WQ0013348_Monitoring - 03-2021_20210504

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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City; (State) (Zip, ■ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Arapahoe spraysite No. of wells to be sampled: 17 ❑ 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: 20 ft. Well Diameter: 2 in. pH 00400: 5.96 units Temp. 000lc 15.8 °C DRY at
Depth to Water Level 82546: 4.6 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: sulphur sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance weak tea here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3)as N 00620 <.04 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.1 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 390 mg/L Al-Aluminum oii05 mg/L RP^('-i1�E®
pH (Lab)00403 units Ba-Barium 01007 ,, ug/L t ,,11�-
TOG 00680 114.8 mg/L Ca Calcium 00916 V mg/L MAY 0 4 2021
Chloride 00940 67 mg/L Cd-Cadmium 01027 ,) ug/L
Arsenic 01002 ug/L Chromium:Total 01034 T., Y.ug/L DWR SECTION
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, dN� �Q� 0CESSIN+G UNIT
Phenol 32730 ug/L Fe- Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 J ug/L Lab Report Attached? ❑ Yes (1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 ►-.." mg/L VOC 7873 , method# 6200c
Total Ammonia ooseo 0.57 mg/L 00927 mg/L , method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L , method#
TKN as N oo62s 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 possibi'':y u,`fines „id imprisonment for knowing violations.
Chris Venters d /,#:�/ �+�" �. 'APR 28 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Apertil-- (Date)
GW-59 Rev.8/2013

• SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
•
GROUNDWATER QUALITY MONITORING: and 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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City, (State) (Zip) • Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Arapahoe spraysite 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: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 5.44 units Temp. 000ic 15.9 °C DRY at
Depth to Water Level 82546: 5.7 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
sulphur sampling,
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance light gray here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb- Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3) as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.16 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
'Dissolved Solids:Total 70300 50 mg/L Al-Aluminum o11os mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 9.84 mg/L Ca-Calcium oos16 mg/L
Chloride oosao 6 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance 000ss µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia o0610 0.11 mg/L 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 possil-.,... of fine^and imprisonment for knowing violations.
Chris Venters dri" �jf 'APR 2 8 7021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature o •e i =e fit •• (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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City, (State) (Zip) ■ Spray Field El Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Arapahoe spraysite 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: 20 ft. Well Diameter: 2 in. pH 00400: 6.45 units Temp. 000lc 18.2 °C DRY at
Depth to Water Level 82546: 4.1 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: sulphur sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance light gray here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 1 /100mL Nitrate (NO3)as N 00620 <.04 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.11 mg/L
(Note: Use MPH method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 200 mg/L Al-Aluminum 01105 mg/L
pH (Lab)ooao3 units Ba-Barium 01007 ug/L
TOC 00680 15.34 mg/L Ca-Calcium oosls mg/L
Chloride oosao 14 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe- Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No (0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia o0610 0.18 mg/L 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 po^.,uii.:•"of f',as and'mpri-,onment for knowing violations.
Chris Venters ,�4 APR 28 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized RiiLTffl (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ❑ Lagoon ❑ Remediation: Infiltration Gallery
(city) (State) (Zip) • Spray Field CI Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Arapahoe spraysite No. of wells to be sampled: 17 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-C4R Date sample collected: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 4.25 units Temp. 000ic 15.9 °C DRY at
Depth to Water Level 82546: 6.7 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: irony sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance orangish brown here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3) as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 <.04 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 60 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 16.94 mg/L Ca-Calcium oos16 mg/L
Chloride oosao 21 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia oosio 0.07 mg/L 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 possihiiity of fines and imprisonment for knowing violations.
Chris Venters .// �p APR 2 8 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature• --'m' -e Fo (Date)
GW-59 Rev.8/2013

• SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zips • Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Arapahoe spraysite 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: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 5.59 units Temp. 000ic 16.6 °C DRY at
Depth to Water Level 82546: 5.6 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
light sulphur sampling,
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: gcheck
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance light gray here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.1 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 260 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 2.65 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 117 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia o0610 0.18 mg/L 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.Chris Venters APR A
PR 28
Permittee(or Authorized Agent)Name and Title-Please print or type Sig . . • -:.• •;AV;/ , ear' t) (Date)
GW-59 Rev.8/2013

• SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
• GROUNDWATER QUALITY MONITORING: and copy t0: DIVISION OF WATER RESOURCES-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1 61 7 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES W00013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) • Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Arapahoe spraysite 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: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 5.34 units Temp. 000ic 18.2 oC DRY at
Depth to Water Level 82546: 5.1 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
light iron sampling,
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: g check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance milky orange here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.25 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 120 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium o1007 ug/L
TOC 00680 1.78 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 52 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) El No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia ooslo <.04 mg/L 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 possibilit,, `nes a-.d imorisonment for knowing violations.
Chris Venters iirr %��� ,- I APR 28 2011
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Pe it ee 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 27699-1 61 7 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name (if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico • Lagoon ❑ Remediation: Infiltration Gallery
Katy) (State) (zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: jc./bor. TreG:4-14.e•44 No. of wells to be sampled: 17 ❑ Water Source Heat Pump Cl Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-7 Date sample collected: _ 3/9/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 7.09 units Temp. 000lc 16.9 °C DRY at
Depth to Water Level 82546: 3.3 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance light milky orange here:
Samples for metals were collected unfiltered: YES El NO and field acidified: YES El NO
LABORATORY INFORMATION
Date sample analyzed: 3/9/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.08 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.28 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 1100 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 4.67 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 35 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe- Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia 00610 0.2 mg/L 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 possibi';,y u;finer and imr risor.ment for',nowing violations.
Chris Venters �� �1111VP-f "ti--~) .APR 2 8 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 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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico • Lagoon ❑ Remediation: Infiltration Gallery
(city) (State) (Zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor E Land Application of Sludge
Well Location/Site Name: 150.1 (pea° 'I'"yarc-irn,enk Pico* 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: 3/9/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 6.82 units Temp. 000ic 197 °C DRY at
Depth to Water Level 82546: 4.4 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: light iron sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance milky orange here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES LI NO
LABORATORY INFORMATION
Date sample analyzed: 3/9/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.91 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 710 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 3.38 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 62 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 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 7873 , method# 6200c
Total Ammonia o0610 0.17 mg/L 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 possibilif; fines-.,id imprsonr lent for knowing violations. 2091
Chris Ventersillrr �,�.� .,...
.�_J 1 APR 28
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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico • Lagoon ❑ Remediation: Infiltration Gallery
iaty, (State) (Zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: 13o.,y br,,,v 1 '-e -i►a,.+ PIGk 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: 3/9/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 5.54 units Temp. 000ic 16.5 °C DRY at
Depth to Water Level 82546: 5.9 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
iron sampling,ht
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: light check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance milky orange here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/9/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.19 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 160 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 2.45 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 16 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 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? E Yes(1) ❑ No (0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia 00610 0.05 mg/L 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 possibilit''•f finee and imrrisor,ment for snowing violations.irfra...—~
Chris Venters % P4 f APR 2 8 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of•-rmittee(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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico • Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Bayboro Treatment Plant 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: 3/9/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 7.35 units Temp. 000ic 18 °C DRY at
Depth to Water Level 82546: 5 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond.00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
clear check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/9/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.11 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.18 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 500 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC aim 2.91 mg/L Ca-Calcium oos1s mg/L
Chloride 00940 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 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia o0s10 0.09 mg/L 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 possibii of fines and imprisonment for knowing violations.Chris Venters ' / fn I APR 2 8 2071
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of er itt (dr 4 t ho 1-- ' (Date)
GW-59 Rev.8/2013

• SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and copy t0: DIVISION OF WATER RESOURCES-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1 61 7 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name (if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico • Lagoon 0 Remediation: Infiltration Gallery
(city) (State) (Zip) 0 Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name: Bayboro Treatment Plant 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-11 Date sample collected: 3/9/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 7.04 units Temp. 000lc 171 °C DRY at
Depth to Water Level 82546: 5.2 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance orangish brown here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/9/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2) as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.05 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.22 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 540 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 3.52 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 31 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia o0610 0.13 mg/L 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�: :nes ar d imprisonmr.nt for knowing violations.
Chris Venters 'fir I APR 28 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Pe ittee or Auth ze.r nt (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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ■ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Bayboro Treatment Plant 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: 3/9/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 7.55 units Temp. 000ic 16.7 °C DRY at
Depth to Water Level 82546: 6 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: Mhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance light grey here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/9/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3) as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.27 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 480 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium o1007 ug/L
TOC 00680 1.71 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 65 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia oos10 0.09 mg/L 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 imprisonm.nt for knowing violations.
Chris Venters FIFA
pper�,// APR2 8 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Sig - . o -- ? dhbrize. •pen (Date)
GW-59 Rev.8/2013

• SUBMIT FORM ON YELLOW PAPER ONLY
• Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico • Lagoon ❑ Remediation: Infiltration Gallery
(City: (State) (Zip, ❑ Spray Field 0 Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Bayboro Treatment Plant 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: 3/9/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 7.22 units Temp.000lc 18 °C DRY at
Depth to Water Level 8254s: 3.8 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: light iron sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance clear here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/9/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb-Lead o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 <.04 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.12 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 _mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 630 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium o1007 ug/L
TOC 00680 2.79 mg/L Ca-Calcium oo916 mg/L
Chloride 00940 57 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? D Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K- Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia oos10 0.18 mg/L 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 pose"uiity of fines and impr.onment for knowing violations.
Chris Venters 41110reirAe 'APR 2 R 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature• 'er itteror Authorized ••- (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 2769 9-1 61 7 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico • Lagoon ❑ Remediation: Infiltration Gallery
(City, (State) (Zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Bayboro Treatment Plant 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: 3/9/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 6.63 units Temp. 000ic 18.2 °C DRY at
Depth to Water Level 82546: 4 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
clear check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/9/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 <.04 mg/L Zn-Zinc o1092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P oo665 0.12 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 570 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 4.32 mg/L Ca-Calcium oosls mg/L
Chloride 00940 35 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper o1042 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 7873 , method# 6200c
Total Ammonia 00610 0.1 mg/L 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 submiring false information,including the posr.oility r;fir.:s anr'it ipris,mment fr. knowing violations.
Chris Venters 7 �P'{ '.""�"` APR 28 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 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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ■ Lagoon ❑ Remediation: Infiltration Gallery
(city, (State l (Zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Oriental Treatment Plant 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: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 7.02 units Temp. 000ic 17.2 °C DRY at
Depth to Water Level 82546: 3 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance light grey here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb-Lead o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3) as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 0.16 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 550 mg/L Al-Aluminum 01105 mg/L
pH (Lab) 00403 units Ba- Barium o1007 ug/L
TOC 00680 3.12 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 45 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 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 7873 , method# 6200c
Total Ammonia oos10 0.08 mg/L 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 possibi'::y u:fines and imprisom.tent for knowing violations.
Chris Venters dwr '/ ref ,,C A PR 2 8 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agen (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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico ■ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Oriental Treatment Plant 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: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 6.83 units Temp. oo01c 161 °C DRY at
Depth to Water Level 82546: 3.5 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
light check
re
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance g grey here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2) as N 00615 mg/L Pb-Lead o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N oos2o <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.74 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 690 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 8.37 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 53 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe- Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 , mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia o0610 0.11 mg/L 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 possibil,', :'nes-,.d imorinonrr.nt for knowing violations.
Chris Venters //J�� APR 28 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agen (Date)
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 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: 8/31/2024
Facility Name: Bay River MSD Non-Discharge WQ0013348 UIC
Permit Name(if different): NPDES WQ0013348 Other
Facility Address: 101 North Fourth Street TYPE OF PERMITTED OPERATION BEING MONITORED
Bayboro NC 28515 County Pamlico • Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) ❑ Spray Field ❑ Remediation:
Contact Person: Chris Venters Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Oriental Treatment Plant 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: 3/24/2021 FIELD ANALYSES: WAS
Well Depth: 20 ft. Well Diameter: 2 in. pH 00400: 7.03 units Temp. oo01c 17.2 °C DRY at
Depth to Water Level 82546: 8 ft. below measuring point Screened Interval: 3 ft. to 15 ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
check
Volume of water pumped/bailed before sampling: 1.5 gallons Appearance orangish brown _ here:
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 3/24/2021 Laboratory Name: Environment 1 Certification No. 10
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2) as N 00615 mg/L Pb-Lead o1051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3)as N 00620 <.04 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.5 mg/L
(Note. Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 740 mg/L Al-Aluminum 01105 mg/L
pH (Lab) 00403 units Ba-Barium 01007 ug/L
TOC 00680 4.77 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 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 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑ No (0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# 6200c
Total Ammonia oos10 0.13 mg/L 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 po�..iollity of fi,es ar-1 i,ipri,-Jnment fr'r knowing violations.
Chris Venters 41Pr /i'F+.i APR 28 2021
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.8/2013