WQ0000185_Monitoring - 04-2022_20220531 (3)

n ..
DWR - NonDischarge Monitoring Report Submittal •4
NORTH CAROLINA
Enrlr...1M Qua(ily
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0000185
Name of Facility:* Ocean Sands WWTP
Month:* April Year:* 2022
Report Information
Type* Upload Document*
GW-59 Ocean Sands 251.97KB
G W 59_05312022221935.p df
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:* Rod Holley
Signature:
Date of submittal: 5/31/2022
This will be filled in automatically
Initial Review
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0000185
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Accepted Date: 6/28/2022

Enter date monitoring results were due. (3Tt o/ZZ) Will this monitoring report(GW-59 and GW-59A) YES I*
be submitted after the established due date?
2 Was any required information missing on the GW-59 report forms? YES 1'JO
IF the answer to question 1 or 2 is"YES", xsi in the space provided below the web identification numbers)and
exarain the prorafems 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.;?fft ie answer is "Yes",contact the regional Office ce for gu.aaree.
4 Are any monitored constituents equal to or above the established standards? (Ti' ,)Ci---ES3 NO
If ire answer tc question 4 is"NO", skip to section 8.
If the answer to question 4 is "YES",/st the affected wells individually wit consfiruent(s)and ccncentratron(s,
exceeding standards in the space provided below:
- . 1 CA-I D s: 2. 7 3`P '1 ' i f«
'rt , - 113 -fq C .oa•át.-2,la Clt jo�•r ' Z&i3
5 Forthe constituents identified n question 4 above,have standards been exceeded previously for they NO
same constituents)in the same wells)in the last two years?
If the answer to question 5 is NC', skip to section 8.
lr the answer ro question 5 is "YES';list in the space provided below, each west.with constitoert(s)exceeorng
standards, concentration(s)reported,and sample collection date for each ccourrecce(for the Est two years).
�1� mil. �
1
71
o all Ow OM 3 �v fly dkr
6 Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES (i )
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 maybe improperly
►ocated;contact the Regional Office.
7 s the permittee implementing previously approved actions required by the Division involving this YES 1 NO
g-oundwater quality problem? '
'f the answer to question 7 is"YES" descnbe those actions in the space pro.4ded below.
If the answer to question 7 is "NO",contact the Regional Office within 90 days:an evaluation may ee
required to determine the impact the waste disposal system ís havin4 at the review and compliance
boundaries surrounding this facility. Failure to do so may subject the aermittee to a Notice of Violation,
fines,and/or penalties. F ,
e v, W tl+rl r`•r o !mod E ttit-i`1-" LA_1`4,*). C oa ti
0 ems' c i L ft F r.� itw ., fG Q •rvL , C, � c n:d I i e ,
ASS" 5 s i t' i m lay(.rya 5, b err. s Crzrc. s,l ¡AA- :wl t...44'Ay
8 The person completing this portion(G Wi!59A)of the monitoring report should sign below and submit this
form with GW-59 forms for required welts 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 G�Wj-59A)`s true and complete to the best ar my knowledge.
...
� /4'te: 3 ' /2 a
Signature of Permittee(or Authoízed Agent) Date

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 RALEIG€t,NC 27099 1017 P€rude:(9f9)733d.1222I
FACILITY INFORMATION Please Rini Clearly orType PERMIT Number: WQ0000186 Expiration Dale: 6/30/2024
Facility Name: Ocoan Sands Noit-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address' 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (Sheet) NC 27927 Cow Ity Currituck [1 t agoon n Remediation•Infiltration(=allery
{city) (Sate) VIP) ❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump ❑■ Other: II iIÍI1.r Liüf l
(from Pomtitl
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW4 Date sample collected:4/11/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diamotor: 3 in. pH 00400:7.2 units Temp.0001o: 17.6 °C DRY at
Depth to Water I.ever 8"t4b 10.0 1l below rr1F'lsuiing pi did Scrberled Intel val 12 ft to 17 1-1 Stier Guild 00094• µMlu s nine of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor o0085: none check
Volume of water pumpedlhrllled before surmpling 5.0 gallons Applarranc. Clear here•
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: E YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:4/11/22 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 0.02 mg/L Pb-Lead 01051 uglL
Coliform: MF Fecal 31616<1 1100mL Nitrate(NO3)as N 0o620 2.77 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 2.80 mglL
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mglL Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 7030o 644 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 7.2 units Ba Barium 01007 uglL
TOC 00680 5.8 mglL Ca-Calcium 00916 mglL
Chloride 00940 262 mgfL Cd-Cadmium 01027 uglL
Arsenic 01002 uglL Chromium:Total 01034 ug/L
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 mglL Hg-Mercury/1900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: , method#
Total Ammonia o0610 3.1 mg/L Mg-Magnesium 00927 mgll , method#
(Annul la Nitrogen,NH,as 14,Ai vnunla N€trugen,I etat) Mn-Manganese a1055 uglL , mothod#
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(mituy that,to(tie tuna of my.Iliowledeer and belief,the information submitted
in Vile repel l [uc,�euio°
lU,and uzFulvlu,:üdlhal the lühelulory uiulyllcul.tiata wo Niduce[J tslnp c{Nr6vcr rnUlicisof unuly�l� ,y a
iDWQ retlifietl lalioato . I m aw-rrt t there e si nifi nl( 1 es for u rrnllinp fake information,üchdna the possibility of fines and imprisonment for knowing Giolattons.
Rod Holley Wastewater Superintendent Trainee ( fv £ 1.1—t,1 5/30/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authoriz Agent) (Dato)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT a NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY INFORMATION.PROCESSING UNIT
and 1:copy to
COMPLIANCE REPORT FORM 1617.MAIL8ERVI0ECENT N,RALEIGII;NC-grass 11)17 rhr,hr:as19}r35-5 21
FACILITY INFORMATION PrHasH Print Malty to Ty/le PLRMIT Number, WQ0000188 Exultation Dula. 0/30/2024
Facility Name: Ocean Sands Non Discharge UIC
Permit Name(if different): NPDES Other
Facility Address. 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (skeet) NC 27927 Count y Currituck El Lagoon El Rornodiulion: ]n(i[lralion Gallery
(City) (State) (Zipl
❑ Spray Field ❑Remediation:
Contact Person: Rod I Jolley Telephone#:[phone] 0 Rotary Distributor El Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ElWater Source Heat Pump ID Other: MD-ration(from Permit)
SAMPLING INFORMATION if WELL
WELL ID NUMBER(from Permit): MW5 Date sample collected:4/11/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.6 units Temp.00010: 18.0 °C DRY at
Depth to Water l evel 82'145.5.2 ft below measuring point Screened Interval. 12 ft to I/ tt Spec Cenci00094• µMhos liino of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volurno of~tor lunfil,t,(lltrdl(al t,('f(tr(. o-dngtling 6.0 gallutrf, AlrltaIdirit-r: oleer1Tr_rit lu,ro r '
Samples for metals were collected unfiltered: IJ YES CI NO and field acidified: ❑YES El NO
u
LABORATORY INFORMATION
Date sample analyzed:4/11/22 Laboratory Name: Enviro Chem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mglL Nitrite(NO2)as N 00615 0.07 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 3.53 mg/L Zn-Zinc et092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 2.29 mg/L
(Nola: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 279 mglL Al-Aluminum a1105 mg/L
pH (Lab)00403 7.6 units Ba Barium 01o07 ug/L
TOC 00o60 14.5 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 86 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 uglL Chromium:Total 01034 ug/L
Grease and Oils 00552 mglL Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron o1045 uglL (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) 0 No(0)
Specific Conductance 00095 jMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610 0.9 mg/L Mg-Magnesium 00927 mglL ,method#
(.ritnuiiia N)irugen,NI I3as N.Ammonia Nitrogen, total) Mn-Manganese 01055 uglL ,method#
TKN as N o0625 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 best
a r. K. , -..:....:
certify that, the:be.t of my)iiirvdled r airier belief,the Information�ulsrtilttFd)n thl._re pen 1..true,aecur�te� and r.i�iti'd�1e arid that tire l�ltnratar analytic ilnla wa. �rr�ducc�d u�inr �, �rr:vFcl m�thrsrl�of msr,l xir t� r;
Y .. .... I! I � Y Y I. .I ('I Y Y.
DwQcerlit dlaboratory..) "ore Met there are.,ig ifiu. penaltie
s fur submitting false tníurmalum,including the possibility ruins and imprisonment for knowing violations. ,
Rod Holley Wastewater Superintendent Trainee 1(d 4 ¿ p 5/30/22
Pormittee(or Authorized Agent)Name and Title-Please print or typo Signature of Permutes(or Authorized gent) (Date)
GW-59 Rev.212010

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 •COMPL IANCF REPORT FORM 1017 MAIL SERVICE CENTER,RALEIGI If NG.27899 1817 Phouie (ls19)733-3 21 -:
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
1-acuity Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla {street) NC 27927 County
Curritucfc El Lagoon I-1 Remediation: Infiltration gallery
(City} (srute) (ZIP) ❑ Spray Field ❑Remediation:
Contact Person: Rod Holley Telephone#:[phone] E Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name.Ocean Salida No.of wells to be sampled: 5 ❑ Water Source Heal Pump El Other: Infiltraliori
..�..,.,... .., .„_............... (from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW6 Date sample collected:4/11/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft, Well Diameter: 3 in. pH 00400: 1.6 units Temp.come: 18.7 °C DRY at
time of
Depth le Water Level arme:0.8 it below measuring point Sci tined Interval' 12 ft to 17 tt Spec Gond meal- Milos sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00065: none check
Volume of water puiriped/bailed berm a sarnplitig: 4 Cl gallons Appearance Clear here r r
Samples for metals were collected unfiltered: El YES ❑ NO and field acidified: ❑YES El NO
u
LABORATORY INFORMATION
Date sample analyzed:4/11/22 Laboratory Name: Enviro Chem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N o0615 0.02 mg/L Pb-Lead ote51 ug/L
Coliform: MF Fecal 3161s<1 /100mL Nitrate(NO3)as N 00620 21.5 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 1100mL Phosphorus:Total as P 00665 2.70 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
]issolved Solids:Total 70300 739 mg/L Al-Aluminum 01105 mg/L
pH (I ab)00403 7.6 units Ba-Barium 01007 ug/L
.IOC 00680 4.3 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 261 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 uglL Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mglL ORGANICS:(by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron o1045 uglL (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 µMhos K-Potassium 00937 mg/L VOC 76732: , method#
Total Ammonia 00610 0.9 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NI Ides N;Ammonia Nilreyen,Total)
Mn-Manganese el055 uglL , method#
TKN as N a0s25 mg/L Ni-Nickel 01067 uglL , method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mgll. VOC Removal%
S,
c'rErlil lhnC to thr lre..l of rri km; l I �.'
y t w E•c c zücl br•IIr1 tEsf-MIN rnullc n�ui3üi11ti rI in lhí.':icy rt r l P.huh.arc=iir F � � - z � x �
Y.... ri f .,. �l ,�sud ti inl Ic lh,mid tlrni OK-lüt r,relc,ry�üralylicai tláln was picálura.tl u,tua al>I rc veer rnFilic�d. c,i t,ritily�,l. try<t
DWQ-ecrlined laboratory...l.am.aware.'hot there are significant penalliea for submitting tale inlúrinaliufl including. the pussibilit liI fines and irn risorinlenl rot knowing violations.
Y P a
Rod Holley Wastewater Superintendent Trainee , ),.,-?d tr 4 5/30/22
Permittee for Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized lent) (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 tti
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTEf.fALEGH,Nc,27600 1617 Phone:(fl14).73l-3221, .
FACILITY INFORMATION Please Ptini Clearly or Type PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name. Ocean Sands Non-Dischargo UIC
Permit Name(if different): _ NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (Street) NC 27927 County
Currituck ❑ Lagoon n Remediation: Infiltration Gallery
(City) (Slate) (zips n Spray Field n Remecliation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump El Other: Infiltration
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW7 Date sample collected:4/11/22 FIELD ANALYSES: WAS
Well Depth' [7.6 ft Well Diameter: 3 in. pH 00400:7.4 units Temp.0001o: 17 8 °(.: DRY at
Depth to Water Level uemb.4.8 rt.below measuring point Screened Interval. 12 R. to 17 lt. Spec:.Concl.00444 µMllos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volume of water puiriped/bailed before sampling. r1 5 gallons Allltt-lriranue Tan luere-¡ '
Samples for metals were collected unfiltered: [OYES El NO and field acidified: ❑YES ❑NO u
LABORATORY INFORMATION
Date sample analyzed:4111122 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<0.02 mg/L Pb-Lead roost ug!L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 4.12 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.68 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
pissolved Solids:Total 70300 390 mg/L Al-Aluminum o11os mg/L
pH (Lab)00403 7.4 units Ba-Barium 01007 uglL
IOC 00000 15.1 mg/L Ca-Calcium 00915 mg/L
Chloride 00940 135 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 ugiL Fe-Iron et045 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 Mhos K-Potassium 00937 mg/L VOC 78732: , method#
Total Ammonia oosto<0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;Nil,as N;Alnnronia Ni€iogen,To(sl
Mn-Manganese 0105s 110. ,method#
TKN as N 00625 mg/L Ni-Nickel et067 ug/L ,method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I i:tor*lli t to the.I.eü of m kit it {s , .,. i i „ f
A, y ( 1I d(JU.:tlllf t(if{.í,tilt Illfl�C111.11IU11 4 LII.nllll('d irlll[f?�.fC!uncut I t l.,boo,11C C'Lllálle,mid complete,mind Mat Me Idtt![JIdt1VCy UI}kllytleui(1(,lu Wag I3rUÚU(:6'{!twin unmoved nlutllUds of üllC(I iá bya
0Y�
I ',DW{�-ci;itific{ I.be raIcil . I,on ciwurL:tlli,t 11li.rc ale�i nifiL,aslt riitallieg íai zllilnitliir íalae information,including(u the possibility I I I €y g }, y . �uLl.y l e puss a Illy of fines and mpr surilne}I for knuwtng.vlulalluns.
Rod Holley Wastewater Superintendent Trainee e I , 5/30/22
Permittee(orAuthorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized ent) (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 1017 MAIL 8ERVLOE OENTER BALE OII,NO 27099 1617: Pftone (919)733=3221 .,.'
FACILITY INFORMATION Please A/1W Clearly or Type PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (Street) NC 27927
County Currituck ❑ Lagoon ❑Remediation: Infiltration Gallery
(evy) plate) PP) ❑ Spray Field ❑Remediation:
Contact Person: Rod Holley Teleplione#:252-232-6065 ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ot.eaN Sands Nº.of wells to be sampled: 5 ❑ Water Source Heat Pump ❑Other: hall Agin
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW9 Date sample collected:4/11/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.4 units Temp.00010: 17.1 °C DRY at
tA+llur., time of
Du ills to Walur tovel(WAG 6.1 ft below mea urlugl point Screened interval- 12 ft to 17 ft Spec t'ºnd 000ci- I sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volturio crf water (rtunlrucl/tiniicrcl Lc,foie s,urrliriiny `•)0 _(pillions Appearanre Clout here'❑
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:4/11/22 Laboratory Name: Enviro Chem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N oos15<0.02 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 6.45 mg/L Zn-Zinc 01r92 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P Doses 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 645 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 7 4 units Ba-Barium 01007 ug/L
TOC 00680 4.6 mg/L Ca-Calcium oo91s rrig/L
Chloride o0940 263 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 uMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia ooslo 1.4 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ainmuniu Nitrogen,NI i,ur,N,Alnrnipnitr Nllroyorr,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 r.r-rlrf that;to the bi- l of rn tuna lc tl t�ncl Lr.lnr f.Ile Lefr,c:ration-ubmi to I it h:141,011 n, r , - _ F nu-thuds(Hay that y fl t t t t i L .. i tut-.at,r.trralr,and c ctnl h tr nnc[that the I�tt,aláh�iy hür,lyllrc,l ilnta w�. l rüiluc�rl rr,tq(J ni=hrt,�E•il t 1 ennly,i,by a
DWQ-certified laboratory. lam aware that there are significant penalties for,submitting false information,including the possibility of fines and imprisonment for knowing violations. J
Rod Holley Wastewater Superintendent Trainee .4 ni i / 5/30/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittes(or Authorized A. nt) (Date)
GW-59 ReV.2/2010