WQ0002428_Monitoring - 03-2021_20210506 (2)

GW-59A COMPLIANCE REPORT FORM Permit# 1/4000 2 2 9
(Submit one each monitoring period with GW-59 forms.)
1 Enter date monitoring results were due.( 3 iI Will this monitoring report(GW-59 and GW-59A) YES NO
be submitted after the established due date I -
2 Was any required information missing on the GW-59 report forms? YES N�
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.
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 constituent(s)and concentration(s)
exceeding standards in the space provided below:
/v\b,/ Z p 4 b. 4D
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? t/
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).
Mv) 2 -pt► 3/2.3I/9 6.OD
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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 maybe 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? I/
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 j npact the waste disposal system is having at "view and compliance
boundaries surrounding is facility. Failure to do so may subject the pe t to a Notice of Violation,
fines,and/or penalties.
o MAY 1 2 2021
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8 The person completing ► poJn 59A)of the monitoring report sifould sign below and submit this
4/
form with GW-59 formslor requ`iPed; s to the address provided at the top of the current GW-59 form.
cc
I hereby acknowledge At,the above information was evaluated and the information submltte ,
report(Compliance Report GW-59A)Is true and complete to the best of my,knowledge. - ;:° '
, IV, .4"94----- i
SI re of Permittee(or Authorized Agent) ate
GW-59A 12/8/2003

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 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0002428 Expiration Date: / ./. i/L0Z,(o
Facility Name: Mountaire/Mt.Vernon Non-Discharge X UIC
Permit Name(if different): ,4400A1T, iir 14/If•AS i9C NPDES Other
Facility Address: 175 Foust Road TYPE OF PERMITTED OPERATION BEING MONITORED
Siler City (Street) NC 27344 Count
y Chatham ❑ Lagoon El Remediation: Infiltration Gallery
rcry) (State) (Zia.)
❑■ Spray Field ❑ Remediation:
Contact Person: Doug Goodwin Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Mountaire Mt.Vernon No. of wells to be sampled: 4 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW Date sample collected: 03/04/21 FIELD ANALYSES: WAS
Well Depth: 26.2 ft. Well Diameter: 2 in. pH 00400: 6.73 units Temp. 00010: 12.3 °C DRY at
Mhos time of
Depth to Water Level 82546:5.0 ft. below measuring point Screened Interval: ft. to ft. Spec.Cond.oea4 e µ sampling,
Measuring Point is 4 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 7.50 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ■❑ NO
LABORATORY INFORMATION
Date sample analyzed: 03/04-16/21 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 o0s1s mg/L Pb-Lead o1os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.923 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P oo665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 _ mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 347 mg/L Al-Aluminum o11o5 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 1.23 mg/L Ca-Calcium o0s1s mg/L
Chloride 00940 37.7 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 Notts 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 oo095 µMhos K-Potassium 00937 mg/L VOC 78732: , method# 8260B
Total Ammonia oos10 <0.100 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen,NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L ,method#
TKN as N ooszs 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.
2JO UGL 4S W (o r t,.1 NRicNERY M41,JA( e,c' f '�/'. a f//L9/L/
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of 'ermittee(or Authorized Agent) (Date)
G'
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail Original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER OUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM and 1 copy to: 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0002428 Expiration Date: /Lf 3//LOLln
Facility Name: Mountaire/Mt.Vernon Non-Discharge X UIC
Permit Name(if different): ,44O(/A)74i r<E. A.A./EMS /AlK NPDES Other
Facility Address: 175 Foust Road TYPE OF PERMITTED OPERATION BEING MONITORED
Siler City (Street) NC 27344 County
Chatham CI Lagoon ❑Remediation: Infiltration Gallery
c-,; (State) (Zip) ❑■ Spray Field ❑Remediation:
Contact Person: Doug Goodwin Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Mountaire Mt.Vernon No. of wells to be sampled: 4 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-2 Date sample collected: 03/04/21 FIELD ANALYSES: WAS
Well Depth: 16 ft. Well Diameter: 4 in. pH o0400. 6.40 units Temp.00010: 13.7 °C DRY at
Mhos time of
Depth to Water Level 82546: 3.6 ft. below measuring point Screened Interval: ft. to _ft. Spec.Cond.aaaa4; µ sampling,
Measuring Point is 1 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 11.5 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES ❑■ NO and field acidified: ❑YES ■❑NO
LABORATORY INFORMATION
Date sample analyzed: 03/04-16/21 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 o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.103 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P o0665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 139 mg/L Al-Aluminum o1105 mg/L
pH(Lab)00403 units Ba-Barium o1007 ug/L
TOC 00680 <1.00 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 6.00 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 o1045 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 oos10 <0.100 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3 as N,Ammonia Nitrogen,Total) Mn-Manganese o1055 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
j)6061.4.S W GoADwtn) N,FicaERy M4,u46 'Z , '�` .� * - //Z 9/2,
Permittee(or Authorized Agent)Name and Title-Please print or type Signaturel Permittee(or Authorized Agent) ( ate)
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
COMPLIANCE REPORT FORM and 1 copy to: 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Pont Clearly or Type PERMIT Number: WQ0002428 Expiration Date: /2../3u/L O Z 4;
Facility Name. Mountaire/Mt.Vernon Non-Discharge X UIC
Permit Name(if different): 4400,JT4l2E CA4nn_ /nJIC NPDES Other
Facility Address: 175 Foust Road TYPE OF PERMITTED OPERATION BEING MONITORED
Siler City (Street) NC 27344 County
Chatham ❑ Lagoon ❑ Remediation: Infiltration Gallery
(Giry) (State) (Zir,
❑• Spray Field ❑ Remediation:
Contact Person: Doug Goodwin Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Mountaire Mt.Vernon No. of wells to be sampled: 4 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-3 Date sample collected: 03/04/21 FIELD ANALYSES: WAS
Well Depth: 15 ft. Well Diameter: 4 in. pH 00400: 6.63 units Temp.00010. 12.2 °C DRY at
Mhos time of
Depth to Water Level 82546:5.2 ft. below measuring point Screened Interval: ft. to ft. Spec.Cond.000e4: µ sampling,
Measuring Point is 1 ft. above land surface Relative M.P. Elevation: ft. Odor 00085 check
Volume of water pumped/bailed before sampling: 9.00 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES ❑■ NO and field acidified: ❑YES •NO
LABORATORY INFORMATION
Date sample analyzed: 03/04-16/21 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 ooszo 0.363 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P oosss mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 216 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 <1.00 mg/L Ca-Calcium oosss mg/L
Chloride 00940 16.0 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 o0095 µMhos K-Potassium 00937 mg/L VOC 78732 , method# 8260B
Total Ammonia oosio <0.100 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen,NH3as N,Ammonia Nitrogen,Total) Mn-Manganese o10ss 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�nm for knowing violations.
i661J6L AS kv' 400NaM/4 /lf4TCk Eft if AA/1✓�} 6.k' r 'v ,,,,',,,,,L.,.., 1f/29/2 l
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of'- 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: DIVISION OF WATER QUAUTY-INF MATIONPROCESSING.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: WQ0002428 Expiration Date: /Z/.7//242.1a
Facility Name: Mountaire/Mt.Vernon Non-Discharge X UIC
Permit Name(if different): f Ot/A/T41?E g441.4 /n/L NPDES Other
Facility Address: 175 Foust Road TYPE OF PERMITTED OPERATION BEING MONITORED
Siler City (Street) NC 27344 County
Chatham ❑ Lagoon Ill Remediation: Infiltration Gallery
(City) (State) (Zip)
❑■ Spray Field ❑Remediation:
Contact Person: Doug Goodwin Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:Mountaire Mt.Vernon No.of wells to be sampled: 4 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-4 Date sample collected: 03/04/21 FIELD ANALYSES: WAS
Well Depth: 17 ft. Well Diameter: 4 in. pH o0400: 6.73 units Temp.00010: 12.6 °C DRY at
Depth to Water Level 82546: 6.0 Mhos time of
p ft. below measuring point Screened Interval: ft. to _ft. Spec. Cond.eoeaa: µ sampling,
Measuring Point is 1 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 12.5 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES • NO and field acidified: ❑YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 031047-16/21 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 00620 0.074 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P oosss mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
'Dissolved Solids:Total 70300 194 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 <1.00 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 5.00 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 o1045 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 <0.100 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen,NH3 asN,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. /
P6064.4S" h GOOD W .4 4A-/C#e R y I 4/✓A ^' / /.t� a�_ y/29/. .l
Permittee(or Authorized Agent)Name and Title-Please print or type Signatu/ Permittee(or Authorized Agent) ( ate)
GW-59 Rev.2/2010