WQ0004823_Monitoring - 11-2021_20211222 (2)

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DWR - NonDischarge Monitoring Report Submittal
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Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0004823
Name of Facility:* PINE ISLAND CURRITUCK CLUB
Month:* November Year:* 2021
Report Information
Type* Upload Document*
GW-59 WQ0004823 MW NOV 21.pdf 1.28MB
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: 12/22/2021
This will be filled in automatically
Initial Review
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Mokashi, Poorva

Is the project number correct?* WQ0004823
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Accepted Date: 1/27/2022

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: 2-28-2024
Facility Name: Pine Island-Currituck Club LLC Non-Discharge WQ0004823 UIC
Permit Name(if different): NPDES Other
Facility Address: Old Stoney Rd. TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla NC 27927 County Currituck ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:PICC MW#1 No. of wells to be sampled: 4 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): PI-MW-1 Date sample collected: 11/15/2021 FIELD ANALYSES: WAS
Well Depth: / ft. Well Diameter: 2 in. pH 00400: 6.44 units Temp.00010: 22.9 °C DRY at
Mhos time of
Depth to Water Level 82546:6 ft. below measuring point Screened Interval: 12 ft. to 22 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 2.25 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 0.07 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3)as N 00620 2.78 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 1.76 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 470 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 2.9 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 189 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 on file in office , 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.
TINAGEE-MGR L . ,.t—_ 12/22/21
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: 2-28-2024
Facility Name: Pine Island-Currituck Club LLC Non-Discharge WQ0004823 UIC
Permit Name(if different): NPDES Other
Facility Address: Old Stoney Rd. TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla NC 27927 County Currituck ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:PICC MW#2 No. of wells to be sampled: 4 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): PI-MW-2 Date sample collected: 11/152021 FIELD ANALYSES: WAS
Well Depth: 23 ft. Well Diameter: 2 in. pH 00400: 6.49 units Temp.00010: 22.7 °C DRY at
Mhos time of
Depth to Water Level 82546:6.25 ft. below measuring point Screened Interval: 12 ft. to 22 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 2.1 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Light 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 0.09 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3)as N 00620 3.45 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 1.93 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 460 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 3.4 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 168 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 on file in office , 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-MGR 12/22/21
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: 2-28-2024
Facility Name: Pine Island-Currituck Club LLC Non-Discharge WQ0004823 UIC
Permit Name(if different): NPDES Other
Facility Address: Old Stoney Rd. TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla NC 27927 County Currituck ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:PICC MW#4 No. of wells to be sampled: 4 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): PI-MW-4 Date sample collected: 11/152021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 7.10 units Temp.00010: 17.8 °C DRY at
Mhos time of
Depth to Water Level 82546:6.5 ft. below measuring point Screened Interval: 10 ft. to 20 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 2.1 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: Faint check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Light 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 0.06 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 1.04 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 246 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 9.8 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 61 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 2.2 mg/L Mg-Magnesium 00927 mg/L on file in office , 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-MGR .s,f - -,.t-- 12/22/21
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: 2-28-2024
Facility Name: Pine Island-Currituck Club LLC Non-Discharge WQ0004823 UIC
Permit Name(if different): NPDES Other
Facility Address: Old Stoney Rd. TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla NC 27927 County Currituck ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tina Gee Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:PICC MW#5 No. of wells to be sampled: 4 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): PI-MW-5 Date sample collected: 11/152021 FIELD ANALYSES: WAS
Well Depth: 13 ft. Well Diameter: 2 in. pH 00400: 6.92 units Temp.00010: 18.6 °C DRY at
Mhos time of
Depth to Water Level 82546:5.5 ft. below measuring point Screened Interval: 5 ft. to 13 ft. Spec. Cond. 00094: µ sampling,
Measuring Point is 1.8 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: Faint check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Light 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 6 /100mL Nitrate (NO3)as N 00620 <0.2 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.26 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 89 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 6.6 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 14 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 1.8 mg/L Mg-Magnesium 00927 mg/L on file in office , 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-MGR Li—, �, 12/22/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.2/2010