WQ0014565_Monitoring - 11-2021_20211228

DWR - NonDischarge Monitoring Report Submittal
NORTH CAROLINA.
Enrlranmenlcl Quaflly
Monitoring Report Submittal
Permit Number #*
Name of Facility: *
Month:* November
Report Information
Type*
GW-59
wq0014565
Pilgrims
Year:* 2021
Upload Document*
Sanford Nov signed.pdf 329.03KB
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 Pedley
Signature:
j
Date of submittal: 12/28/2021
Initial Review
.........................................................
Reviewer:
Mokashi, Poorva
This will be filled in automatically

Is the project number correct?*
wg0014565
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Accepted Date: 1/20/2022

GW-59A COMPLIANCE REPORT FORM Permit # IVQ 001tf s4 S
(Submit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due. ( l2'90-2$ Will this monitoring report (GW-59 and GW-59A)
YES
10
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be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
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
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Office for guidance.
YES
4
Are any monitored constituents equal to or above the established standards?E
J
NO
If the answer to quest+on 4 is "NO" skip to section 8
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentratonls,'
exceeding standards in the space provided below
1'&W-3 pH (o.39
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same well(s) in the last two years?
r1/42)
NO
1standards
A")
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) exceedng
concentration(s) reported, and sample collection date for each occurrence (for the last two years• 1121 pti 5 ail il/2o pH 5nko 3110 pN '."o
Nat ?A S•o9 ''nu ?tl 5.14 At4" 4t
11M1a1 p14 4.02
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6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
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
groundwater quality problem?
YES
C
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 Realonal 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.
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.
l2-L1-
Signature of Permittee or Authorized Agent) Date
GW-59A 12/8/2003

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