WQ0000185_Monitoring - 01-2022_20220228 (3)

DWR - NonDischarge Monitoring Report Submittal y. •4 ..
NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0000185
Name of Facility:* Ocean Sands WWTP
Month:* January Year:* 2022
Report Information
Type* Upload Document*
GW-59 Ocean Sands 727.74KB
G W 59_02282022170813.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: 2/28/2022
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
Reviewer: _anonymous
Review Date: 7/25/2022

N( 011: R kPO IR' )R Per 11 dl o o Uq-S—
(Ar,bmnnal?nano,ran h inn nnhn ri un n'oil 9 hvnin
1 Enter date monitoring results were due. 5/ 1-.) Will this monitoring report(GW-59 and GW-59/114 YES (N)N
be submitted after the establish:-i due date?
2 Was any required information missing on the GW-59 report forms? YES (NO
IF the answer to question I or 2 is "YES", list in the space provided below the well identification number(s)ard
explain the problems encountered if:obta:Ang the required information.
3 Are any of the monitlr wells in need of repair or maintenance(damaged casing,unlocked or missing cap,missing YES ET
identification plate,area overgrown,etc.)?:Phe answer is "Yes'', contact the Regional Officelbr guidance.
4 Are any monitored constituents eaual to or above the established standards? (YITS), NO
If the answer to question 4 is "NO", skip tc 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:
AN kN; v•.;
\11) le,Z
5 For the constituents identified in estion 4 above, have standards been exceeded previously for the ES) NO
same constituent(s)in the same well(s) in the last two years?
If the answer to question 5 is WO", 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).
Mk/44 erNI.N)'; tpa 12-1? I
Ths -12/2, N t43 fi57",, iaiih -1-Ts),(""
1°12° ' 12"1
02, 7/ 1
6 Are the monitoring wells listed in sectior 5 located at or beyond the review boundary? YES
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 • 'proved actions required by the Division involving this VES1 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. -i- „.1 tiv 4 cA„,,„
c tA )41 6-e.i 3 .11 „ A, 5 5 0„, ) •
r
) M•• Ntt 4"..P
8 The person completing this portioln(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 trio and complete to the best of my knowledge.
„t
2 - 2_7 -
Signature of Permittee(or Autiorized Agent) Date
,0'Vk 0'00 0 418

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,RALEIGGH NC 27699 1617_ Phone:(919}733-3221
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ00001 t85 Expiration Date. 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 `si`t='; NC 27927
County Cunituck ❑ Lagoon ❑Remediation: Infiltration Gallery
c, �.'t°' 1Z 0 Spray Field 0 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 0 Water Source Heat Pump ®Other: Infiltration
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW4 Date sample collected: 1/27/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.0 units Temp.00010: 14.8 °C DRY at
Depth to Water Level 82546:9.2 ft. below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: Mhos time of
sampling,
Measuring Point Is 2 ft.above land surface Relative M P Flevation• ft Odor 00085: none check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Tan here:❑
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:1/27/22 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 ug1L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 10.2 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 3.80 mg/L
(Note: Use MPN method for highly turbid samries) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 625 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 7.0 units Ba-Barium 01007 ugh.
TOC 00680 6.7 mg/L Ca-Calcium 00916 mg/L
Chloride 00040 203 mg/L Cd Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug1L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC,GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug1L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 _rug/L Lab Report Attached? 0 Yes(1) 0 No(0)
Specific Conductance 00005 µMhos K-Potassium 00037 mg/L VOC 7e732: ,method#
Total Ammonia oos10 0.9 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;Nif3as 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%
I certifythat to the best of m knowledge'andbelief esinformation taccurate, at
th sch 3tkad sn thrs..rP report and.coni lete.and that _ ' a r wa -. �Ysubmitted pP tan lyt cal data s produced using approved methods of analysis by a
DW. certifiedarat boo I.a ::aware Q a ,....,laboratory. mthat there are significant penalties-for submitting false information,including the;possibility nf,fines;and rm n5rn)nent for know3n violations.
Rod Holley Wastewater Superintendent Trainee 1 4 I' 2/27/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Atrthi'zed Agent) (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
COMPLIANCE REPORT FORM and 1 copy to.
1617 MAIL SERVICE CENTER,RALEIGH,NC 27 6 9 9-1 61 7 Phone;[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number; W00000165 ExpltalloltDate: 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 S"`'`'i NC 27927
County Currituck D Lagoon 0 Remediation:Infiltration Gallery
«33v z3"€ ❑ 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: Infiltration
thorn Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW5 Date sample collected: 1/27/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.1 units Temp.00010: 14.3 °C DRY at
Depth to Water Level 82546:5.0 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: )Mhos time of
sampling,
Measuring Point Is 2 ft.above land surface Relative M.P. Elevation: ft. Odor 00065: none check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Tan here:❑
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: 0 YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:1/27/22 Laboratory Name: Enviro Chem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO3)as N 00615<0 02 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 4.56 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 2.16 mg/L
(Note; Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
3issolved Solids:Total 70300 490 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 7.1 units Ba-Barium 01007 ug/L
TOC 00680 9.3 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 1/8 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 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 ugli. 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 (iMhos K-Potaccium 00037 mg/L VOC 76732. ,method##
Total Ammonia 00610 4.2 mg/L Mg-Magnesium 00927 mg/L
method#
(Ammonia Nitrogen:NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 UgIL 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 certifytha to. best i.
{,. heof.m .and::beLef,theinfotm . submitted ;
anon in tit€sre o is. .true accurate,<>and. analytical .. ... ..
p rF , ccUra e complete,and that the lalioratgry, dala was ;us€n ,ap rgvod:methods:of;anal analysis bya
c ,ig.i
produced9 P Y
DWQ- erGiiediaborato I am aware that:there are.:sa significantpenalties.for submitting false information.including . . .laboratory, 9 _ ..9..�1$ n }atwn,€rtclud€r�q the and imprisonment foi;l�h�vingulolations
Rod Holley Wastewater Superintendent Trainee 1 I , 2/27/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authzed 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 WATER QUAI ITYaNFORMATION PROCESSING UNITCOMPLIANCE REPORT FORM and 1'copy to
1617 MAIL SERVICE CENTER,RAt-EiGN NC 27699 9617 Phone;(919)7334221
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0000195 Expiration Dale: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facihity Address- 741 Ocean Trail TYPE or PERMITTED OPERATION BEING MONITORED
Corolla ''""il NC 27927
County Ourrituck ❑ Lagoon 0 Remediation:Infiltration Gallery
iuprs "` ' "` 0 Spray Field 0 Remediation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump INOther: Infiltration
(from Permit) _
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW6 Date sample collected: 1/27/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.9 units Temp.00010: 14.3 °C DRY at
Depth to Water Level 82546:5.9 ft.below measuring point Screened Interval: 12 ft. to 1/ ft. Spec.Cond.00094: ItMhos time of
sampling,
Measuring Point is 2 IL above land surface Relative M.P. Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 4.5 gallons Appearance Clear here:❑
Samples for metals were collected unfiltered: ®YES 0 NO and field acidified: 0 YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:1/27/22 Laboratory Name: Enviro Chem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 0os1s 0.04 mg/L Pb-Lead o1os1 uglL
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 16.6 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 2.35 mg/L
(Note: use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 641 mg/L Al-Aluminum o1105 mg/L
pH(Lab)00403 7.9 units Ba-Barium oioo7 ug/L
TOC 00680 4.6 mg/L Ca-Calcium 00916 mg/L
Chloride oos4o 254 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 twit. Chromium-Total 01o34 uglL
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC,GC/MS,HPLC)
Phenol 32730 ug/L Fe-Iron 01045 uglL (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? 0 Yes(1) 0 No(0)
Specific Conductance(mo95 p.Mhas K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610 2.6 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NI-1,as 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'certr that,to the best;of my knowledge and belief'the informtion'submittede 9 information in this report is true accurate,and complete,and that thehe.la�iarato :anal rcal datawasproduced usingapproved methodsof.anal is bya
P � Yt pP analysis
O1NOcerGfiedlalaoratory,;lam aware that there are sigriftcank' ealllosfor;submittingfalse including the possibility of,finesa d:imprisonment f
penalties . 9 p ty n tmPl?..:..... nE or�k0aw:pg violations._,� _.. ... .� .. . ..,., ..::.. ....... -
Rod Holley Wastewater Superintendent Trainee 4 ! 1.4,� 2/27/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Atfthorized 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 WATER QUALITY-INFORMATION PROCESSING UNIT
and 1 copy to
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1 6 17 Phone:;[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0000185 Expiration Dote: 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 i.�"``.' NC 27927 Count
y Currituck ❑ Lagoon ❑ Remediation: Infiltration Gallery
it,t;' `s`"°' ib ) 0 Spray Field ❑ Remediation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor 0 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 ID NUMBER(from Permit): MW7 Date sample collected: '1/27/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.7 units Temp.00010: 12.9 °C DRY at
Depth to Water Level 62546:3.9 _ft.below measuring point Screened Interval: 12 ft. to 17 ft, Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2 .ft.above land surface Relative M.P. Elevation: ft. Odor 00085: none check
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:1/27122 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 ug/L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 2.20 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.79 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 284 mg/L Al-Aluminum o110s mg/L
pH(Lab)00403 73 units Da-Barium o1007 uglL
TOC 00680 1,4 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 127 mg/L Cd-Cadmium 01027 uglL
Arsenic 01002 ugh'.. Chromium.Total 010s4 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC,GC/MS,HPLC)
Phenol 32730 uglL Fe-Iron o1045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? 0 Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610<0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NHsas 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%
n:
I certify that,to the best of myknowledge and belief,the information submitted in this report is true,accurate,.and camfete and laboratory.anal icai dota,was produced using approved methods of analysis b PoPanalytical ng PPr4 ys y a
DW.Q-certified laboratory. 1 am aware that there are;sl significant penalties for:submittingfalse information,including the'possibility of rfines.a dimprisonmentr in g A_�. , g_.�.:Po -._.,y-- �..9 foknnwi gvlotatrons ..:.....
Rod Holley Wastewater Superintendent Trainee / I b 2/27/22
Petmittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Aphorized 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 WATER QUALITY-INFORMATION PROCESSING UNIT
and 1 copy to
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER,RALEIGH,NC 27699 1617: Phone;;'[phone]
FACILITY INFORMATION Please Print 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 `b€"C'i NC 27927
County Currituck ❑ Lagoon ❑Remediation:Infiltration Gallery
�;ii si-,A, izpi ❑ Spray Field 0 Remediation:
Contact Person: Rod Holley Telephone#:[phone] 0 Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 0 Water Source Heat Pump ®Other: Infiltration
(from Permtt)
SAMPLING INFORMATION if WELL
WELL ID NUMBER(from Permit): MW9 Date sample collected. 1/27/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:6.8 units Temp.00010: 13.9 °C DRY at
Depth to Water Level 82546:6.0 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: }Mhos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Clear here:❑Samples for metals were collected unfiltered: ®YES 0 NO and field acidified: 0 YES 0 NO
LABORATORY INFORMATION
Date sample analyzed:1/27/22 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 ug1L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 7.27 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 40665 1.25 mg/L
(Note: use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 605 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 6.8 units Ba-Barium 01007 ugh
TOC 0068o 4.6 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 280 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 uglL Chromium:Total 01034 ug!L
Grease and Ulis 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? 0 Yes(1) ❑ No(0)
Specific Conductance 00095 }Mhos K-Potassium o0037 mg/L VOC 70732: ,method#
Total Ammonia 00610 1.2 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen:NH�as N:Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L ,method#
TKN as N 00625 mg/L NI-Nickel 01067 ug1L ,method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
g ve a
1 certify that to Me best of my knowledge and belief,the information submitted in this report is true accurate`-and complete and" that. the laboratory.anal €cal data:was,produced sin .a rave' methods.,.; alysis by a
P analytical using approved .af as
DW.Q-certif€ed;laboratory..I am aware that there are:significant penalties for:cubm€ttrn ,false information,cincludin the oss€b€li of fines and imprisonment fo:knowing"v"I 0 9 A ry ..>' La aktans...� _. .
Rod HolleyWastewater SuperintendentTrainee4 , 2/27/22 2
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee`tor Autho Zed Agent) (Date)
GW-59 Rev.2/2010