WQ0009267_Monitoring - 03-2021_20210506

GW-59A COMPLIANCE REPORT FORM Permit#_WQ0009267
(Submit one each monitoring period with GW-59 forms.)
Enter date monitoring results were due. (04/30/2021) Will this monitoring report(GW-59 and GW-59A)be YES NO
submitted after the established due date?
2 Was any required information missing on the GW-59 report forms? YES NO
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:
MW 10—TDS 683 mg/L
MW 14—Total Ammonia Nitrogen 2.06 mg/L
5 For the constituents identified in question 4 above, have standards been exceeded previously for the same NO
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).
MW10—all TDS—3/2019(676.5), 6/2019(648 mg/I), 9/2019(643 mg/L), 12/2019(568.5 mg/L),
3/2020(618 mg/L),6/2020(596.5 mg/L),9/2020(628 mg/L), 12/2020(579 mg/L)
MW14—Total Ammonia Nitrogen—3/2019(2.31 mg/L), 12/2020(1.96mg/L)
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 groundwater ® NO
quality problem?
LV
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** required to determiteelhei
impact the waste disposal system is having at the review and compliance bounds surround this facility. is 2i•
Failure to do so may subject the permittee to a Notice of Violation,fines,and/or alties.�
MW10—high background TDS—noted in current permit b'' <~
77
c
8 The person completing this portion (GW-59A) of the monitoring report should Jr el. :nit, bmit this form
with GW-59 forms for required wells to the address provided at the top of the rent t. 4 -5rm.
I hereby acknowledge that the above information was evaluated and the information submitted in this
report(Co pliance Report GW-59A)is true and complete to the best of my knowledge
4-22-2021
Signature of Permittee(or Authoriz d Agent) Date
GW-59A 12/8/2003

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original E ,,; t OF &NA OURCE8= I
GROUNDWATER QUALITY MONITORING: Di� T INFd�� ROgES �
and 1 copy to �r,
COMPLIANCE REPORT FORM i il'# IC i sc 2/ 046'i Phone t19 /4306-<,
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (Sta°e) (Zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-1 No. of wells to be sampled: 17 0 Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-1 Date sample collected: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 16.6 ft. Well Diameter: 2 in. pH 00400: 5.1 units Temp. 00010: 16 °C DRY at
Depth to Water Level 82546: 5.3 ft. below measuring point Screened Interval: 3 ft. to 13 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 3.2 ft. above land surface Relative M.P. Elevation: 2.1 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 5.42 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 o1os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.14 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 131 mg/L Al-Aluminum o11os mg/L
pH (Lab)00403 5.14 units Ba-Barium 01007 ug/L
TOC 00680 14.9 mg/L Ca-Calcium 00s1s mg/L
Chloride 00940 47 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 16 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia 00610 <0.1 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 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
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
William E. Brown-ORC / /� �K,ZvYI 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

, • SUBMIT FORM ON YELLOW PAPER ONLY
Mail original t! !` EfttOF t,� t® i NAT RALRE8OUR ES
and 1 copy to.�-
GROUNDWATER QUALITY MONITORING: ►4� _ - ,INFO,,-1 ON,P IN,G ESS f 4uP;
COMPLIANCE REPORT FORM i s ms 'N ' ',`e : s. t o IPt _! . #., .,,
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Lip)
X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-2 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-2 Date sample collected: 3/25/2021 FIELD ANALYSES: WAS
Well Depth: 17.0 ft. Well Diameter: 2 in. pH 00400: 5.2 units Temp. 000lo: 15.8 °C DRY at
Depth to Water Level 82546: 5.2 ft. below measuring point Screened Interval: 3 ft. to 13 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.4 ft. above land surface Relative M.P. Elevation: 2.8 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 5.66 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/25/2021 Laboratory Name: 1.Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 010s1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.17 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.2 mg/L
(Note. Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 135 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 5.23 units Ba-Barium 01007 ug/L
TOC 00680 1.8 mg/L Ca-Calcium oosls mg/L
Chloride oosao 72 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 <5 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia 000lo <0.1 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
DWR-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 L 1 KJ�
William E. Brown-ORC * 602•1)1 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original A,RTMENT'O� NIMIENT RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to '-� :, -/ o O ' ' U
COMPLIANCE REPORT FORM cry_p �'... �_...
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-3 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-3 Date sample collected: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 17.0 ft. Well Diameter: 2 in. pH 00400: 5 units Temp. 00010: 15.2 °C DRY at
Depth to Water Level 82546: 5.9 ft. below measuring point Screened Interval: 3 ft. to 13 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 3.2 ft. above land surface Relative M.P. Elevation: 2.7 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 5.33 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: 1.Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 0.06 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 24 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 4.96 units Ba-Barium 01007 ug/L
TOC 00680 1.1 mg/L Ca-Calcium Oos1s mg/L
Chloride aim 11 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium:Total 0103a 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 <5 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 000ss µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia o0610 <0.1 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3 as N;Ammonia Nitrogen,Total)
Mn-Manganese oloss 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
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information including the possibility of fines
sa/and
di�imprisonment for knowing violations
William E. Brown-ORC L%! <IL-ts. 405,.4e}"L4.4Y) 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original i, ; ' OFF TtNIEN ES URCEB
GROUNDWATER QUALITY MONITORING: h I• WA U 'PROCESSING UNIT
and 1 copy to °: 9.. ,
COMPLIANCE REPORT FORM 17MAAAILMEf � gam, wts ' fne:9 174$8
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] El Rotary Distributor El Land Application of Sludge
Well Location/Site Name MW-4 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-4 Date sample collected: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 16.0 ft. Well Diameter: 2 in. pH 00400: 5 units Temp. 00010: 14.3 °C DRY at
Depth to Water Level 82546: 4.8 ft. below measuringtime of
point Screened Interval: 5.8 ft. to 14 ft. Spec. Cond.00094: µMhos sampling,
Measuring Point is 2.68 ft. above land surface Relative M.P. Elevation: 2.12 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 5.38 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: 1.Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 0.19 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 113 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 4.99 units Ba-Barium 01007 ug/L
TOC 00680 1.2 mg/L Ca-Calcium 00916 mg/L
Chloride oos40 37 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 <5 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C _
Total Ammonia o0610 <0.1 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
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information including the possibility of fines and imprisonment for knowing violations
William E. Brown ORC it}7... 6-ta41 2<...6Z444 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original'' - ENTENYIRO NMli*ttlTAMTO A IRCE
GROUNDWATER QUALITY MONITORING: DiViiiinN a t�1"ER ti ti I Et1 iN PROCESSING UNIT
and 1 copy to:
COMPLIANCE REPORT FORM 16i7 MAIL NICE CENTER,RALEIGIt NC 27609.1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) Op) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-5 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-5 Date sample collected: 3/10/2021 FIELD ANALYSES: WAS
Well Depth: 18.1 ft. Well Diameter: 2 in. pH 00400: 5.1 units Temp. 00010: 15.8 °C DRY at
Depth to Water Level 82546: 5.3 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.57 ft. above land surface Relative M.P. Elevation: 2.73 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 6.14 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/10/2021 Laboratory Name: 1.Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 o1os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N oo6zo 0.03 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P o0665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 31.5 mg/L Al-Aluminum oiio5 mg/L
pH (Lab)00403 5.06 units Ba-Barium 01007 ug/L
TOC 00680 <0.5 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 <5 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 <5 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia o0610 <0.1 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 accurate and complete and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
William E. Brown-ORC }/ 73—,c-at// 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
MaiI originaI D I TO I , "ilNrt O RCES:
GROUNDWATER QUALITY MONITORING: ''�r'« °Nx ," INF 1 CE SII
and 1 copy to €�
COMPLIANCE REPORT FORM # ,MAIL,�0I ER,WE*Nerte9946fi Phone,:ate1O i.
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Ln) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-6 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-6 Date sample collected: 3/10/2021 FIELD ANALYSES: WAS
Well Depth: 16.8 ft. Well Diameter: 2 in. pH 00400: 5.7 units Temp. 000to: 25.2 °C DRY at
Depth to Water Level 82546: 3.5 ft. below measuringtime of
point Screened Interval: 3.5 ft. to 14 ft. Spec. Cond. 00094: µMhos sampling,
Measuring Point is 2.65 ft. above land surface Relative M.P. Elevation: 0.85 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 6.38 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/10/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2.94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N oos1s 0.09 mg/L Pb-Lead oiosi ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 <0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P oo665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 210 mg/L Al-Aluminum oiios mg/L
pH (Lab)00403 5.71 units Ba-Barium 01007 ug/L
TOC 00680 6.5 mg/L Ca-Calcium oo91s mg/L
Chloride 00940 25 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 oioas ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 27 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia oos10 <0.1 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 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
DWR-certified laboratory I am aware that there are significant penalties for submitting false information including the possibility of fines and imprisonment for knowing violations
William E. Brown-ORC l L,1%/GLV cor- iLGr_c4'l 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: Mail original DEPART ` OF M�'AW iLREEOUR S
COMPLIANCE REPORT FORM and 1 copy to 'i ' A�O 0''�T ' ENGU
t ERWE Da; y _ , ,440 7r. 919- 07-6 ,
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-7 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-7 Date sample collected: 3/10/2021 FIELD ANALYSES: WAS
Well Depth: 15.0 ft. Well Diameter: 2 in. pH 00400: 4 units Temp. 00010: 19.9 °C DRY at
Depth to Water Level 82546: 2.8 ft. below measuring point Screened Interval: 2.5 ft. to 13 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 3 ft. above land surface Relative M.P. Elevation: -0.2 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 5.86 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/10/2021 Laboratory Name: 1.Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 o1os1 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P oosss <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 187 mg/L Al-Aluminum o11os mg/L
pH (Lab)00403 4.04 units Ba-Barium 01007 ug/L
TOC 00680 5.4 mg/L Ca-Calcium oosss mg/L
Chloride 0094o 67 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 48 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 000ss µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia oosio <0.1 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3 as 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 accurate and complete and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory I am aware that there are significant penalties for submitting false information including the possibility of fines and imprisonment for knowing violations.
William E. Brown-ORC ---(-2-,--40.-�� 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permi ee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original l ,aF 4,_®' MENT tt ES E
GROUNDWATER QUALITY MONITORING: and 1 copy to .0,',�'!� TE E: ` ESS1
COMPLIANCE REPORT FORM M. � C ' ,� ,,,i' ,,.F;'_ !-:,—Pho , 1 r� <
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (De) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-8 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-8 Date sample collected: 3/17/2021 FIELD ANALYSES: WAS
Well Depth: 12.1 ft. Well Diameter: 2 in. pH 00400: 4 units Temp. mow: 14.4 °C DRY at
Depth to Water Level 82546: 5.2 ft. below measuring point Screened Interval: 3 ft. to 9 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 3 ft.above land surface Relative M.P. Elevation: 2.2 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 3.31 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/17/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.09 mg/L Zn-Zinc o1os2 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P ooss5 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 391 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 4.04 units Ba-Barium 01007 ug/L
TOC 00680 2.7 mg/L Ca-Calcium oosls mg/L
Chloride 00940 6 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 146 _mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance moss µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia ooslo <0.1 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,accurate and complete.and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
William E. Brown-ORC /C)�/� i /� ��,� -L./Y\, 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of of Pe mittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

•
SUBMIT FORM ON YELLOW PAPER ONLY
Mail original Ell7r7,17 QR i T° OURcES ,
GROUNDWATER QUALITY MONITORING: ONOF -.M ,,. 1
COMPLIANCE REPORT FORM and 1 copy to x :..3i.3t�3�
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) State) (Zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-9 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-9 Date sample collected: 3/17/2021 FIELD ANALYSES: WAS
Well Depth: 14.0 ft. Well Diameter: 2 in. pH 00400: 4.2 units Temp. 000to: 14.2 °C DRY at
Depth to Water Level 82546: 5 ft. below measuringtime of
point Screened Interval: 7 ft. to 11 ft. Spec. Cond. 00094: µMhos sampling,
Measuring Point is 2.55 ft. above land surface Relative M.P. Elevation: 2.45 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 4.32 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/17/2021 Laboratory Name: 1.Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 19 /100mL Nitrate(NO3)as N 00620 <0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 309 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 4.2 units Ba-Barium 01007 ug/L
TOC 00680 1.9 mg/L Ca-Calcium oo91s mg/L
Chloride oosao 8 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 100 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia 00610 <0.1 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3 as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L , method#
TKN as N oo625 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
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information.including the possibility of fines and imprisonment for knowing violations
William E. Brown-ORC ///,,t f, /Z-- 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

• • SUBMIT FORM ON YELLOW PAPER ONLY
Mail original ,EPART IENT OF ENVRIMMENTNMENT&NA1URAL RESOURCES
GROUNDWATER QUALITY MONITORING: FFWATER URGES'II FORMA`F 1I!ROGESSINGUN/
copy r� ,�. _
COMPLIANCE REPORT FORM and 1 co to _r1 SFg o TERt »I«I Sr. 1T Phone e1» IO
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow El Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] El Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-10 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-10 Date sample collected: 3/17/2021 FIELD ANALYSES: WAS
Well Depth: 30.1 ft. Well Diameter: 2 in. pH o0400: 6.5 units Temp. mow. 17.8 °C DRY at
Depth to Water Level 82546: 5.9 ft. below measuring point Screened Interval: 17 ft. to 27 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.9 ft. above land surface Relative M.P. Elevation: 3 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 11.62 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES El NO
LABORATORY INFORMATION
Date sample analyzed: 3/17/2021 Laboratory Name: 1.Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P oo665 0.97 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 683 mg/L Al-Aluminum o1105 mg/L
pH(Lab)00403 6.53 units Ba-Barium 01007 ug/L
TOC 00680 2.3 mg/L Ca-Calcium oasis mg/L
Chloride 00940 17 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 173 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia o0s10 <0.1 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3 as 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,accurate and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
rf
William E. Brown-ORC 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Pe mittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT 8,NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy t0: DIVISION OF WATER RESOURCES-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge W00009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(city) (Zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-11 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): _ MW-11 Date sample collected: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 22.2 ft. Well Diameter 2 in. pH 00400: 4.6 units Temp. 000io: 15.8 °C DRY at
Depth to Water Level 82546: 7.6 ft. below measuring point Screened Interval: 5 ft. to 20 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.25 ft. above land surface Relative M.P. Elevation: 5.35 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 7.01 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed 3/24/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 oiosi ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3)as N 00620 0.56 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 18 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 4.64 units Ba-Barium 01007 ug/L
TOC 00680 <0.5 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 8 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 o1o4s ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 12 mg/L Hg- Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) X No(0)
Specific Conductance 000ss ftMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia oos10 <0.1 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3 as N;Ammonia Nitrogen,Total) Mn-Manganese o1055 uglL , 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
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
William E. Brown-ORC N l. JZ.: i, 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

• • SUBMIT FORM ON YELLOW PAPER ONLY
Mail original '--41,11TN EPM IENTOF M NTS �$UIR S lURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to ` fJN$� OF WAS ll�c TItN PFtSCESINt�t1
COMPLIANCE REPORT FORM 1*NAIL s _s , 9 Aso Pho � 43t .N.
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-12 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-12 Date sample collected: 3/10/2021 FIELD ANALYSES: WAS
Well Depth: 18.3 ft. Well Diameter: 2 in. pH 00400: 5.6 units Temp. mow: 21 °C DRY at
Depth to Water Level 82546: 4.9 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 3.04 ft. above land surface Relative M.P. Elevation: 1.86 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 6.43 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES El NO
LABORATORY INFORMATION
Date sample analyzed: 3/10/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 0.04 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 <0.02 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 123 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 5.55 units Ba-Barium 01007 ug/L
TOC 00680 20.2 mg/L Ca-Calcium oo91s mg/L _
Chloride 00940 8 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 8 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance o0095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia oos10 <0.1 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,accurate and complete and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information including the possibility of fines and imprisonment for knowing violations
William E. Brown-ORC / G, Y 3 -49 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or Woe Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

• SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to: DIVISION OF WATER RESOURCES-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name (if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville is,Jc 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (Zip)
X Spray Field El Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-13 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): _ MW-13 Date sample collected: 3/17/2021 FIELD ANALYSES: WAS
Well Depth: 23.2 ft. Well Diameter: 2 in. pH 00400: 4.9 units Temp. 000lo. 16.4 °C DRY at
Depth to Water Level 82546: 14 ft. below measuring point Screened Interval: 10.5 ft. to 23.2 ft. Spec. Cond. 00094: [Mhos time of
sampling,
Measuring Point is 2.75 ft. above land surface Relative M.P. Elevation: 11.05 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 4.51 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/17/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 <0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 127 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 4.85 units Ba- Barium 01007 ug/L
TOC 00680 3 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 24 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 <5 mg/L Hg- Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K- Potassium 00937 mg/L VOC 7872 , method# SM 6200C
Total Ammonia oosio 0.17 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
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
William E. Brown-ORC / i_aiYL/ /Z%�,/y-L 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type mature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

• SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT-GP ENVIRONMENT l A #I RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to: 1VI 1 .wAx' RI SOU1 AA;� RvCESSINGU IT
COMPLIANCE REPORT FORM 16f7 NMI. RVICE CENTER,RMEtG$NC 27699.1611 Phoney 9fl ` O6
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-14 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-14 Date sample collected: 3/17/2021 FIELD ANALYSES: WAS
Well Depth: 17.9 ft. Well Diameter: 2 in. pH 00400: 4.9 units Temp. 0o010: 15 °C DRY at
Depth to Water Level 82546: 8.4 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 3.2 ft. above land surface Relative M.P. Elevation: 5.2 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 4.56 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/17/2021 Laboratory Name: 1.Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 oiosi ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 <0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 93.5 mg/L Al-Aluminum o11os mg/L _
pH (Lab)00403 4.92 units Ba-Barium 01007 ug/L
TOC 00680 17.7 mg/L Ca-Calcium oosls mg/L
Chloride 00940 11 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 <5 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia 00610 2.06 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 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
DWR-certified laboratory I am aware that there are significant penalties for submitting false information including the possibility of fines and imprisonment for knowing violations
William E. Brown-ORC / Lifi2 vt.-o,I 04/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

• SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to:;DIVISION OF WATER RESOURCES-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) zip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-15 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-15 Date sample collected: 3/25/2021 FIELD ANALYSES: WAS
Well Depth: 15 ft. Well Diameter: 2 in. pH 00400: 3.3 units Temp. oo010: 16.2 °C DRY at
Depth to Water Level 82546: 3.5 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.9 ft. above land surface Relative M.P. Elevation: 0.6 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 5.52 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/25/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 3.19 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 99.5 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 3.33 units Ba-Barium 01007 ug/L
TOC 00680 0.8 _ mg/L Ca-Calcium o0916 mg/L
Chloride 00940 51 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 <5 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia oo610 <0.1 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 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
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
William E. Brown-ORC // 411° 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

' SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy t0 DIVISION OF WATER RESOURCES-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name (if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) Lip) X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-16 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-16 Date sample collected: 3/22/2021 FIELD ANALYSES: WAS
Well Depth: 25 ft. Well Diameter: 2 in. pH 00400: 5 units Temp. 0001o: 17.2 °C DRY at
Depth to Water Level 82546: 8.3 ft. below measuring point Screened Interval: 15 ft. to 20 ft. Spec. Cond. 000sa: µMhos time of
sampling,
Measuring Point is 2.4 ft. above land surface Relative M.P. Elevation: 5.9 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 8.02 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed. 3/22/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 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 o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3) as N 00620 <0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P o0665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 142 mg/L Al-Aluminum 01105 mg/L
pH (Lab) 00403 4.97 units Ba-Barium o1007 ug/L
TOC 00680 1.1 mg/L Ca-Calcium oos16 mg/L
Chloride(mac) 24 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 11 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No (0)
Specific Conductance 00095 µMhos K- Potassium 00937 mg/L VOC 7873. , method# SM 6200C
Total Ammonia o0610 <0.1 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,accurate,and complete.and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
William E. Brown-ORC Al! /L7 E 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or time Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013

• J SUBMIT FORM ON YELLOW PAPER ONLY
Mail original *-PARTMENT1WENVIR iNENT0!To LRESOURCESI
GROUNDWATER QUALITY MONITORING: i" `� ATER SOURCESdO 1tON PROCESSING UNIT
COMPLIANCE REPORT FORM and 1 copy to -k. E F -i' MOWER,RoNC r -0 ► *91940 306
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 4/30/2022
Facility Name: City of Jacksonville Land Treatment System Non-Discharge WQ0009267 UIC
Permit Name(if different): NPDES Other
Facility Address: 716 Firetower Road TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip)
X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name MW-17 No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-17 Date sample collected: 3/22/2021 FIELD ANALYSES: WAS
Well Depth: 25 ft. Well Diameter: 2 in. pH 00400: 4.3 units Temp. 00010: 17.7 °C DRY at
Depth to Water Level 82546: 6 ft. below measuring point Screened Interval: 15 ft. to 20 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 1.9 ft. above land surface Relative M.P. Elevation: 4.1 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 9.12 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/22/2021 Laboratory Name: 1. Jacksonville 2. Environmental Chemists Certification No. 1. 128 2. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N o0s15 <0.02 mg/L Pb-Lead oiosi ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N ooszo <0.02 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 178 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 4.34 units Ba-Barium 01007 ug/L
TOC 00680 0.9 mg/L Ca-Calcium oos1s mg/L
Chloride 00940 34 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 8 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 000ss µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia oos10 <0.1 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NR3as 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 accurate and complete and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations
William E. Brown-ORC Alr /�jrr/ At--(- yi 4/22/2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013