WQ0003067_Monitoring - 03-2021_20210426

T' I -' SUS.MtT FORM ON YELLOW PAPER ONLY
r , i
•''Ma11.O.ridi.nat ar d DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: -•r •' . DIVISION OF WATER RESOURCES-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1 1617 MAIL SERVICE CENTER,RALEiGrl,NC276991617 Phort 91 06
FACILITY INFORMAT! Pu Type - PERMIT Numbe A1 E iration Date:
Facility Name: Vli Non-Discharge INL• '14 / UIC -
Permit Name(if dtfferen NPDES '. Other .
FaciltyAddress: PE OF PERMITTED OPERATION BEING MONITORED
County ❑ I] Remediation:Infiltration Gallery
' fly Spray Field O.Remediation:
Contact Persor' n/i//e � Cie Ciea Telephone C-bi—g/9-1417 c ❑`Rotary Distributor ❑ Land Application of Sludge
G .
WellLocation/$ite Name: (��, No_of wells to be sample(!' - . 0 Water Source Heat ❑Pump Other:
. _• r r , -
SAMPUNGINFORMATION La 4 �j n • If WELL
Date sa le collected:✓1 t' / f L' FIELD ANAL ES: WAS DRY
WELL ID NUMBER(fram Irirtit2; mp ►I/ at time of
I II Q 11�r Well Diameter: in_ pH ooaoo-"1• units Temp.mom `C
Welt Depth: � // fnt ( sampling.
Depth to WaterL-evets2s46: IQ 2 R below measuring point Sutured Interval: ft to ft Spec.Cond.00094: `K r� t+a'l check
Measuring Point is fL above.land surface Relative MR Elevation: f. Odor°Doss: /05 ) .
Volume of water:pumped/bailed before sampling: ig gallons CAPPa /Clip.
Samples;for metals-were collected.unfiltered: ES ❑ NO and field acidified: 0 YES 0 NO E.FF
LABORATORYINFORMATIONanalyzed:
3�2ct 12 I Laboratory Name: 1 Rc im ! 1-� .LNG•• _
Date sample analyzed [, Certification No_ 1
PARAMETERS NOTE:Values sho Id reflect dissolved and colloidal concentrations. •
COD o0335 mg/L Nitrite(NO2)as N:oasis /� mg/L Pb-lead o10 1 ug/L -
Coliform:MF Fecal 31616 J /100rnL Nitrate(NO3}as N 00620 Q. 3!i mg/L Zn-Zinc 01092 mg/L
Conform:MF Total315oa /100mL Phosphorus=Total as P Doss 0• ti,0 mg/L
(Norm Use iHPNrr,edrod for highly wreid ) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentra Units):
W ng/L Al-Aluminum a m0s mg/L /sp.\
Dissolved Solids_Total.7o300
pH(Lab)00403 /� units Ba-Barium 01007 ugh. ` -
TOCDose° 137� 0 mg/L Ca Calcium 00916 mg/L % to-
�5ti
Ctiloiideoosao mg/L Cd-Gadrriitmo•;o27 ug/L
Arsenic.01002 - ug/L Chromium:Total01o3a I %r_ ug/L
Grease and Oils oo552 mg/L Cu-Copper 01042 rt , ORGANICS:(by GC,GC/MS,HPLC)
Phenol 32730 ug/L Fe-Iron 01045 -- ug/L (Specify test and:method#.ATTACH LAB REPORT.)
Sutfafe oo9as mg/L Hg-Mercury 71900 -. ug/L Lab Report.Attached? 0 Yes(1) El No(0)
Specific Conductance°Doss ttos VOC raise ,method#
fiM K.-:Potasswm o0937 rflg/L
Total Ammonia ooclo �0•04 mg/L Mg_!Magnesium 00927 +, !Nit ,method#
(Ammon;aNgrogercr 3 N:'Ammonia t -Total) Mn-Manganese 01o55 ugh method# 1
TKN as N.0062, - mg/L Ni-Nickel o1o67 ug/L ,method#
For Rernedration.Systems Only(Attach:Lab Reports): influent Total VOCs: mg/L Effluent Total VOCs mg/L VOC Removal l
I kn'wl C e and belief�theinfoanatien:subraiuetin="is repoa is-trne,•aeeaate:•:and:corripletecandVtiat the laboratory analytical-data vras•piodueed vsing aWroveemathods o;anatyisms•by a::'"
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Peirnitee(or•✓rr•-•._'Agent)•Name and Title •:t or type Sigrauve of Perrrouee(or Authorized Agent) (Date
GW-59 Rev.82013

#,* SUBMIT FORM ON YELLOW PAPER ONLY
1
101F.Orlg,tial.aiid DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING_ 'I copyto DIVISION OF WATER RESOURCES-INFORMATION PROGESSRNG UNIT
COMPLIANCE REPORT FORM • 1617 MAIL SERVICE C RALEIGH,NC 27 1617 Phone„919-80
FACILITY INFORMATION n _ ?ease Print C c� O1 T Number_ ,I
Numbe i�i cation Date: g 1�ap4
FaaTty Name: �e5gA/•' y //f tk Ore.95y /e i e k j Non-Discharge UIC fff
Permit Name(if different): �4 g' i E ✓ NPDES Other
Faa!tyAddress: tltiy 5 Qj s Am D As , A. , / "et 1, • OF PERMITTED OPERATION BEING MONITORED
County 'I rA:R I 13 Lagoon D Remediation_Infiltration Gallery
!f )Spray Field O.Remediation:
Contact Person: l E.L G.}(�9i):tI C C Telephone# SR:_39,�-0Q/20 0 Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name VAAJ`t f ` No_of wells to be sampled: " 0 Water Source Heat Pump 0 Other:
SAMPLING.INFORMATION If WELL
WELL ID NUMBER(from Permit): 5 Date sarnple collected: ✓1 I l j 2i I FIELD Y. S: WAS DRY
Well.Depth: /y Well Diameter: in. pH own."f. louts Temp_00010- oC . at tune of
) /! sampling,
Depth to Water Level 8254: / fL below measuring:point Screened Interval: ft. to ft. Spec_Cond_00094: I'MhOS check
Measuring Point is R above land surface Relative M.P.Elevation: fL Odor°noes: NU 1- here:
Volume of water pumped/bailed before sampling: gallon .
.! Eu
Samples for metals were collected:unfiltered: •CII YES. D NO and field acidified:�i❑AYES Q�D/1N�O,•,_�`►•- (� {LABORATORY �-
ple INFORMATION /ZI 29/H Laboratory Name: e- `r Vi6C �'"Y ` i .014 • Certification No_ I 0
Date sample aria ed: ,J _I
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations_
COD o033s mg/I_ Nitrite(NO2)as N ooe;s mg/L Pb-Lead moss ug/L
Colrform:MF Fecal31616 / /100mi_ Nitrate(NO,,)as N wiz) - mg/L Zn-Zinc otg2 mg/I
Coliform:MF Total 31504 i► / /100mL Phosphorus:Total as P noses mg/L
(Noes Use►+PNmethoarocirgMj.asbid=rooks)_-
C7V7, Orthophosphate•70507 mg/L Other(Specify Compounds arid Concent ation Units):
DissolvedSolds_Total:70300 mg/L Al-Aluminum mos, mg/L
pH_(lab)owe units Ba-Barium u1007 ug/L
TOCoosao • mg/L Ca-Calcium 0o9zs mg/L
Chloride:oo9ao- mg/L Cd-Cadmium o102r ug/L
Arsenic 01002 • ug/L Chromium:Total oio34 ug/L
Grease and Oils 0055z mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC,GC/MS,HPLC)
Phenol 3273o ug/L Fe-Iron roes..
- ug/L (Specify test arid:mettiod:#ATTACH LAB REPOf2T_)
Sutlate oo94s mg/L Hg-Mercury 71906 - ug/L Lab•ReportAttached? Q Yes:(Y) 0 No(0)
Specific Conductance-000ss. . [ Ohm K-Potassium oo9aF rpg/C VOG;nsrst .method;#
Total Ammonia-iosmo �Q Q 14 mg/L. Mg-Magnesium oos¢7 mg/I_
method#
t!4!°^orra LNH asN:Ariirrionia tMrogett Toty) Mn-Manganese moss ugh -
. ,method•#
TKNJ asN:oo&-s mg/L Ni-Nickel mos7
ug/L ,method
For.Remediation Systems Only;(Attach Lab Reports)_ Influent Total VOCS` Effluent Total VGs: VOO Removal" .,
mg/L mg/L
is erafysnat.to the.bestof my knowledge anOCehef the effonnation subn mein this resod is true aecoa:e.an0 eomp1e1e,^a061flat tie laboratory analyneatdaM was protuet )using approvetlmethods of anatys*s by a r
DWRReert)tieettibotaiory.'t ant eivare•:Trat there are ssininieant aenafl esfersubmittin 'afsemfcf iraian. ::_'• 'X r
9 •'rlelu�fngthe'possibitiiy'o[�u�'pri5o r.
nme
�nq
!a a" GPIII . • .�
vote =:
Perm-tee(or AuthoriieoAgentyNameand.roc_ or ;, ,. __ � /'*' `9 1
Prior tYce Sig.• e o 'emssttee(or Authorized Agent)
fGw-59 Rev.82013

SUBMIT FORM ON YELLOW PAPER ONLY
* LA
• Mall original and DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: • • :1'copy to'DIVISION OF WATER RESOURCES-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM ,.., ,• 1617 MAIL SERVICE CENTER,RALEIGH,NC27699-1617 Phone:919-8 .
FACILITY INFORMA nt a ype PERMIT Number- EX iration Date: 31�p�O`
Facility Name: e A / / �C� k7 dIQS Non-Discharge/,(/(�(��golQ7 inc
Permit Name(if different): NPDES Other
Facility Address: AA0�( �j '{ , 'ECG I t G TYPE OF PERMITTED OPERATION BEING MONITORED
1 County aeRei- Q ® Remediation:Infiltration Gallery
'`., :�,,, /: ^•1 Spray Feld 0 Remediation:
Contact Person:�/ ,, ,„, j 4� Telephone#-�� F7 ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: No.of wells to be sampled: " 0 Water Source Heat Pump ❑ Other
riv,o rat
SAMPLING INFORMATION �j n n ' If WELL
WELL ID NUMBER(from omit):1A Date sample collected: +J ( I L-/ FIELD�Y S: WAS DRY
Well Depth: IT iv ft. Well Diameter in. pH 00400-16 gunits Temp.oomo: at time of
n -- tlos sampling,
Depth to Water Level 82546: 10 1 fL below measuring point Screened Interval: fL to ft. Spec-Cond.00094: check
Meacr tring Point is ft above land surface 5 Relative M.P.Elevation: ft. Odor 00085: Qn 6 here:
Volume of water pumped/bailed before sampling: gallons E frie eara pi t� -�
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: ❑ YES 0 NO I y �Gr D.
DateABORApORY INFORMATION tON /L 29 21Laboratory 61/4M g en. i► I,'/�'�
sample analyzed: �/ Name: . Certification No.
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N oasts mg/L Pb-Lead most ug/L
Coliform:MF Fecal 31616 Z. 1 /10om OP/Mir
�L Nitrate(NO3)as N 00620 mg/L Zn-Zinc 01o9z mg/L
m Colifor :MF Total 31504 L /100mL Phosphorus:Total as P owes ©• SP► mg/L
(Note:Use MPN method for highly turbid
Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 O mg/L Al-Aluminum a11os mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC oosao t► 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 Otis 00552 mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC,GC/MS,HPLC)
Phenol 32730 ugh Fe-Iron 01o4s ugh (Specify test and method#.ATTACH LAB REPORT)
Sulfate oo9a5 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ® No(0)
Specific Conductance oboes 1MhOS K-Potassium 00937 mg/L VOC 787a2 ,method#
Total Ammonia 00610 `�©• 0 4 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nte cfC NN'as N;Ammm is Nitrogen.Total) Mn-Manganese 01055 ug/L ,method#
TKN as N oo62s 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% 1
I certify that,Mee`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 approvedinethods of analysis by a;•. ..•
DWR•certified laboratory. I am aware that there are significant penalties submitting fatse•infonnatah;inctuding the possibTty of Sties and•irriprisonment for knowing violavm '••• .
Permittee(or Authorized Agent)Name and Title-Pirate print or type Sig.._of Permittee(or Authorized••ent) (Date)
GW-59 Rev.8/2013