY BLVD TYPE OF PERMITTED OPERATION BEING MONITORED
KILL DEVIL HILLS NC 27948 County DARE ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:CW-A No. of wells to be sampled: 7 ❑ Water Source Heat Pump ■❑ Other: Conjuntive Reuse
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): CW-A Date sample collected: 9-28-2021 FIELD ANALYSES: WAS
Well Depth: 15 ft. Well Diameter: 2 in. pH 00400: 6.72 units Temp.00010: 24.2 °C DRY at
Mhos time of
Depth to Water Level 82546:5 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 1 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Clear here:
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: Envirochem 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 0.03 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.62 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 107 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 7.3 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 6 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 0.2 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.
TINA GEE-O&M MGR R 1-v.=,-.=_. .`-t 10/22/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (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
and 1 copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2022
Facility Name: KDHWWTP Non-Discharge WQ0002829 UIC
Permit Name(if different): NPDES Other
Facility Address: 801 W OCEAN BAY BLVD TYPE OF PERMITTED OPERATION BEING MONITORED
KILL DEVIL HILLS NC 27948 County DARE ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:36 0.476N-75 40.181W CW-B-1 No. of wells to be sampled: 7 ❑ Water Source Heat Pump ■❑ Other: Conjuntive Reuse
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): CW-B-1 Date sample collected: 9-28-2021 FIELD ANALYSES: WAS
Well Depth: 14 ft. Well Diameter: 2 in. pH 00400: 6.82 units Temp.00010: 23.6 °C DRY at
Mhos time of
Depth to Water Level 82546:8.5 ft. below measuring point Screened Interval: 4 ft. to 14 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 3 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: Slight check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Clear here:
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: Environmental Chemist Certification No.
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 <0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.63 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 111 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 1.8 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 8 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 <0.2 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.
TINA GEE-O&M MGR #.v 10/22/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Prmittee(or Authorized Agent) (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
and 1 copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 6/30/2022
Facility Name: KDHWWTP Non-Discharge WQ0002829 UIC
Permit Name(if different): NPDES Other
Facility Address: 801 W OCEAN BAY BLVD TYPE OF PERMITTED OPERATION BEING MONITORED
KILL DEVIL HILLS NC 27948 County DARE ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:CW-C No. of wells to be sampled: 7 ❑ Water Source Heat Pump ■❑ Other: Conjuntive Reuse
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): CW-C Date sample collected: 9-28-2021 FIELD ANALYSES: WAS
Well Depth: 16 ft. Well Diameter: 2 in. pH 00400: 6.78 units Temp.00010: 20.9 °C DRY at
Mhos time of
Depth to Water Level 82546: 11 ft. below measuring point Screened Interval: 6 ft. to 16 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 3 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Clear here:
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: Envirochem Certification No.
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations:
COD 00335 mg/L Nitrite (NO2)as N 00615 0.04 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3)as N 00620 22.8 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.23 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 381 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 16.1 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 <0.2 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.
TINA GEE-O&M MGR -- 10/22/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permit tee(or Authorized Agent) (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
and 1 copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 6/30/2022
Facility Name: KDHWWTP Non-Discharge WQ0002829 UIC
Permit Name(if different): NPDES Other
Facility Address: 801 W OCEAN BAY BLVD TYPE OF PERMITTED OPERATION BEING MONITORED
KILL DEVIL HILLS NC 27948 County DARE ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:CW-D No. of wells to be sampled: 7 ❑ Water Source Heat Pump ■❑ Other: Conjuntive Reuse
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): CW-D Date sample collected: FIELD ANALYSES: WAS
Well Depth: 17 ft. Well Diameter: 2 in. pH 00400: units Temp.00010: °C DRY at
Mhos time of
Depth to Water Level 82546: 16.5 ft. below measuring point Screened Interval: 7 ft. to 17 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 3 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: gallons Appearance here:) ,
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑ NO L
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: Envirochem Certification No.
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 /100mL Nitrate (NO3)as N 00620 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 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 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 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.
TINA GEE-O&M MGR t 10/22/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittie(or Authorized Agent) (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
and 1 copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 6/30/2022
Facility Name: KDHWWTP Non-Discharge WQ0002829 UIC
Permit Name(if different): NPDES Other
Facility Address: 801 W OCEAN BAY BLVD TYPE OF PERMITTED OPERATION BEING MONITORED
KILL DEVIL HILLS NC 27948 County DARE ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:CW-E-1 No. of wells to be sampled: 7 ❑ Water Source Heat Pump ■❑ Other: Conjuntive Reuse
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): CW-E-1 Date sample collected: 9-28-2021 FIELD ANALYSES: WAS
Well Depth: 13 ft. Well Diameter: 2 in. pH 00400: 6.60 units Temp.00010: 24.6 °C DRY at
Mhos time of
Depth to Water Level 82546:6 ft. below measuring point Screened Interval: 5 ft. to 13 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 3 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: Slight check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Light Yellow here:
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: Envirochem Certification No.
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 0.13 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.56 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 445 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 11.4 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 157 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 0.5 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.
TINA GEE-O&M MGR ,- -f- 10/22/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (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
and 1 copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 6/30/2022
Facility Name: KDHWWTP Non-Discharge WQ0002829 UIC
Permit Name(if different): NPDES Other
Facility Address: 801 W OCEAN BAY BLVD TYPE OF PERMITTED OPERATION BEING MONITORED
KILL DEVIL HILLS NC 27948 County DARE ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:CW-F No. of wells to be sampled: 7 ❑ Water Source Heat Pump ■❑ Other: Conjuntive Reuse
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): CW-F Date sample collected: 9-28-2021 FIELD ANALYSES: WAS
Well Depth: 15 ft. Well Diameter: 2 in. pH 00400: 6.24 units Temp.00010: 24.2 °C DRY at
Mhos time of
Depth to Water Level 82546:5.5 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 3 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 6 gallons Appearance Clear here:
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: Envirochem Certification No.
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 8.93 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 4.09 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 439 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 1.6 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 150 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 <0.2 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.
TINA GEE-O&M MGR , } -f. t__e_ 10/22/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (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
and 1 copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 6/30/2022
Facility Name: KDHWWTP Non-Discharge WQ0002829 UIC
Permit Name(if different): NPDES Other
Facility Address: 801 W OCEAN BAY BLVD TYPE OF PERMITTED OPERATION BEING MONITORED
KILL DEVIL HILLS NC 27948 County DARE ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:CW-G No. of wells to be sampled: 7 ❑ Water Source Heat Pump ■❑ Other: Conjuntive Reuse
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): CW-G Date sample collected: 9-28-2021 FIELD ANALYSES: WAS
Well Depth: 14.6 ft. Well Diameter: 2 in. pH 00400: 6.96 units Temp.00010: 24.0 °C DRY at
Mhos time of
Depth to Water Level 82546:3.5 ft. below measuring point Screened Interval: 5 ft. to 14.6 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 1 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 6 gallons Appearance Clear here:
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: Envirochem Certification No.
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations:
COD 00335 mg/L Nitrite (NO2)as N 00615 0.23 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3)as N 00620 3.34 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 4.08 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 366 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 4.08 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 104 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 <0.2 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.
1
TINA GEE D-O&M MGR 10/22/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(o Authorized Agent) (Date)
GW-59 Rev.2/2010