WQ0002648_Monitoring - 03-2021_20210506 (2)

GW-59A COMPLIANCE REPORT FORM Permit# W ftDOO 26 Y'S
(Submit one each monitoring period with GW-59 forms.)
1 Enter date monitoring results were due.(_g-3a-2t d Will this monitoring report(GW-59 and GW-59A) YES 60
be submitted after the established due date?
2 Was any required information missing on the GW-59 report forms? YES 4S3'
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 llim
identification plate,area overgrown,etc.)?If the answer is "Yes", contact the Regional Office jor guidance.
4 Are any monitored constituents equal to or above the established standards? YES
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:
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?
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 d so may subject the permittee to a Notice of Violation,
fines, and/or penalties. 313V
m ?1
I,IAY .3 Z021
rp 8 The person completing this portion(GW-59A) of th tititog reo rt should sign below and submit this
form with GW-59 forms for required wells to the address provided4 the top of the current GW-59 form.
I hereby acknowledge that the above information was revaluated and the information submitted in this
report(Compliance Report GW-59A)is true and complete to the best of my knowledge.
S g re of ermittee(or Authorized Agent) Date
GW-59A 12/8/2003

Cameron Testing Services, Inc. Laboratory Report NC DENR 1654
NC PHHS e37799
III Seagrove Utah
March 2021 MWs , „.,.,Poik..,1,t,,,.te • ,
' '''''''! **** 2103-205
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Yes US EPA eNC01915
Page 1 of 2
Sample information
ME C.Cameron 11111 03/23/21 111.1 WA,.
J. Cameron ',„,,,, ,'t 03/23/21
,,ezA„r
Analyses and Results
1.. .,
2103-205 01 MW-I ow Gt TDS 94,0 ir41. 26 03124/21 2540 C••TDS
Chiantis 10.1 vet oot 03/26,321 4500 CI-0
N4903 0$40 tnit alas 0312912 i 4500 1403-E
N-NH3 '0,100 mot 01 03125121 4500 NH3-D
Tot.P 0.231 wet 040 03130/21 4500 P-B/E
Fec.cot(Water) 41 if" $ 03123/21 9222 D-ME
02 MW-2 ow Or TDS 495 mot a 03124/21 2540 C-TDS
Chloride 114 * (le 0128/21 4500 Cl-0
N-NO3 1.51 wet o 03129121 4500 NO3-E
N-N113 40,100 Imo. 0$ 03/25f21 4500 NH3-0
Tot.,P 0.086 not a DS 03/30121 4500 P-WE
rec.coil (Water) 41 oc*u ii 05/23,21 9222 0-ME
03 MW4 ow Gt TDS 448 toot 1$ 03i24421 2540 C.TDS
Chloride 91.1 (11041, tun 03129121 4500 Cl-D
N-NO3 1 62 INN o o5 0=9121 4500 NO3•E
N-NH3 40,100 at 01 03/25121 4500 NH3-0
'Tot P 0.082 watt 0 05 03/30121 4500 P•WE
Fec..cot(Water) 41 iiCozintut. 1 03123121 9222 0-ME
, .„. .
Report
,...._-
Projrct,Manager Date
219 S.Seek Str, 91940$4240
Sanford NC 27330 ciwisOcameivotaiinfecom
, __......_

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 t0: 1617 MAIL SERVICE CENTER,RALEIGH,NC 27899-1617 Phone:[phone]
FACILITY INFORMATION Please Pnnf 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 ;`"'`') NC 27341 County Randolph P ❑ Lagoon ❑ Remediation: Infiltration Gallery
(Stdie;:
❑■ 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-1 Date sample collected: 03/23/21 FIELD ANALYSES: WAS
Well Depth: 90.8 ft. Weil Diameter: 4 in. pH 00400: 6.27 units Temp. 000io: 17.3 °C DRY at
Depth to Water Level 82546:36.8 ft. below measuringMhos time of
point Screened Interval: ft. to ft. Spec.Cond. 00094: 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: 106.5 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES 0 NO and field acidified: ❑YES •NO
LABORATORY INFORMATION
Date sample analyzed: 03/23/21-04/05/21 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 oos1s mg/L Pb-Lead o1os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 0oszo 0.140 mg/L Zn-Zinc olosz mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P oosss 0.231 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 94.0 mg/L Al-Aluminum o11os mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 10.1 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 o0oss µMhos K-Potassium 00937 mg/L VOC 78732: , method# 8260B
Total Ammonia o0610 <0.100 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NHjas N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L , method#
TKN as N oos2s 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
DWo-certified laboratory. I am aware that there are significant penalties for submitting false information,including the poss bility.of fines and imprisonment for knowing violations.
�( �)a•{ �U�� Cii'u/ 1 S�«�%ry X J/ , atj2_ Coal? Pg.2 Z-c1 z l
Permittee(or Authorized Agent)Name and Title-Please print or type Sig rture 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 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: 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 NC 27341 County Randolph ❑ Lagoon ❑ Remediation: Infiltration Gallery
• 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: 03/23/21 FIELD ANALYSES: WAS
Well Depth: 29.6 ft. Well Diameter: 4 in. pH 00400: 5.75 units Temp. 00010: 14.5 °C DRY at
Mhos time of
Depth to Water Level 82546:10.5 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: 37.5 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES ❑■ NO and field acidified: ❑YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 03/23/21-04/05/21 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 o1os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 1.51 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.086 mg/L
(Note- Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 495 mg/L Al-Aluminum o11os mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium oos16 mg/L
Chloride 00940 114 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01ooz 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 000ss µMhos K-Potassium 00937 mg/L VOC 78732: , method# 8260E
Total Ammonia o0610 <0.100 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen,NH3as 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
/011
We,,� l W��t�X`d J f -1et.O 10i r �Rr 4' .4 1 - � — _ _
/ fl? `G�-.�� �1
Permittee(or Authorized Agent)Name and Title-Please print or type 1 gn-are of•ermit ee(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 QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM and copy to: 1617 MAIL SERVICE CENTER,RALEIGH,NC 2 76 99-1 61 7 Phone:[phone]
FACILITY INFORMATION Please Pnnf 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 NC 27341
County Randolph ❑ Lagoon ❑Remediation: Infiltration Gallery
❑■ 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: 03/23/21 FIELD ANALYSES: WAS
Well Depth: 25.6 ft. Well Diameter: 4 in. pH o0400 6.08 units Temp.00010: 15.6 °C DRY at
Depth to Water Level 82546:14.9 Mhos time of
p ft. below measuring point Screened Interval: ft. to _ft. Spec.Cond. 000sa: 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: 21.0 gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES ■❑ NO and field acidified: ❑YES ■❑NO
LABORATORY INFORMATION
Date sample analyzed: 03/23/21-04/05/21 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 0os15 mg/L Pb-Lead o10s1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N ooszo 1.62 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P oosss 0.082 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 448 mg/L Al-Aluminum o11os mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 91.1 mg/L Cd-Cadmium 01027 ug/L
Arsenic olooz 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 o0945 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,NH3as 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 certify that.to the best of my knowledge and belief,the information submitted in this report is true,ac4urate.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 informatio .including the.possibility of fines and imprisonment for knowing violations.
X /Pr C 44 ► Wetlkpr -Fefe fr,:7 X 1 P '1-1.1-(%' i`. , 4 z 2O Z /
Permittee(or Authorized Agent)Name and Title-Please print or typb Sig =ture,of Permittee(or Authorized Agent) (Date)
GW-59 Rev.2/2010