HomeMy WebLinkAboutWQ0000185_Monitoring - 02-2022_20220331Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * February
Report Information
Type *
GW-59
WQ0000185
Ocean Sands WWTP
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
Ocean Sands 249.12KB
MW_03312022230815.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
rod.holley@currituckcountync.gov
Rod Holley
Reviewer: Gerald, Wanda
�iYell/I�,I
3/31 /2022
This will be filled in automatically
Is the project number correct?* WQ0000185
Is the monitoring report accepted?* YeS No
Regional Office* Washington
Accepted Date: 4/18/2022
j
Enter rate monitoring results were due. -37" ] Will this monitorinc report rGW-59 and GW-59k YES
be submitted after the established due date?
2
Was ani required information missing on :he GW-59 report forms? YESCO
IF the answer to question I or 2 is "YES", li`F in the space provided below the well identination number's) a.nd
exp;ein to problems encountered rn obtaini-2g the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, urlockrd or missing cap, missing YES
identification plate, area overgrowr, ere.r If !;w answer is "Yes", contact the Regicr. al OrTrce (or guidance.
i
O
Are any monitored constituents equal to or above the established standards? YES
E
NO
If the answer to question 4 is "NO, skip to section B.
If the answer to question 4 is "YES" Fst the affected wells individually with constituent(s) anc conceny-arion(s)
exceedting standards in the space provided below:
Al Vj
6S - &S`-q ��-7 dd-,i re- Z 2 � b �u ,t�i1 �-/.Z -:-63
1J143- b.S wb r -- 3a, ciJo'b�C - ?-&7
5
For -the constituents identified in question 4 above, have standards been exceeded previously for the Y'E
same constituent(s) in the same wall(s) fir the last two years?
NO
If the answer to question 5 is "NO', skip to section 8.
If the answer to question 5 is "YES"I Ixt :, the space provided below, each well with censtitaent(s) exceear7g
standards, concentration(s) report�al, enc' sample collection date for each occurrence (for the last two yeas,.
JAW —1
It Is
lG+L
Are the monitoring wells listed ir• section 5 located at or beyond the review boundary? YES
N
If the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFiCE IMMEDIATELY FOR GWDANCE. If the answer is "NO", monitoring welts may be improperly
locarea: contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this S
groundwater quality problem?
NO
If the answer to question 7 is "YES ". describe those actions in the space provided beow.
If the answer to question 7 is "AO", 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 com liance
boundaries surrounding this facility. Farnvre to do so maV subject the permittee to a Norice of Violation
fines. aid/or penalties. I od ' r
� 4 u 5 .�t,. d �nr I nl � � o In
S
The person completing this portion (,Glh=5.9A) of the monitoring report sPould sign flelow and submit this
form with G W-59 forms for required wells to the address provided at the top of the current GW-59 form.
I hereby.acknowledge.that the above infcrmation was evaluated and the information submitted.in'this
report Xompliance'.Report GIN-59A;.Is true and complete to the best of my knowledge
Signature of Permittee (or Au Prized Agent) Date
SUBMIT FORM ON YELLOW PAPER ONLY
r
DEPARTMENT OF ENVIRONMENT li NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALrrY INFORMATION PROCESSING UNIT,
COMPLIANCE REPORT FORM
1617.MEAILSERVICE CENTER,,RALEIGH, NC 27699-1617 Phone. 919} 7333221
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
Permit Name (it dilfE ient)
NPI)E-;; Other
F acility Addrro ss: 741 0onan Trall
TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla ('`°°ti NC
21921
County Currituck
❑ Lagoon ❑ Remediation: Infiltration Gallery
(city) istetel
(zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Narne: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑■ Other: Infiltration
(frr,m reirmit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (burn Permit). MW4
Date sarrlple culler led. 2/22/22
FIELD ANALYSES.
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 6.9 units Temp. 00010: 16.8 °C
DRY at
Depth to Water Level 82546:9•7 ft. below measuring point Screened Interval: 12 ft. to
17 ft. Spec. Cond. 000sa: µMhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 000as: none
check
Volume of water pumped/bailed before: sampling:
6.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: EYES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:2122122
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335
mg1L
Nitrite (NO2) as N 00615 <0.02
mg1L Pb - Lead oio5) ug1L
Coliform: MF Fecal 31616 4
1100ml-
Nitrate (NO3) as N 00620 4.49
mg1L Zn - Zinc 01092 mg/L
Coliform: IMF Total 31504
/100mL
Phosphorus: Total as P 00665 2.18
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 703o0 654
mg1L
Al -Aluminum 01105
mg/L
pH (L ab) 0040*1 6-9
units
Ba - barium 01007
ugll
TOG 00080 5.3
mg1L
CA Calcium 00910
mg/L
Chloride 00e40 246
mg/L
Od - Cadmium 01027
uQIL
Arsenic 01002
ug1L
Chromium: I Otal 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg1L ORGANICS: (by GC, GC1MS, HPLC)
Phenol 32730
ug1L
Fe - Iron 01045
ug11L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug1L Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 0009.5
uMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia ooslo 1.9
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammama Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug1L , method #
TKN as N oos25
mg/L
Ni - Nickel o1o67
ug1L method #
For Ramediation SyFtems Only (Attach Lab Reports):
Influent Total VOCs-
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Aqent) Name and Title - Please print or type
GW-59 Rev.2/2010
mry1L Fffluent Total VQCs•
mg/L VOC: Removal%a
SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT &NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
:
DIVISION OF WATER QUALITY INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
9697 MAIL Sl RYICE,CENTER RALEIGH; NC 27899,ifi17 Phone{999j 73322t ,
FACILITY INFS2RM&LION
Please Print Clearly or Type
FERMI I Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
I aclllty Addrear' 741 Oanan Trall
TYPr Or PFRMITTFD GPFRATION BrING MONITORFD
❑Lagoon ❑ Kemediatton: Infiltration Gallery
Corolla (street) NC 27927 CountyCurrituck
Eery) [state)
(Zdp)
❑ Spray Field ❑Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump X Other: Infiltration
(from r'ormit)
SAMPLING INFORMATION
If WELL
WELL ID NUMUL-R (from Permit): MW6
Date sample collected: 2122122
11LLD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7A units Temp. 000lo: 15.1 °C
DRY at
Depth to Water Level s2546:5.7 ft. below measuring point Screened Interval: 12 ft.
to 17
—
ft. Spec. Land, 00094' gMhos
tit of
sampling,
Measuring Point is 2 ft. above land ourfaoe
Rolativo M.P. Elovotion:
ft,
Odor corns: none
clteuk
Volume of water pumped/bailed before sampling:
5.0
gallons
Appearance Tan
hero:
❑
Samples for metals were collected unfiltered: 0 YES
El NO and field acidified: El YES
El NO
LABORATORY INFORMATION
Date sample analyzed:2122122
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mglL
Nitrite (NO2) as N 00615 0,03
mglL Pb - Lead 01o59 ug1L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 11.4
mglL Zn - Zinc 01092 mglL
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P 00665 2.31
mglL
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg1L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7030o 597
mg1L
Al - Aluminum oilo5
mg/L
pH (l ab) oo4oci 7.4
units
Sa - Barium olout
upll..
TOC 000so 7.8
mglL
Ca Calcium 0091G
mglL
Chloride 0094o 282
mg1L
Cd - Cadmium 01027
ug/L
Arsenic 01002
uglL
Chromium: I otal 01034
ug1L
Grease and Oils 00552
mg1L
Cu - Copper 01042
mg1L ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730
ug1L
Fe - Iron 01045
uglL (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg1L
I Ig - Mercury 71900
uglL Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mglL VOC 78732: method #
Total Ammonia ooslo 6.5
mglL
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH,asN; Ammonia Nitrogen, Total)
Mn - Manganese 01055
uglL method #
TKN as N 00625
mglL
Ni - Nickel 01067
uglL , method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total V00s:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
V YY-V�
r WC . -4. IV
mglt
Fffluent Total VOC,:
mglL
VOC Removal%a
SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT:OF.,ENVIRONMENT:&.NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DEVISIONOFWATERQUALITY 14FORMATION.PROCESSINGUNIT
COMPLIANCE REPORT FORM
1677,NIAIL SERVICE CENTER RALEIGH, NC 27699 iPi7 , Phona:;(979) 733-3221
FACILITY INFORMATION
PleasePrini Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Occan Sands
Non -Discharge UIC
Permit Name (if different):
NPDES Other
Facility Addres9• 741 Ocean Trail
TYPr OF PFRMITTED OPERATION BEING MONITORIFD
Li Lagoon LI Remediation: Infiltration Gallery
Corolla to°"'° NC 21921 Count y Currituok
(010
LJ Spray Field Lf Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
ElRotary Distributor ElLand Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump 0 Other: Infiltration
(From Permit)
SAMPLING INFORMATION
If WELL
WI=I I ID NLIMRFR (from Permit)- MW6
Date Rample collected. 2/22122
FIFL D ANAL YSFS•
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 0040o: 7.1 units Temp. 000io: 16.0 "C
DRY at
Depth to Water Level 82546:b.b ft. below measuring point Screened Interval: '11 ft. to
11 ft.
—
Spec, Cand, 000W4 µMlws
time of
sampling,
Measuring Point i5 2 ft above lapel surface
Relative M P Flevatiorr ft
Odor 0008fi- node
ehach
Volume of water pumped/bailed before sampling:
4.0
gallons
Appearance Clear
here:
❑
Samples for metals were collected unfiltered: RI YES
El NO and field acidified: El YES El NO
LABORATORY INFORMATION
Date sample analyzed:2122122
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 0.03
mg/L
Pb - Lead o1051 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 11.8
mglL
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 2.37
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7030o 670
mg/L
At - Aluminum 01105
mg/L
pH (Lab) oo4m 7.1
units
Ba Barium 01007
uglL
TOC omao 4.0
mg/t
Ca - Calcium 00916
mfllL
Chlondo 00940 328
mg/L
Cd - Cadmium 01027
ug/L
Awoulu wook
ug/L
Chroinlum! Total 01W4
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
uglL
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
pMhos
K - Potassium 00937
mg/L
VOC 78732: method #
Total Ammonia oo610 1.3
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total)
Mn - Manganese o1 o55
uglL
, method #
TKN as N 00625
mg1L
Ni - Nickel 01067
ug1L
method #
I -or Remediation Systems Unly (Attach Lab Reports):
Influent I otal VUCs:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Aqent) Name and Title - Please print or type
GW-59 Rev.2/2010
mg/L Lffluent Iotal VUUs:
mg/L VUG Removal%
SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT;OF ENVIRONMENT & NATURALRESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION oFWATERQUALITY-IN FORMATION.PROCESSINGUNIT
COMPLIANCE REPORT FORM
"
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699 1617 Phon(:. (919) 73"221
FAG ILITY INFORMATION
Please Print Clearly or type
PCRMIT Number- W00000185 Cxpiration Dater 611012024
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
U Lagoon U Retnedialion: Infiltration Gallery
Corolla (s'raDl) NC 21021 Count y Currituoll
` AY' t'l` "'
01't
U Spray Field U Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
ElRotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑■ Other: Infiltration
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ICI NUMBER (from Permit), MW7
Date sample oollooted• 21?21?2
FIFL D ANAL YSES-
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 0040a: 1.2 units Temp. 0ao10: 13.8 "(;
DRY at
Depth to Water Level 82546:4.6 ft. below measuring point Screened Interval: 1x ft.
to 'I 1 ft. Spec. Cond. 00094: µMMus
Limo of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft, Odor 00085: none
check
Volume of water pumped/hailed before sampling'
4.5
gallons
Appearance tan
here:
❑
Samples for metals were collected unfiltered: ® YE6
ElI\10 and fleld acidified: ❑ YES
El NO
LABORATORY INFORMATION
Date sample analyzed:2122122
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mglL
Nitrite (NO2) as N 00515 <0.02
mg1L Pb - Lead oio51 ug/L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 2.25
mglL Zn - Zinc 01092 mglL
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P o0665 0.83
mg/L
{Noce: Use MPN method for highly turbid samples)
Orthophosphate 70507
mglL Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7030o 349
mglL
AI - Aluminum 01105
mglL
PH (Lab) 00403 7.2
units
E3a - Barium 01007
uglL
TOC oosao 19.6
mglL
Ca - Calcium 00916
mglL
Chlorido omma 128
moll
Cd Cadmium 01027
uglL
At but nc01002
uy1L
Chloirllufn. JUIUIOI034
uy1L
Grease and Oils 00552
mglL
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
uglL
Fe - Iron 01045
uglL (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/1
Hg - Mercury 71900
uglL Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mglL VOC 78732: method #
Total Ammonia oo810 <0.2
mg1L
Mg - Magnesium 00927
mg1L method #
(Ammonia Nitrogen: NHaas N: Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug1L , method #
TKN as N 00625
mg1L
Ni - Nickel 01067
ug1L method #
For Remedlatlon Systems Only (Attach Lab Reports): Influent I otal VUGs:
Rod Holley Wastewater Superintendent Trainee
Permitlee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.212010
mg1L Lffluent I otal VOGs:
mglL VU(; Removal%
3/31/22
(Date)
SUBMIT FORM ON YELLOW PAPER ONLY
• .
DEPAI'TMENT:OF ENVIRONMENT & NATURAI. RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
96t7 MAIL SERVICE CENTER RALEIGH, NC 27699 1617; Phane:.(919) 733-3221 .
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Dale. 6/30/2024
Facility Name: Ocoan Sande
Non -Disc, large UIC
NPDES Other
Permit Name (if different):
Facility Address, 741 Ocean Trall
TYPF OF PERMITTED OPFRATION BEING MONITORED
Corolla tst ob-ii NC
21921 CountyCurrituolc
Li Layoan U Rernediatiun. Intillration Gallery
(city)
U Spray Field )J Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump N Other: Infiltration
(From P mit)
SAMPLING INFORMATION
If WELL
WF1 L ID NUMRFR (from Permit): MW9
Date sample collected: 2122122
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 0040o: 7.1 units Temp. 000lo: 15.7 °C
DRY al
Depth to Water Level 825405.E ft. below measuring point Screened Interval: 12 ft.
to 11 ft. Spec. Coed. 00094: µMhos
time, of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor a0089, none
oheok
Volume of water Pumped/bailed before sampling-
5.0
gallons
Appearance clear
here -
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:2122122
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD oo335
mg1L
Nitrite (NO2) as N 00615 <0.02
mg1L Pb- Lead o1o51 ug1L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (1103) as N 00620 8.05
mglL Zn - Zinc 01092 mg1L
Coliform: MF Total 31504
1100ml-
Phosphorus: Total as P oo665 1.23
mg1L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mglL Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7o3oo 620
mg1L
Al - Aluminum 01105
mg1L
pH (Lab) 004o3 7.1
units
Ba Barium 01007
ug1L
TOC 0068o 4.1
mglL
Ca - Calcium oo916
mg1L
Chloride 0094o 267
mg1L
Cd - Cadmium 01021
ug1L
Art urlio oIoo2
ug1L
Cluolnlum. Totul 0•10s4
ug1L
Grease and Oils 00552
mg1L
Cu - Copper 01042
mg1L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug1L
Fe - Iron 01045
ug1L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg1L
Hg - Mercury 71900
ug1L Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mglL VOC 78732: method #
Total Ammonia 00610 1.0
mg1L
Mg - Magnesium 00927
mglL method #
(Ammonia Nitrogen; MHaas N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
uglL , method #
TKN as N 00625
mglL
Nf - Nickel 01067
uglL method #
For Rernedlallon Systerns Unly (Attach Lab Reports): Influent Iola[ VUCs
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
mglL Lffluent Total VOUs:
mglL VUG Removal%
3/31122
GW-59 Rev.212010