WQ0000185_Monitoring - 10-2021_20211130 (2)

Monitoring Report Submittal
Permit Number #* WQ0000185
Name of Facility:* Ocean Sands Wastewater Treatment Plant
Month: * October Year: * 2021
Report Information
Type* Upload Document*
GW-59 Ocean Sands 693.06KB
GW59_11302021141010.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: * Rod Holley
Signature:
Date of submittal: 11/30/2021
This will be filled in automatically
Initial Review
Reviewer: Zhong, Vivien

Is the project number correct?* WQ0000185
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Accepted Date: 12/13/2021

GW-59A COMPLIANCE REPORT FORM Permit # t,i 0 J 0 01 � S
(Submit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due. -2A ) Will this monitoring report (GW-59 and GW-59A)
YES
NQ
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES I
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
O
identification plate, area overgrown, etc.)? If the answer is "Yes ", contact the Regional Offrce.for guidance.
4
Are any monitored constituents equal to or above the established standards?
a
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.
W44i - 303
S
For the constituents identified in ques ion 4 above, have standards been exceeded previously for the
ES
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 B.
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).
rn w M
6%- "1 VzI T65- Ion- 9121 Nfl� -�.1 4121
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
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
ES
N0
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.
1); - GC 4 A � miv W -41.. i g
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g
The person com leting this portion (G W-59A) of the moniforing 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.
2 2 I
Signature of Permittee (or uthorized Agent) Date
GW-59A 12i812003

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