WQ0003090_Monitoring - 03-2022_20220421 (2)

DWR - NonDischarge Monitoring Report Submittal . wF
NORTH CAROLINA
ErtrOranm@,NQl Qaafily
Monitoring Report Submittal
Permit Number#* WQ0003090
Name of Facility:* Town of liberty WWTP
Month:* March Year:* 2022
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR spray report 3 22.pdf 3.99MB
PDF Only
GW-59 gw 59 322.pdf 2.91 MB
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:* Elix Fike
Signature:
Date of submittal: 4/21/2022
This will be filled in automatically
Initial Review

Reviewer: Gerald,Wanda
Is the project number correct?* WQ0003090
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date: 4/26/2022

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY s DIV.OF WATER RESOURCES�
GROUNDWATER QUALITY MONITORING: y\y��V INFORMAIIONPROCESSINGUNIT
and 1 copy t
COMPLIANCE REPORT FORM ° 1617 MAIL SERVICE CENTER RALEIGH,NC27699-1617
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8131t2024
Facility Name: Town of Liberty WWTP Non-Discharge W00003090 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC 27298 County Randolph ❑ Lagoon Cl Remediation:Infiltration Gallery
❑ Spray Field 0 Remediation:
Contact Person: Tremaine Fike Telephone#: [phone] ❑ Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name: MW 2 No.of wells to be sampled: 5 0 Water Source Heat Pump 0 Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 2 Date sample collected: 3/21/2022 FIELD ANALYSES: WAS
Well Depth: 30.40 ft. Well Diameter: 2 in. pH 00400: 6.34 units Temp.00010: 16.8 °C DRY at
Depth to Water Level 82546:12,34 ft.below measuring point Screened Interval: ft. to_ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 3.00 gallons Appearance Clear here:®
Samples for metals were collected unfiltered: ❑YES ❑NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:3/21/2022 Laboratory Name: PACE ANALYTICAL LABS,INC. Certification No. 12 40 633
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N oe15 mg/L Pb-Lead oios1 ugiL
Coliform:MF Fecal 31616 2.0 /100mL Nitrate(NO3)as N 00620 0.27 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.050 mg/L
(Note: Use MPH method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 34.0 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 uglL
TOC 00680 <1.0 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 2.9 mg/L Cd-Cadmium 01027 uglL
Arsenic o1o02 uglL Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L 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/L Hg-Mercury 71900 uglL Lab Report Attached? ❑ Yes(1) 0 No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 ,method#
Total Ammonia oosio <0.10 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ansrwnia Nitrogen:NH3 as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 uglL ,method#
TKN as N 00625 mg/L Ni-Nickel 01067 uglL ,method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
i certify ,,the \ . ,, �. F ac: n :complete.e� a a the laboratoryanalyticalda\ cdu��tt sr� ��.�e, methods��� by��\\\�
�� .best.� ��red �n, a Per to crttta o�uuit�e�trs sra� ,u�o accurate and�crr r e�ntt�tt ra 1a c � �
ram. � �
a o,y.s to >e, s�fbt of dltn r�son for�t�sc�\uora�o. �, �v e e. r .apes .., f _,.. se. � �b o �laboratory .�. � 'e z� for z� � t �l p � ._..� ��\\���\
Scott Kidd Town Manager
Permittee(or Authorized Agent)Name and Title-Please print or type Si.r—p. tte_=-(or Authorized gent) (pate)
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
aioriginal DEPARTMENT OF ENVIRONMENTAL QUALITY-DIV,OF WATER RESOURCES
GROUNDWATER QUALITYMONITORING: d\ \\\ INFORMATION PROCESSING UNIT
copy t
C® PLI CE REPORT FORM \\\\�\` 1617 MAIL SERVICE CENTER,RALEIGH,NC27699-1617
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP Non-Discharge WQ0003090 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC 27298 County Randolph ❑ Lagoon 0 Remediation:Infiltration Gallery
❑ Spray Field 0 Remediation:
Contact Person: Tremaine Fike Telephone#: [phone] 0 Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: MW 4 No.of wells to be sampled: 5 0 Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 4 Date sample collected: 3/21/2022 FIELD ANALYSES: WAS
Well Depth: 30.63 ft. Well Diameter: 2 in. pH 00400: 6-77 units Temp.00010: 17.1 °C DRY at
Depth to Water Level 8254s:10.3 ft.below measuring point Screened Interval: ft. to ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 3.75 gallons Appearance Clear here:
Samples for metals were collected unfiltered: ❑YES IN NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:3/21/2022 Laboratory Name: PACE ANALYTICAL LABS,INC. Certification No. 12 40 633
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 <1.0 /100mL Nitrate(NO3)as N 00620 0.90 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.050 mg/L
(Note. Use MPH method far highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 72.0 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 uglL
TOC 00680 <1.0 mg/L Ca-Calcium 00916 mg/L
Chloride oo940 10.9 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ugfL
Grease and Oils 00552 mg/L Cu-Copper 01042 mglL ORGANICS:(by GC,GC/MS,HPLC)
Phenol 32730 ugfL Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug1L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 ,method#
Total Ammonia 00610 <0.10 mg/L Mg-Magnesium 00927 mglL ,method#
(Ammonia Nitrogen:NH3 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%
ertthr td the \ .. t a( meth \\...
��YEr�that:r . best-of knowledgeand b=1 � orm o�sub.ttt �ar'�this report: 1re2�=.accurate' :�� :coat Tit��d� .. ta�orato =. - :datawas r�dts�eda� r��edY�iet methods ; eb�
� o� �t�an � � � moo.� r� and � \� that � i�lica? 'a stn � � a'�fp �
...
-tee � o.\�zssWar;=. at,. on pe ethes for suorratonzfalser.orm orsmtldtn.:the.assi 11 -fates and impmsonment for knomng,sore s �.. \ \\� .\\. �\\�\
Scott Kidd Town Manager
`>Permittee(or Authorized Agent)Name and Title-Please print or type Sao ertnittee or Authorized Agent) (Da e
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTALQUAUTY-DIV-OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT
ands copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER RALEIGH,NC27sss-1617
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP Non-Discharge W00003090 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC 27298 County Randolph ❑ Lagoon ❑Remediation:Infiltration Gallery
I Spray Field ❑Remediation:
Contact Person: Tremaine Fike Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: MW 5 No.of wells to be sampled: 5 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 5 Date sample collected: 3/21/2022 FIELD ANALYSES: WAS
Well Depth: 27.15 ft. Well Diameter: 2 in. pH 00400: 6.59 units Temp.00010: 17 °C DRY at
Mhos time of
Depth to Water Level 82546:20.34 ft,below measuring point Screened Interval: ft. to�ft, Spec.Cond.00094: µ sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 6.5 gallons Appearance Clear here: g
Samples for metals were collected unfiltered: El YES 0 NO and field acidified: ❑YES 0 NO J
LABORATORY INFORMATION
Date sample analyzed:3/21/2022 Laboratory Name: PACE ANALYTICAL LABS,INC. Certification No. 12 40 633
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mgiL Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ugfL
Coliform:MF Fecal 31616 <1.0 /100mL Nitrate(NO3)as N o0620 0.60 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.050 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 uglL
TOC 00680 2.5 mg/L Ca-Calcium 00916 mg/L
Chloride oo94o 40.7 mg/L Cd-Cadmium 01027 ugfL
Arsenic 01002 ugfL Chromium:Total 01034 ugfL
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC,GC/MS,HPLC)
Phenol 32730 ugfL Fe-Iron 01045 ugfL (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 cocas µMhos K-Potassium 00937 mg/L VOC 7873 ,method#
Total Ammonia 00610 <0.10 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen,NH3as N:Ammonia Nitrogen,Total) Mn-Manganese 01055 ug!L ,method#
TKN as N 00625 mg/L Ni-Nickel 01067 ugfL ,method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mgiL 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
DWR certfied laboratory;(am.aware that there are;significant penalties for submitting false information,includingthe possibility of fines and imprisonment for knowing violations.:.
Scott Kidd Town Manager - (II' -i z 2—
Permittee(or Authorized Agent)Name and Title-Please print or type Signature='*"erm ittee(or Authorized Agent) i pate)
GW 59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY DIV.OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: copy# INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM and 1 1617 MAIL SERVICE CENTER,RALEIGH,NG27699-1st r
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP Non-Discharge WQ0003090 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC 27298 County Randolph ❑ Lagoon ❑Remediation:Infiltration Gallery
0 Spray Field ❑Remediation:
Contact Person: Tremaine Fike Telephone#: [phone] D Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: MW 6 No.of wells to be sampled: 5 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 6 Date sample collected: 3/21/2022 FIELD ANALYSES: WAS
Well Depth: 30 ft. Well Diameter: 2 in. pH 00400: 6.56 units Temp.oa01o: 16.4 °C DRY at
Depth to Water Level 82546:18.89 ft.below measuringMhos time of
point Screened Interval: ft. to_ft. Spec.Cond.00094: µ sampling.
Measuring Point is 2 ft,above land surface Relative M.P.Elevation: ft. Odor 00085' check
Volume of water pumped/bailed before sampling: 9.25 gallons Appearance Clear here:❑
Samples for metals were collected unfiltered: ❑YES ❑® NO and field acidified: ❑YES ■❑NO
LABORATORY INFORMATION
Date sample analyzed:3/21/2022 Laboratory Name: PACE ANALYTICAL LABS.INC. Certification No, 12 40 633
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 <1.0 /100mL Nitrate(NO3)as N 00620 0.48 mg/L Zn-Zinc 01092 mg/L
Coliform:ME Total 31504 /100mL Phosphorus:Total as P 00665 <0.050 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 62 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ugiL
TOC 00680 <1.0 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 4.4 mg/L Cd-Cadmium 01027 ug/L
Arsenic el002 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? l Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 ,method#
Total Ammonia 00610 <0.10 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen:NHaas N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L ,method#
TKN as N 00625 mg/L Ni-Nickel 01067 ugiL ,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 i i this report is-true accurate and complete and that the laboratory analytical data was produced using approved methods of analysts bya
DWR-certified laboratory.:Cam aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations:
Scott Kidd Town Manager :' 7
Pennittee(or Authorized Agent)Name and Title-Please print or type Sig Permittee(or Authorized Agent F (Dae)
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY=DIV.OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT
and I copy to:
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER.RALEIGH,NC 27699-1617
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP Non-Discharge W00003090 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Bx 1006 TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC 27298 County Randolph ❑ Lagoon ❑Remediation:Infiltration Gallery
11 Spray Field ❑Remediation:
Contact Person: Tremaine Fike Telephone#: [phone] ❑ Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name: MW 7 No.of wells to be sampled: 5 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 7 Date sample collected: 3/21/2022 FIELD ANALYSES: WAS
Well Depth: 27.20 ft. Well Diameter: 2 in. pH 00400: 6.48 units Temp.coot 0: 17.9 °C DRY at
Depth to Water Level 82546:16.95 ft.below measuring point Screened Interval: ft. to ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 4.75 gallons Appearance Clear here:
Samples for metals were collected unfiltered: ❑YES 0 NO and field acidified: ❑YES Ei NO
LABORATORY INFORMATION
Date sample analyzed:3/21/2022 Laboratory Name: PACE ANALYTICAL LABS,INC. Certification No. 12 40 633
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 0o615 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 <1.0 /100mL Nitrate(NO3)as N 00620 0.84 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.050 mg/L
(Note. Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 76.0 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 uglL
TOC 00680 <1.0 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 16.1 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 uglL 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 o1045 ugtL (Specify test and method#,ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? D Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 ,method#
Total Ammonia 00610 <0.10 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NNaas N;Ammonia Nitrogen.Total) Mn-Manganese o1055 uglL ,method#
TKN as N 00625 mg/L Ni-Nickel 01067 uglL ,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=analysts by a
MR-certified laboratory,Iam aware that mere are significant penalties for submitting false information.including the possibility of'f'ines and tmpnsonmentfor knowing violations...:,.. ...
Scott Kidd Town Manager Permittee(or Authorized Agent)Name and Title-Please print or type Sigrt ermittee(or Authorized Agent) IV2Z1
(DO)
GW-59 Rev.06-07-2018

51)A 11,1AN("111" El,()RT Permii II W00003090
(SU Nub tqwh inouiforirgg period with Glr-59
1 Enter date monitoring results were due. (4/31/2022 ) Will this monitoring report(GW-59 and GW-59A) YES NO
be submitted after the established due date?
X
2 Was any required information missing on the CW-59 report forms? YES NO
X
IF the answer to question 1 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 NO
identification plate,area overgrown,etc.)?If the answer is "Yes",contact the Regional Office for guidance.
X
4 Are any monitored constituents equal to or above the established standards? YES N
A
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:
5 For the constituents identified in question 4 above,have standards been exceeded previously for the YES 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 8.
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).
6 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 YES NO
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 subiect 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 knowle ge.
1 2,2/2
Signafu of Permittee(or Authorize Agent) Date
( W,59 is, 2/8/Z01)3

Pace Analytical Services,LLC
aceAnalytica! 1377 South Park Drive
o
Kernersville,NC 27284
www.pacelabs.com [phone]
i
Page 1 of 2
Laboratory Report
Tremaine Fike Report Date: 03/31/2022
Town of Liberty Date Received: 03/21/2022
PO Box 1006
Liberty, NC 27298
Project: Town of Liberty-MW
Pace Project No.:92594434
Sample: MW-2 Lab ID: 92594434001 Collected: 03/21/22 09:00 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540C-2015 Total Dissolved Solids 34.0 mg/L 25.0 03/22/22 11:09
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 0.27 mg/L 0.040 03/22/22 13:46
SM 9222D-2015 Fecal Coliforms 2.0 CFU/100 mL 1.0 03/22/22 14:56
EPA 300.0 Rev 2.1 1993 Chloride 2.9 mg/L 1.0 03/23/22 15:13
EPA 350.1 Rev 2.0 1993 Nitrogen,Ammonia ND mg/L 0.10 03/31/22 14:31
EPA 365.1 Rev 2.0 1993 Phosphorus ND mg/L 0.050 03/30/22 16:42
SM 5310E-2014 Total Organic Carbon ND mg/L 1.0 03/23/22 14:52
Sample: MW-4 Lab ID: 92594434002 Collected: 03/21/22 09:30 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540C-2015 Total Dissolved Solids 72.0 mg/L 25.0 03/22/22 11:09
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 0.90 mg/L 0.040 03/22/22 13:49
SM 9222D-2015 Fecal Coliforms ND CFU/100 mL 1.0 03/22/22 14:56
EPA 300.0 Rev 2.1 1993 Chloride 10.9 mg/L 1.0 03/23/22 15:28
EPA 350.1 Rev 2.0 1993 Nitrogen,Ammonia ND mg/L 0.10 03/31/22 14:32
EPA 365.1 Rev 2.0 1993 Phosphorus ND mg/L 0.050 03/30/22 16:44
SM 5310B-2014 Total Organic Carbon ND mg/L 1.0 03/23/22 15:42
Sample: MW-5 Lab ID: 92594434003 Collected: 03/21/22 09:56 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540C-2015 Total Dissolved Solids 246 mg/L 25.0 03/22/22 11:09
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 0.60 mg/L 0.040 03/22/22 13:51
SM 9222D-2015 Fecal Coliforms ND CFU/100 mL 1.0 03/22/22 14:56
EPA 300.0 Rev 2.1 1993 Chloride 40.7 mg/L 1.0 03/23/22 15:44
EPA 350,1 Rev 2.0 1993 Nitrogen,Ammonia ND mg/L 0.10 03/31/22 14:34
EPA 365.1 Rev 2.0 1993 Phosphorus ND mg/L 0.050 03/30/22 16:45
SM 5310B-2014 Total Organic Carbon 2.5 mg/L 1.0 03/23/22 16:01
Sample: MW-6 Lab ID: 92594434004 Collected: 03/21/22 10:50 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540C-2015 Total Dissolved Solids 62.0 mg/L 25.0 03/22/22 11:10
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 0.48 mg/L 0.040 03/22/22 13:54
SM 9222D-2015 Fecal Coliforms ND CFU/100 mL 1.0 03/22/22 14:56
EPA 300.0 Rev 2.1 1993 Chloride 4.4 mg/L 1.0 03/23/22 15:59
EPA 350.1 Rev 2.0 1993 Nitrogen,Ammonia ND mg/L 0.10 03/31/22 14:35
EPA 365.1 Rev 2.0 1993 Phosphorus ND mg/L 0.050 03/30/22 16:46
SM 5310E-2014 Total Organic Carbon ND mg/L 1.0 03/23/22 16:19
Sample: MW-7 Lab ID: 92594434005 Collected: 03/21/22 10:25 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540C-2015 Total Dissolved Solids 76.0 mg/L 25.0 03/22/22 11:10 Page 1 of 4

Pace Analytical Services,LLC
aceAnalytical 1377 South Park Drive
Kernersville,NC 27284
www.pacelabs.com [phone]
Page 2 of 2
Sample: MW-7 Lab ID: 92594434005 Collected: 03/21/22 10:25 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
EPA 353.2 Rev 2.0 1993 Nitrogen,Nitrate 0.84 mg/L 0.040 03/22/22 13:53
SM 9222D-2015 Fecal Coliforms ND CFU/100 mL 1.0 03/22/22 14:56
EPA 300.0 Rev 2.1 1993 Chloride 16.1 mg/L 1.0 03/23/22 16:15
EPA 350.1 Rev 2.0 1993 Nitrogen,Ammonia ND mg/L 0.10 03/31/22 14:36
EPA 365.1 Rev 2.0 1993 Phosphorus ND mg/L 0.050 03/30/22 16:46
SM 5310B-2014 Total Organic Carbon ND mg/L 1.0 03/23/22 16:38
Reviewed by:
� ' -`
�
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#:E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden,NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Certification#:37738 VirginiaNELAP Certification#:460025
Page 2 of 4

GROUNDWATER MONITORING FIELD LOG
Personnel Present CONIMENTS:
Facility Town of Liberty
03/21/22 Glenn Price
Weather Clear 48°F Date
NiOniMrin Weil,No.;.-.s*:.:-. ':..•-:MW-2:-::-:- ..':..-:MW-4:.:-... ....,::10W-5.:•.'.-:. :.:.:.:.:MW:•6:.-:...: .--:..•M\v,:l.:-:•.:-: ':-..:.:-:.:..-:-:.:-:..:..:..Eff:.-..-. .::.-.::.::.•:: .:•..::.: .....-:... ••:.. : :.. :: : - -
_ . .
Total Depth(FT.) 30.40 30.63 27.15 30.00 27.20
Surface Depth(FT.) 18.06 20.33 6.81 11.11 10.25
Water Depth(Fr.) 12.34 10.30 20.34 18.89 16.95
Diameter (IN.) _-, -”,
_ 2"
2"
2"
. .
- r
Conversion Factor 0.16 0.16 0.16 0.16 0.16
. .. -
Well Volume(GAL.) 1.97 I.65 3.25 3.02 2.71
. ,
Volume(GAL.) X 3 5.92 4.94 9.76 9.07 8.14
24 20 40 37 33
#Bails(I.)
Purge Date 03/21/22 03/21/22 03/21/22 03/21/22 03/21/22
Purge Time(hrs.) 0849 0917 0938 1038 1011
, .
Purge Method Bailer Bailer Bailer Bailer Bailer
. _Volume Removed(GAL.) 3.00-Dry 3.75-Dry 6.50-Dry 9.25 4.75-Dry
. ,Sampling Date 03/21/22 03/21/22 03/71/27 03/21/22 03/21/22 03/21/22
. ,Sampling Time(hrs.) 0900 0930 0956 1050 1025 1000
Sampling Method Bailer Bailer Bailer Bailer Bailer Grab
. -
pll(Standard Units) 6.34 6.77 6.59 6.56 6.48
•Temperature(EC) 16.8 17.1 17.0 16.4 17.9
Conductivity(pmhosicin)
) .Dissolved Oxygen(mg/I..)
. .- .. - -
Observations/Sampling Clear Clear Clear Clear Clear
- -
..... _

8 CHAIN-OF-CUSTODY Analytical Request Document ��LAB USE ONLY-Affix Workorder/Login Label Herr or l it co w .0 -+-_ --,---- -
`aceAnalytical.v NiT11`
Chain-of-Custody is a LEGAL DOCUMENT-Complete all relevent fields
Company: Town of Liberty Billing Information: �� 1 1 ill
ALL SHADED ARE III
Address: Container Preservative Type"" �2594434
3 I u ! 2 i 8 I o I I
Report To: Email To: "'Preservative Types:(1)nitric acid,(2)sulfuric acid,(3)hyuwuuur¢acid,ia)sodium hydroxide,(5)zinc acetate, [i
(6)methanol,(7)sodium bisulfate,(8)sodium thiosulfate,(9)hexane,(A)ascorbic acid,(B)ammonium sulfate,
Copy To: Site Collection Info/Address: (C)ammonium hydroxide,(D)TSP,(U)Unpreserved,(D)Other 1
Analyses Lab Profile/Line:' (
Customer Project Name/Number: State: County/City: Time Zone Collected: Lab Sample Receipt Checklist:
/ [ ]PT[ ]MT[ ]CT [ ]ET` P / � I
Custody Seals Present/Intact Y N Q. II
Phone: Site/Facility ID#: !Compliance Monitoring? ( 1 custody signatures Present N L A
!' II Collector Signature Present N NA
Email: [ Yes [ ]No # Bottles Intact N NA
Collect d jay(print): Purchase Order#: 'DW, PWS ID#: ! ( Correct Bottles N NA
f�J _ !!! Sufficient Volume N NA I
O�/`J(/l t Quote#: D Location Code:
t J Samples Received on Ice N NA
Collected By(ssignnatur/): Turnaround Date Required: Immediately Packed on Ice: I VOA Headepace Acceptable N
,- -"-- .1/ j `\--- [ ]Yes [ ]No USDA Regulated Soils N NAB
Samples in Holding Time N A
Sample Disposal: Rush: Field Filtered(if applicable): Residual Chlor c r ent Y N>IA I
[ ]Dispose as appropriate [ I Return [ ]Same Day [ ]Next Day [ ]Yes [ ]No M Cl Strips: 7j ���
[ ]Archive: [ ]2 Day [ ]3 Day [ ]4 Day [ ]S Day sample pH A uAtiabl.e �� / Y,N NA
Analysis: Z pH Strips:` a", aV-hV
[ ]Hold: (Expedite Charges Apply) Sulfide Present Y N fA (
"Matrix Codes(Insert in Matrix box below):Drinking Water(OW),Ground Water(GW),Wastewater(WW), 00 76 Lead Acetate Strips: i
V Product(P),Soil/Solid(SL),Oil(OL),Wipe(WP),Air(AR),Tissue(TS),Bioassay(B),Vapor(V),Other(OT) o 1— o i
tp Hcv al LAB USE ONLY: ?
Comp/ Collected(or 1 Res #of co -o z — ( Lab Sample a / Comments:
il Composite End
x Customer Sample ID Matrix" Grab Composite Start) Cl Ctns 0 o A U U f i
►ate ! Time Date Time >O U Z ;u �O (
MW-2 gw g r5ArAae-oo I 4 f
MW-4 gw g 1 D?30 4 ♦ ler 1
MW-5 �gw g I6. 4 * a �
MW-6 gw g /05-0 4 X IX u i
lMW-7 gw g 02.j 4 �/
il
I
1HTHnLtW± ..
Customer Remarks/Special Conditions/Possible Hazards: c Type of Ice
{ YP Used: (-)
Blue Dry None SHORT HOLDS PRESENT(<72 hours): Y N N/A (Lab Sample Temperature Info:
3 Temp Blank Rec i d: Y N NA
Packing Material Used: Lab Tracking#:
' m . _ I Therm ION: 0
Groundwater Monitoring j �` -__ Cooler 1 Temp pon Receipt: - oC
NA
,Samples received via: Cooler 1 Therm Corr.Factor: Q 0C
I Radchem sample(s)screened(<500 cpm): Y N
i p , FEDEX UPS Client Courier Pace Cour' Cooler 1 Corrected Temp: (rx oC
Relinquished by/C pany:(Si a r ) 42-
Requishedi �j !Re' }� by/Company:(Si na re) Date/Time: (> ( MTJL Y Comments:
t'p 1 �/by/Compa :(Signature) Date/Time: Received by/ mpany:(Signature) Date/Time:
tQ Template: Trip Blank Received: Y N NA
m HCL McOH TSP Other
w Prelogin:
Rel quished by/Company:(Signature) Date/Time: Received by/Company:(Signature) i Date/Time: n f j
a PM: Non Conformance(s): Page:
PB: �� YES / NO _ of:

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