WQ0040918_Monitoring - 03-2022_20220418

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GW-59A COMPLIANCE REPORT FORM Permit#
(Submit one each monitoring period with GW-59 forms.)
1 Enter date monitoring results were due. 'Il ►b a 1(ill this monitoring report(GW-59 and GW-59A) YES NO '
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 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.
Are anyof the monitor wells 3 e Is 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.
4 Are any monitored constituents equal to or above the established standards? YES NO
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 constitue t(s)and concentrations)
exceeding standards in the spat rovided below: kNk\ —- t WN',-*'`- )-7--0 C 6 q
m)1--g,___- ,k.\ A (“4-s-) Ai /9 TilL
5 For the constituents identified in question 4 above, have standards been a seeded 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, concent tion(s)reported, and sample collection date for ch occurrence(for last two years). (C1J
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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_T#E REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO",monitoring wells maybe improperly
located;contact the Regional Office. 1 1
_S 7)fix.
x: 4
0rg, ,
7 Is the permittee implementing previously approved actions required by the'bivison it Gblving this YES NO
groundwater quality problem? fi#
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 90ys;an evaluation maybe
required to determine the impact the waste disposal system is having at tA review and compliance
boundaries surrounding this facility. Failure to do so may subject the permittee to a Notice of Violati$n,
fines nd/or penalti s. -o
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8 The person completing\this portion(GW-59A) of the monitoring report sIMftuld sign bel 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(Complance^Repport`GW,89A)is ce complete to the best of my kuuwledy.
21.:so �
Signature of Pe ittee(or Authorized Agent) Date
GW-59A 12/8/2003

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SUBMIT FORM ON YELLOW PAPER ONLY
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atld 1 copy to , � ) 1°ij $ 11 , y
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f � 9Y r (,Mail original i i a ,,I , x � jAP 0 1 y i `4 T � ' �
GROUNDWATER QUALITY MONITORING: � ,° � r4 I l ,tii I� I ��' I A{� iRi'rfY 1�, (COMPLIANCE REPORT FORM tJ
tr yar°Ar4,3'14s:l:Nfdk.'v44 ?: yn,.-:,kmMA;:�ralietii :Dui�r .f �h�kd..;1i 1
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number4�� fo, l/ pirahon Date:
Facility Name: q �c��e N ��-Q`1 Qc ��� l
Permit Name(If different): 4 \ Non-Discharge UIC
Facility Address: a NPDES Other
O n d M 0 TYPE OF PERMITTED OPERATION BEING MONITORED
n;h,:.,r
�`,:���0\\0. � � T`� County (A._ ‘.� ----
+tutu) , ►moon ❑Remediation: Infiltration Gallery
�\ �, q spray Field ❑Remediation:
Contact Person: f Q-. Telephone#. I r"a l3 -3 ..3 (" D Rotary Distributor Ti Land Application of Sludge
Well Location/Site Name: MU's S (eta, No.of wells to be sampled:
Pern,il� ❑ Water Source Heat Pump CJ Other:
SAMPLING INFORMATION
--
11�\\
WELL ID NUMBER(from Permit): �J `'` _ � If WELL
'mi Date sample collected: FIELD AN LYSES: n WAS
VVell Depth: 0 ft. Well Diameter: in. - 1/ 6'
Depth to Water Level 62sa6:�� pH o0400�,� units Temp. 00010 r c. DRY at
ft. below measuring point Screened Interval: _ft. to ft. Spec.Cond.00094 µMhos time of
Measuring Point is ft.above land surface,_- Relative M.P.Elevation: ft. sampling,
Volume of water pumped/bailed before sampling: gallons
Odor 000es �(� ^(��' check
g 0 NO Appearance ()C��n� herea—t
Samples for metals were collected unfiltered: ®YES 0 NO and field acidified: Di YES I 'LABORATORY INFORMATION
Date sample analyzed3— ` —1 ' 3—1 3-f )3 a3--aaboratory Name: N t e
SO
PARAMETERS NOTE:Vales shod
d reflect dissolved and colloidal concentrations, t�;'\, Certification No. oN
COD 00335 mg/L Nitrite(NO2)as N 00615
Coliform:MF Fecal 31616 ,� k �0\ mg/L Pb-Lead 010 nigug/L
/100mL Nitrate(NO3)as N 00620 mg/L Zn-Zinc 01092 /L
Coliform: ME Total 31504 m
/100mL Phosphorus:Total as P 00e85 r 3 mg/L
(Note. Use Mf'N method for highly turbid samples)
Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 1 ` mg/L Al-Aluminum o110s
pH(Lab)00403 mg/L
units Ba-Barium 01007 ug/L
TOC ooeso �tng/L Ca-Calcium 00916 mg/L
---- -
Chloride o094o
mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium:Total 01034
Grease and Oils 00552 ug/L
►ng/L Cu-Copper 01042 mg/L ORGANICS:(by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01046
Sulfate 00945 ug/L (Specify test and method#.ATTACH LAB REPORT.)
mg/L Hg-Mercury 71900 ug/L Lab Report Attached? 0 Yes(1) ❑ No(0)
Specific Conductance 00095 EtMhos
I(-Potassium o0937 mg/L VOC 7873 Total Ammonia o0610 , method#
1 � mg/L (Vlg-Magnesium 00927(Ammonia Nitrogen,NH,as N,Arrnwnia Nitrogen,Total) mg/L method#
(yin-Manganese elms ug/L
TKN as N 00625 rn /L , method#
9 Ni-Nickel 01067 ug/L , method#
For Rernedlatlon Systems Only(Attach Lab Reports): --
P Influent Total VOCs:
mg/L Effluent Total VOCs. mg/L VOC Removal%
I certify Ihril,to the best of icy knowledge and belief the information submitted in this report is foie accurrte,and complete,and that the laboratory analytical d rt-
RWR-cc.rtdler�1phnralory. I am aware Mgt there pie significant penallles for submittin y , .a.-Inr,used using api�roved methods of analysis h;<i
q(else jldonnahon,including the possibility of tines and unpriac'nmen(for knuwprg ,,lapops.
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Permittee(or Au ttoriz Agent)Name and Title-Please print or type �� " �� --
GW-59 Rev.06-07-2018 Signet/ f r a(or Authorized Agent)
(Data)

SUBMIT FORM ON YELLOW PAPER ONLY
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GROUNDWATER QUALITY MONITORING: Mail original it ,1 l 1.' f 1 1 it C
COMPLIANCE REPORT FORM and 1 copy to , t , f A,0 r ° e . ''";' ,,,r?,, ','144. }
, t � � r n � � � �i F���,r�{
FACILITY INFORMATION Please Print Clearly or Type Al ) 'L, l +0� .,,,, �r r ,
A
q PERMIT Number , 9 "t' u•atlon DateFacility Name: C; rPc ` ,i �M-C� \_� c 1_ V
Permit Name(if different):
J Y\ Non-Discharge UIC
Facility Addres NPDES Other
_ c tes �� rnt�..r, ���� — TYPE OF PERMITTED OPERATION BEING MONITORED
q 4. �� Countyg ❑Remediation: Infiltration Gallery
:IIYI \, liitalu ;10 • '► ,L�—}-L- �`oon
Contact Person: ( \ Qs.' pray Field ❑Remediation:
��' Tele hone#: Q �� ❑ Rotary Distributor ❑Land Application of Sludge
jweii Location/Site Name' • ' — {G c4 p El
Water Source Heat Pump Other
SAMPLING INFORMATION of wells to be sampled: �OR1 emu4_... ,. _. .. . .,.. ..... ._ LJ
'''' \\
WELL ID NUMBER(from Permit): W Date sample collected I l Lt'r If WELL
Depth: all ft. W FIELD A A.� SL5: WAS
ell Diameter: in. pH ooaoo units Temp.mom n C DRY at
Depth to Water Level 82546A k3 ft. below measuring point Screened Interval: ft. to ft. Spec. Cond.00094' µlVlhos
time of
Measuring Point is ft.above land surface , Relative M.P. Elevation: ft. sampling,
check
Volume of water pumped/bailed before sampling: Odor 000sc (1 �y�� here p g 1 gallons Appearance
Samples for metals were collected unfiltered: ®YES here:��
❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION 3�^3_a,�
Date sample analyzed—%'—�s 3J-1 C,,�--`) 3-. ll Laboratory Name: AJ r ��, — —
PARAMETERS NOTE:Values should reflect dIssol�ed and colloidal concentrations. ` Certification No. l
COD 00335 mg/L Nitrite(NO2)as N 00615
Coliform:MF Fecal 31s1s mg/L Pb-Lead 01051 ug/L
cis. b /100mL Nitrate(NO3)as N ooszo mg/L Zn-Zinc 01092
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note- Use MPN method for highly turbid samples) mg/L
Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
issolved Solids:Total 70300 mg/L Al-Aluminum o1105
units u mg/L
pH(Lab)00403 _ —
n Ba-Barium 01007 g/L
TOC moo \ 1 d--, mg/L Ca-Calcium 00916
Chloride 00940 , ug/L
`"� mg/L • Cd-Cadmium ownug/L -- —
Arsenic o1002 ug/L Chromium: Total 01034 ----
Grease and Oils 00552 ug/L -�
mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045
Sulfate ug/L (Specify test and method#.ATTACH LAB REPORT.)
00945
mg/L Hg-Mercury 71800 ug/L Lab Report Attached? ❑ Yes('I) ❑ No(fJ)
pecific Conductance 000s5 µMhos
K13_, -Potassium 00937 mg/L VOC 7873 Total Ammonia o06101. method#
mg/L Mg-Magnesium 00e27 mg/L
(Ammonia Nitrogen,NH3 as N;Ammonia Nitrogen Total)
Mn-Manganese 01065 ug/L W method#
TK
N as N 00625 mg/L NiNickel01067
method#
. ... ug/L
'�`" method#
For R@mediation Systems Only(Attach Lab Reports): Influent Total VOCs: _
mg/L Effluent Total VOCs.
',certify ihot,to the I,:"sl of my I no viedge and hellcf rho infollllation srehmitled in Ihls leporl is tole occurate,and cons plefe and I - mg/L VOC R@Isis a°/u
L7VVf-col1iflod bilinrrilof y I am eomfe that from am significantn penalties Ina submitting talsc-mlur no t o I hat ies laboratory analytical nano was f,alati crl using app,oved methods of allay sis
n including the possibility of(uses and iinpnsnhlilenl(or krlo�Ning a alggolts, y by a
5 7 r
Per ttee(of Authori•"d Agent)Name and Title-Please print or type - �— r`-�1( � _ )
GW-59 -ev.06-07-2018 Signatu f r (or Authorized Agent) _" — '--' (
(Date)

SUBMIT FORM ON YELLOW PAPER ONLY
s ma
'GROUNDWATER QUALITY MONITORING: Mail original k ` .' '' I u � i
COMPLIANCE REPORTA FORM and 1 copy to tk YE '"(tss�p i" I a Jw, xNi1 k, (,i} „
FACILITY INFORMATION Please Print Clearly or Type N)tr.� o- 1.t ii P r a!.If", & t fiill ruI) y, t 1,,t t y 4.�
YP *Ir,Fir,,,,,�c 4 �i Ntt,..>
Facility Name: ` r 1 PERMIT Number` i OOlio` i expiration Date
Cbei �C�\1� W CZS, I
Permit Name(if different): Non-Discharge UIC
Facility Addre s L`� ,0.� ' `t _ NPDES Other
0. C\ \� :rr a �. r r� �\ `\ TYPE OF`PERMITTED OPERATION BEING MONITORED
Y cA `��S`� County '�LJ�Q 1� Lam'[
,c arr,i , \ �� a-goon ❑Remediation: Infiltration Gallery
r LJ 5 ra Field
Contact Person: !, �• ` e R 9� `3%3 p y ❑Remediation:
'. Telephone#: J ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: (`�\ S�Sci � ,,
�1,.� ; No.of wells to be sampled: ❑ Water Source Heat Pump ❑Other:
SAMPLING INFORMATION „•„,,ttrom erm!t_...WELL ID NUMBER(from Permit): l If WELL
��S. ft Date sample collects : " L . FIELD Well Depth: . ANALYSES: WAS
Depth to Water Level 82546: ft.below measuringpoint Well Diameter: in. pH 0oao c units Temp. mom 19 r °C DRY at
Screened Interval: _ft. to ft. Spec.Cond. 000sa: µMhos time of
IVleasuring Point is ft.above land surface Relative M.P. Elevation:
ft. Odor 000ss `~(�11✓�'�� sampling,
Volume of water pumped/bailed before sampling: gallons -��'(`� check
Samples for metals were collected unfiltered: ®YES N Appearance tlel'e.�
LABORATORY INFORMATION ❑ NO and fiel�dl acidified: ®YES ❑NO
Date sample analyzed3- -±s�3`f G3 ��3-��')�~ borato N me:PARAMETERS NOTE:Valu s should reflectdissoly d and dolloidal concentrations. \ ���� � Certification No. c�
COD 00335 mg/L Nitrite(NO2)as N o0615
Coliform:MF Fecal 316 Is L��1 mg/L Pb-Lead 01051 ug/L
/100mL Nitrate(NO3)as N soon `
Coliform: MF Total 31504 \ mg/L Zn-Zinc 01092 mg/L
/100mL Phosphorus:Total as P 00665 � (J� mg/L
(Note: Use MPN method for highly turbid samples) '"—
Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
issolved Solids:Total 70300 �� j' mg/L Al Aluminum o1105
pH(Lab)00403 units ug/L
-Barium 01007 mg/L —`-----__ __
TOC ooseo p y 0 mg/L Ca-Calcium 00916
Chloride ammo ,�— mg/L -
-� mg/L Cd-Cadmium 01027
Arsenic 01002 ug/L -_--.--------
ug/L Chromium:Total 01034 ug/L
Grease and Oils 00552
Phenol 0552 mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC, GC/MS, HPLC)
ug/L Fe-Iron 01045
Sulfate 00945 ug/L (Specify test and method#.ATTACH LAB REPORT.)
mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance 000ss flMhos
I(-Potassium 00937 mg/L VOC 7873
Total Ammonia sows0 n , method#
(Ammonia Nitrogen;NH,as N;Ammonia N i ae n,Tootial)- mg/L Mg-Magnesium 00927 mg/L ,method#
Mn-Manganese 01055 ug/L
N as N 00625 mg/L. Ni Nickel 01067 ,method#
ug/L ----
method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: ---"
I[;ertify dial,to the I gat n(iirt I nr.vledgr pod belief the information srlbiniflr,d in Ibis reporfis true.accurate,a mg/L Effluent Total VOCs: `"
mg/L VOC Removal%
and and Ihal Ili(vies
pod
u:afoi, n,t1t,of fl l tie was,location usm
PN/I�-CCllillcrl I�Ihgl+.rlply. I rant nowe Pip!)here are slyitlfinanl penalties for su binitliny.false information including the possibility of fines noel nnpn=�'nnu:of fur luio"lit v.,of o .. .- .
g approved ntethcds of annl,+sis by a,
9 I Ins.
Pennitte=(or Authoriz d Agent)Name and Title-Please print or type v _
' cCk\ 'eLc\C—SAO. Q.-k< "--- ' 7)
GW-59 ` Siynatu f r e(or Authorized Agent)
--'
Rev.06-07-2018 (Date(
i

SUBMIT FORM ON YELLOW PAPER ONLY
' GROUNDWATER QUALITY MONITORING: Mail original Jet r"�k(df1(�� ) ''�IJt t'' t4 tr 4, r �vr�er
j COMPLIANCE REPORT FORM ( r a fr
and 1 copy to � ����� a, t�L"&� 'a k��ii`r� �� �o- µ�� , K
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7, . ter Y dF 4 ,),, 1 z i 4 � !A -O 1`I I t.,-:4 �`...l %'. �4
1_ACILITYINFORMATI Please .4 Oars nark.
1=acilit Name: Cti PERMIT Number, ve iratton Date: A' ,-
1 6fRS\^a
y J �C�S1 e:�,t�, ����e C r� �o�`�, .
Permit Name(if different. Non-Discharge _ UIC
Facility Address: ta..t� L,„ m �� _ NPDES Other
` � hD�� :I : u �. c \ — TYPE OF PERMITTED OPERATION BEING MONITORED
County �� Don
°Y ,;t.�i g ❑Remediation: Infiltration Gallery
Contact Person: c c e-;'` I nUrf\C�� ��
El Rotary
Field LiRemediatiart:
T lephone#: t C1�` '-wc Rotary Distributor ❑Land Application of Sludge
VVell Location/Site Name: \`l, ' , - Cc k o,of wells to b Source- -•- e sampled: ❑ VVater s Heat Pump ❑Other.
!SAMPLING INFORMATION 1 ffrom Fermi
!WELL ID NUMBER(from Permit): v� t �_.01Q If WELL.
Date sample collected - FIELD ANALYSES:
!Well Depth: ft. WAS
Depth to Water Level e25as: ft.below measuringpoint Well Diameter. �� in. pH ooaouS units Temp.oo0t0:19 t u1 °C DRY at
Screened Interval: _ft. to ft. Spec.Cond.Douse µNlhos time of
IVleasuring Point is ft.above land surface Relative M.P. Elevation:
- ft. Odor 000e5: j sampling,
Volume of water pumped/bailed before sampling: ,s, gallons check
Samples for metals were collected unfiltered: ®YES Appearance C�CC-kc �_._ here:
LABORATORY INFORMATION ❑ NO and field acidified: �f YES ❑NO
;Date sample analyze, �� 3_I t 3_ VQ3l Laboratory Name.
" 3 __.
PARAMETERS NOTE:Valu` shouldreflect dis�oived ar(d colloidalconcentrations. v c-pCi\e-1y~
Certification No. ��'
COD 00335 mg/L Nitrite(NO2)as N 00615
Coliform:MF Fecal 3ts�ls mg/L Pb-Lead 01051 uglL
-�- 1 C t /100mL Nitrate(NO3)as N Dom O ,t S mg
/L MF Total 31504 m /L Zn-Zinc 01092 mg/L
(Note: Use MPN method for highly turbid samples) /100mL Phosphorus:Total as P Doses r a mg/L
issolved to !tee:Total 70300 ! Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
1- nig/L Al-Aluminum el1o5
pH(Lab)00403 units Ba-Barmg/L
01007 ug/L
TOC 00680 k, mg/L Ca-Calcium 00916 -mg/L
-
Chloride oo9ao � —`-----
mg/L Cd-Cadmium 01027 ug/L ---
Arsenic o1002 uglL Chromium: Total 01034
I Grease and Oils 00552 ug/L -----
mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC, GC/MS, HPLC)
Phenol 3z73o ug/L Fe-Iron 01045 i
Sulfate 2 mg/L H uglL (Specify test and method#.ATTACH LAB REPORT.)
pecific Conductance 00095 g-Mercury 71900 ug/L Lab Report Attached? ❑ Yes
µMhos I<-Potassium 00937 (1) 0 No(0)
Total Ammonia ooeto mg/L VOC 7873 method
© 1 mg/L Mg-Magnesium oa9z7
(Amrnunia Nitrogen;NH,as N,Ammonia Nitrogen,Total)
mg/L ,method#
Mn-Manganese 01055 ug/L
TKN
as N 00625 rn /L —__
9 u o NiNI Nickel method#
I 01067 uglL
_ ,method#
For Remedlation Systems Only(Attach Lab Reports):
Influent Total VOCs: - Removal%
Fedify(h��l,to lhi I..sl n(my I nrnrol¢dgc rind hr.(�.f the iiirange(iolt sllbnulled in this report is flue accurate,and poi � . mg/L Effluent Total VOCs.
mg/L VOC
li and that the lahand impri anmenrf i it i was produces a.nu) (pu,i:,rl rnelhnds>of anal
4Vh cer(Ified I�Itair)lory. Jam aweue tlxfL(here are significant penalties for submitting false Ildorinahop,including IIiF possibility of Bites and pnpnsciUtteil!(oi klto�Njltg4� lapo(ts.
\ � �s��by a
`ck\ " -'Ai a EPP Permittee(or uthot ed Agent)Name and Title-Please print or type �. ) i%Y-�' %'-e"� (e)) ('�\
GW-59 ev.06-07-2018 Signet fr r e(or Authorized Agent) -
(Date)