WQ0002648_Monitoring - 03-2022_20220509

GW-59A COMPLIANCE REPORT FORM Permit# ljQo©oa6tF8
(Submit one each monitoring period with GW-59 forms.)
Enter date monitoring results were due. ( --SI-Vak) Will this monitoring report(GW-59 and GW-59A) YES
be submitted after the established due date?
2 Was any required information missing on the G11-59 report forms? --- YES 10
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 I�
identification plate,area os ergros‘n,etc.)?I/the aniirer is ").es". contact the Regional(ViceJor guidance.
4 Are any monitored constituents equal to or above the established standards? YES 6)
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(4)aroncentrrtion(s)
exceeding standards in the space provided below: c.") L.- -,
s_
U . Sr
5 For the constituents identified in question 4 above, have standards been exceeded ppe,viottsly 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 subject the permittee to a Notice of Violation,
fines, and/or penalties. DJ
MA'( 10 2022
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 knowledge.
ignature of Permittee(or Authorized Agent) Date
(,W-59A 12/8/2003

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OFWATEROUAL1T -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM and 1 copy to: 1617 MAIL SERVICE CENTER,RALEIGH,NC 2769 9-1 61 7 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0002648 Expiration Date: 09/30/2020
Facility Name: Seagrove-Ulah Metropolitan Water District Non-Discharge UIC
Permit Name(if different): NPDES , Other
Facility Address: P.O.Box 370 TYPE OF PERMITTED OPERATION BEING MONITORED
Seagrove (Street) NC 27341 County Randolph ❑ Lagoon ❑Remediation: Infiltration Gallery
(City) (State) (Zip)
El Spray Field 0 Remediation:
Contact Person: Larry Chilton Telephone#: ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: No.of wells to be sampled: 3 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-1 Date sample collected: 03/10/2022 FIELD ANALYSES: WAS
Well Depth: 90.8 ft. Well Diameter: 4 in. pH 00400: 7.27 units Temp.00010: 17.1 °C DRY at
Mhos time of
Depth to Water Level 82546:36.0 ft. below measuring point Screened Interval: ft. to ft. Spec.Cond.00084; µ sampling,
Measuring Point is 2.0 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 108 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES ❑■ NO and field acidified: ❑YES NO
LABORATORY INFORMATION
Date sample analyzed: 03/10-24/2022 Laboratory Name: Cameron Testing Services Certification No. #654
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N o0615 mg/L Pb-Lead 01os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.130 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P oosss 0.140 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 116 mg/L Al-Aluminum o11os mg/L
pH(Lab)00403 units Ba-Barium o1007 ug/L DJ
TOC 00680 mg/L Ca-Calcium o0916 mg/L
Chloride 00940 11.0 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium:Total 01034 ug/L
Grease and Oils o0552 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 µMhos K-Potassium 00937 mg/L VOC 78732: ,method# 8260B
Total Ammonia ooslo 0.111 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen,NI-13as N,Ammonia Nitrogen,Total) Mn-Manganese°loss 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 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
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment
�for knowing violations.
4--.t.,..y C-4;/4114, O k L /�/ 9-.27-20a
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.2/2010

' SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WAT QUALITY-INFORI ATIONPROCESSING UNIT
COMPLIANCE REPORT FORM and 1 copy to: "P
1617 MAIL SERVICE CENTER RALEltsrt,NC z7sgs..�s1t t�h©ne:(919)7334221,
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0002648 Expiration Date: 09/30/2020
Facility Name: Seagrove-Ulah Metropolitan Water District Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Box 370 TYPE OF PERMITTED OPERATION BEING MONITORED
Seagrove (Street) NC 27341 County Randolph ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) ❑� Spray Field ❑Remediation:
Contact Person: Larry Chilton Telephone#: ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: No.of wells to be sampled: 3 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-2 Date sample collected: 03/10/2022 FIELD ANALYSES: WAS
Well Depth: 29.6 ft, Well Diameter: 4 in. pH o0400: 6.88 units Temp.00010: 17.4 °C DRY at
Mhos time of
Depth to Water Level 82546:11.0 ft.below measuring point Screened Interval: ft. to ft. Spec. Cond.00094, µ sampling,
Measuring Point is 1.0 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 37.0 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES ❑■ NO and field acidified: ❑YES •NO
LABORATORY INFORMATION
Date sample analyzed: 03/10-24/2022 Laboratory Name: Cameron Testing Services Certification No. #654
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 2.74 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.088 mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 445 mg/L Al-Aluminum o11os mg/L �J
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride o0940 106 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 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) 0 No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method# 8260B
Total Ammonia oos10 0.097 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen,NH,as N,Ammonia Nitrogen,Total) Mn-Manganese moss 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 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
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
�
L�„Az C1 r 140A, D12� ,. ` �?-ao2
Permittee(or thorized Agent)Name and Title-Please print or type Signature of P ittee(or Authorized Agent) (Date)
GW-59 Rev 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to: DIVISION OF WATER QUAUTV-INFORMATtONP►ROCESSINGUNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTERS RALEIGH,NC 27699-1617 phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00002648 Expiration Date: 09/30/2020
Facility Name: Seagrove-Ulah Metropolitan Water District Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Box 370 TYPE OF PERMITTED OPERATION BEING MONITORED
Seagrove (Street) NC 27341 County Randolph ElLagoon ❑Remediation: Infiltration Gallery
(City) (State) (Zip) ❑■ Spray Field ❑ Remediation:
Contact Person: Larry Chilton Telephone#: ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: No.of wells to be sampled: 3 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-3 Date sample collected: 03/10/2022 FIELD ANALYSES: WAS
Well Depth: 25.6 ft. Well Diameter: 4 in. pH o0400. 6.90 units Temp.00010: 17.4 °C DRY at
Mhos time of
Depth to Water Level 62546:15.0 ft.below measuring point Screened Interval: ft. to _ft. Spec. Cond.00094, µ sampling,
P g,
Measuring Point is 2.0 ft.above land surface Relative M.P. Elevation: ft. Odor 00085. check
Volume of water pumped/bailed before sampling: 21.0 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES El NO and field acidified: ❑YES ■❑NO
LABORATORY INFORMATION
Date sample analyzed: 03/10-24/2022 Laboratory Name: Cameron Testing Services Certification No. #654
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead o1os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 0062o 5.37 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.095 mg/L
(Note. Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 362 mg/L Al-Aluminum o11os mg/L DJ
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 100 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 µMhos K-Potassium 00937 mg/L VOC 78732. ,method# 8260B
Total Ammonia 00610 0.086 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen,NH,asN;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%
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
DWQ-certified laboratory.//I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Lary) 4 J-�o� o12C. — ./ /' / f`.22—2oAZ
Permittee(or Authorized Agent)Name and Title-Please print or type Signat -of Permittee(or Authorized Agent) (Date)
GW-59 Rev.2/2010

Cameron Testing Services, Inc. Laboratory Report NC DENR#654
NC PHI-IS#37799
US EPA#NC01918
Client: Seagrove Ulah CTS ProL 2203-0126
Project: March 2022 MWs Regulatory Yes Page 1 of 2
Sample Information
Sampled C. Cameron ,:',''''D,,,' °. 03/10/22 4tticeived J. Cameron , ', 03/10/22
,a„ '„' '.
Analyses and Results
,;
a
St&Methods
Lab ID Sample ID 1,-6 F., ,R Ana Result E
'C'''', n 0:. ;,:i Referenco
—
< 0
2203-0126 01 MW-1 -v, '3, TDS 116 ,n.yq. -, 03/14i22 2540 C-IDS
Chloride 11.0 rrigiL c.o.! 03/15/22 4500 Cl-D
N-NO3 0 130 mg/L 0 0.5 03/22/22 4500 NO3-E
N-NH3 0.111 mg& 0.1 03/24/22 4500 NH3-0
Tot.P 0.140 ms/L 0.05 03/24/22 4500 P-B/E
CFU
Fec.coil (Water) <1 i 03/10/22 9222 D-MF
/100ml
02 MW-2 OW Cr TDS 445 mg& 25 03/14/22 2540 C-TDS
Chloride 106 rnort, a m 03/15/22 4500 Cl-0
N-NO3 2.74 max 005 03/22/22 4500 NO3-E
N-NH3 0.097 mait 01 03/24/22 4500 NH3-0
Tot.P 0.088 twit 0.05 03/24/22 4500 P-B/E
CFU
Fec.coll.(Water) <1 1 03/10/22 9222 D-MF
/100mL
03 mw-3 OW Cr TDS 362 mg/L 25 03/14/22 2540 C-MS
Chloride 100 nig& c 01 03/15/22 4500 CI-D
N-NO3 5.37 mg/I 0 Gs 03/22/22 4500 NO3-E
N-NH3 0.086 frig/L. 0.1 03/24/22 4500 NH3-0
Tot.P 0.095 rngil. 0.05 03/24/22 4500 P-B/E
CFU
Fec,coil.(Water) <1 1 03/10/22 9222 D-MF
/10Orr+L
...
Report '
Review ' .0 Ati)/ /
Project Manager Date
219 S.Steele Sir 919-20g-4240
Santbrd SC 27 3t,1 chris@camerontestine.c'om

1 • -
219 S.Steele Str Cameron Testing Services, inc. Chain of Custody
Sanford,NC 27330 Page of
Phone [phone] NC VlitAirGVV Cert #654 NC PHHS Cert#3/799 US EPA NC01918
Company: Seagrove/Ulah Met Water Dist. Email: LChilton 1 [e-mail] CTS lab use
Sample Temp
Contact: Phone: Proj,ID
Larry Chlton 336-302-3782 (C)
:
Address(City Fax ice(YIN)
, P. 0, Box 370
State,Zip) samples colleceted in Mar,July Nov
Seagrove NC 27641 Notes: Permit(Y/N) - l
,
Project: 1. '72- Pki,Lan, Rush(YIN) ' Due
Sample
Name: C L,c,-, C Signature:
Collecion:
Sample Information Number of bottles+ preservative Required Testing/Analysis
CTS
,i, 0_ rjj 15 ,,_. Preservatives (U)npreserved, H(C)i. Sample
Client Sample a.) ca cl. -0 --,-
E E ca — >-• (3 R, -43 (2, a-, <u) 2 H2(S)04, H(N)03,(Na)Thiosolfate,
ID c:) f:: uo (5 r.r
Na(0)1-1, (P)hosphoric.Other(X).Indicate ID
.....
.•,-7—, ....j., '
MW-1 '''',/- IZ3 l (; , (1. ij ,-- iu ,--- TDS, Cl (N-NO2)
_.....,
MW-2 1 .
. 1S , N-NH3. N-NO3, P-TP
MW-3 '
i332- ' 4/ 1Na
Fee-W
€ , .
i
Bottle set for all samples Analyses for all samples
• t
i
. ---.,
1 , ,;
Retie ' Is : Received: Date/Time
--1,4 Z---- --'1'(----- ,,,-/r--"&e.------ L.*„. ---,---/-6-.. 4'4,3/7.--':-Z--. ./Y4,5---
( .
Rush work vviii require prior approval. Additional charges will apply