WQ0009267_Monitoring - 06-2022_20220728

DWR - NonDischarge Monitoring Report Submittal y. •4 ..
NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0009267
Name of Facility:* City of Jacksonville WWTP
Month:* June Year:* 2022
Report Information
Type* Upload Document*
GW-59 WQ0009267 June 2022 GW- 20.82MB
59 MW Report.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1,NDAR-2,NDMLR,GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter:* Amy E. Palaschak
Signature:
4A(5f. 1k
Date of submittal: 7/28/2022
This will be filled in automatically
Initial Review
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0009267
Is the monitoring report accepted?* - Yes No
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 8/16/2022

GW-59A COMPLIANCE REPORT FORM Permit # WQ0009267
(Submit one each monitoring period with GW-59 forms.)
Enter date monitoring results were due. (7/31/2022) 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? ® 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 577 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—6/2020 (596.5 mg/L), 9/2020 (628 mg/L), 12/2020 (579 mg/L), 3/2021 (683 mg/L), 6/2021
(657 mg/L), 9/2021 (675 mg/L), 12/2021 (633 mg/L), 3/2022(607.5 mg/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?
If the answer to question 7 is"YES", describe those actions in the space provided below. If the answer to
question 7 is"NO", contact the Regional Office within 90 days; an evaluation may be required to determine the
impact the waste disposal system is having at the review and compliance boundaries surrounding this facility.
Failure to do so may subject the permittee to a Notice of Violation, fines, and/or penalties.
MW10—high background TDS—noted in current permit
8 The person completing this portion (GW-59A) of the monitoring report should sign below and submit this form
with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
I hereby acknowledge that the above information was evaluated and the information submitted in this
report(Compliance Report GW-59A)is true and complete to the best of my knowledge
.-der/6 7/28/2022
Signatu of Permittee(or Authorized Agent) Date
GW-59A 12/8/2003

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: 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 NC 28540 County _ Onslow ❑ Lagoon E Remediation: Infiltration Gallery
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 ❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-1 Date sample collected: 6/27/2022 FIELD ANALYSES: WAS
Well Depth: 16.6 ft. Well Diameter: 2 in. pH o0400: 5.4 units Temp. 000ic 25.4 °C DRY at
Depth to Water Level 82546: 9.5 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: 6.3 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 3.41 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/27/2022 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 omosi ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.03 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 153 mg/L Al-Aluminum o11os mg/L
pH (Lab) 00403 5.41 units Ba-Barium 01007 ug/L
TOC 00680 14.4 mg/L Ca-Calcium 00916 _mg/L
Chloride 00940 37 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 15 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ® No (0)
Specific Conductance oo09s µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia 00610 <0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L , method#
TKN as N o0625 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.
21 Wally Hansen-Public Services Director ` 7 2F( 2az7
Permittee(or Authorized Agent)Name and Title-Please print or Noe ignatur of P 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 l 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 E Lagoon ❑ Remediation: Infiltration Gallery
`city' ';'°i"' iLipi X Spray Field 0 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: 6/28/2022 FIELD ANALYSES: WAS
Well Depth: 17.0 ft. Well Diameter: 2 in. pH 00400: 5.4 units Temp. 000ic 20.2 °C DRY at
Depth to Water Level 82546: 6.7 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: 4.3 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 4.94 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/28/2022 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 0.03 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 0.04 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 193 mg/L Al-Aluminum 0t 105 mg/L
pH (Lab)00403 5.37 units Ba-Barium o1007 ug/L
TOC 00680 _ 7.4 mg/L Ca-Calcium oosls mg/L
Chloride 00940 61 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 oloas ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 8 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# SM 6200C
Total Ammonia Oos10 0.23 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.
Wally Hansen-Public Services Director €4 " r" 7/Z� 70 7
Permittee(or Authorized Agent)Name and Title-Please print or type 'mature f f 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 l 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 E Lagoon ❑ Remediation: Infiltration Gallery
"""°' ""' "" 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: 6/23/2022 FIELD ANALYSES: WAS
Well Depth: 17.0 ft. Well Diameter: 2 in. pH 00400: 5.3 units Temp. 000lc 23 °C DRY at
Depth to Water Level 82546: 4.4 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: 1.2 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 6.05 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/23/2022 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 omos1 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):
dissolved Solids:Total 70300 83 mg/L Al-Aluminum o11os mg/L
pH (Lab)00403 5.3 units Ba-Barium 01007 ug/L
TOC 00680 9.1 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 15 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) ® No(0)
Specific Conductance moss µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia 00610 <0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen:NH3as N;Ammonia Nitrogen,Total) Mn-Manganese o1o55 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. /
Wally Hansen-Public Services Director 7/ z /tin 2.Permittee(or Authorized Agent)Name and Title-Please print or type Sig ature of P mi ee(or Authorized Agent) ( ate)
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: 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 E Remediation: Infiltration Gallery
city) ""'' "" X Spray Field E Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor ❑ 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: 6/23/2022 FIELD ANALYSES: WAS
Well Depth: 16.0 ft. Well Diameter: 2 in. pH ooaoo: 4.8 units Temp. 000ic 21.5 °C DRY at
Depth to Water Level 82546: 5.9 ft. below measuring point Screened Interval: 5.8 ft. to 14 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.68 ft. above land surface Relative M.P. Elevation: 3.22 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 4.85 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/23/2022 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 oosls <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):
Dissolved Solids:Total 70300 160 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 4.79 units Ba-Barium 01007 ug/L
TOC 00680 1.5 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 60 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 o1o45 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 39 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# SM 6200C
Total Ammonia 00610 <0.2 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.
Wally Hansen-Public Services Director 7 Cede
Permittee(or Authorized Agent)Name and Title-Please orint or tvoe nature f Pe ittee(or Authorized Agent) (Date)c
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: 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 E Remediation: Infiltration Gallery
It ity' " X Spray Field 0 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: 6/23/2022 FIELD ANALYSES: WAS
Well Depth: 18.1 ft. Well Diameter: 2 in. pH 00400: 5.6 units Temp. 000ic 19.5 °C DRY at
Depth to Water Level 82546: 11 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: 8.23 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 3.50 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/23/2022 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 oos15 <0.02 mg/L Pb-Lead 01051 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 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 25.5 mg/L Al-Aluminum al los mg/L
pH (Lab)00403 5.62 units Ba-Barium 01007 ug/L
TOC oos8o <0.5 mg/L Ca-Calcium 00916 mg/L
Chloride oe94o <5 mg/L Cd-Cadmium 01027 ug/L
Arsenic 0100z 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) ® No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia oo610 <0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH,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.
Wally Hansen-Public Services Director — 7, 2 �© Z�
Permittee(or Authorized Agent)Name and Title-Please print or tvoe igna ure Per itt e(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: 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) States
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: 6/23/2022 FIELD ANALYSES: WAS
Well Depth: 16.8 ft. Well Diameter: 2 in. pH 00400: 5.7 units Temp. 000ic 20.3 °C DRY at
Depth to Water Level 82546: 5.4 ft. below measuring point Screened Interval: 3.5 ft. to 14 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.65 ft. above land surface Relative M.P. Elevation: 2.75 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 5.47 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/23/2022 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 0.03 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 0.23 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 242 mg/L Al-Aluminum o11os mg/L
pH (Lab) 00403 5.65 units Ba-Barium 01007 ug/L
TOC 00680 7.3 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 38 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 17 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# SM 6200C
Total Ammonia o0610 <0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese moss 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 off fines and imprisonment for knowing violations.
Wally Hansen-Public Services Director /" �/Z Fl/4o Z Z
Permittee(or Authorized Agent)Name and Title-Please print or type Signature Per i 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 27699-1617 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
"Y, ` '"' '" 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: 6/23/2022 FIELD ANALYSES: WAS
Well Depth: 15.0 ft. Well Diameter: 2 in. pH 00400: 4.4 units Temp. 000ic 19.5 °C DRY at
Depth to Water Level 82546: 9 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: 6 ft. Odor 00085. check
Volume of water pumped/bailed before sampling: 2.88 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/23/2022 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):
dissolved Solids:Total 70300 176 mg/L Al-Aluminum alias mg/L
pH (Lab)00403 4.36 units Ba-Barium 01007 ug/L
TOC 00680 6.3 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 48 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 41 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# SM 6200C
Total Ammonia oosio <0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3 as N;Ammonia Nitrogen,Total) Mn-Manganese°loss ug/L , method#
TKN as N 00625 mg/L Ni-Nickel 01067 ug/L , method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
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.
Wally Hansen Public Services Director y 7�2 N C e z
Permittee(or Authorized Agent)Name and Title-Please print or type Sly ature of ermi ee(or Authorized Aoent) ( te) 77
GW-59 Rev.8/2013

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 'l 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 E Remediation: Infiltration Gallery1D0 ' ''"' i.'irJ) X Spray Field 0 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: 6/22/2022 FIELD ANALYSES: WAS
Well Depth: 12.1 ft. Well Diameter: 2 in. pH 00400: 5 units Temp. 000ic 24.2 °C DRY at
Depth to Water Level 82546: 9.5 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: 6.5 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 1.25 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/22/2022 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 0.05 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 243 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 4.95 units Ba-Barium 01007 ug/L
TOC 00680 3 mg/L Ca-Calcium oos16 mg/L
Chloride 00940 <5 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 118 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ® No(0)
Specific Conductance moss µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia 00610 <0.2 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.
Wally Hansen-Public Services Director /' ,i --�_ /7/2 7' ZD Z Z
Permittee(or Authorized Agent)Name and Title-Please print or tvoe siinnatur f P 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: 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 E Remediation: Infiltration Gallery
"'' """"' "' 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: 6/22/2022 FIELD ANALYSES: I WAS
Well Depth: 14.0 ft. Well Diameter: 2 in. pH 00400: 4.2 units Temp. conic 24.1 °C DRY at
Depth to Water Level 82546: 9.9 ft. below measuring point Screened Interval: 7 ft. to 11 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.55 ft. above land surface Relative M.P. Elevation: 7.35 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 1.97 gallons Appearance here:
Samples for metals were collected unfiltered: X YES E NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/22/2022 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 o0665 <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 278 mg/L Al-Aluminum 01105 mg/L
pH (Lab) 00403 4.17 units Ba-Barium 01007 ug/L
TOC 00680 2.3 mg/L Ca-Calcium o0916 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 105 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# SM 6200C
Total Ammonia 00610 <0.2 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 and imprisonment for knowing violations.
Wally Hansen-Public Services Director �4G 6 " /zic©z,Permittee(or Authorized Agent)Name and Title-Please print or tvoe Si na re of erm tee(or Authorized Aoent) (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 E Remediation: Infiltration Gallery
X Spray Field CI Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] E 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: 6/22/2022 FIELD ANALYSES: WAS
Well Depth: 30.1 ft. Well Diameter: 2 in. pH 00400: 6.6 units Temp. 000ic 24.7 °C DRY at
Depth to Water Level 82546: 11 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: 7.8 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 9.31 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO -
LABORATORY INFORMATION
Date sample analyzed: 6/22/2022 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 0.03 mg/L Pb-Lead 01051 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 1.04 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 577 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 6.6 units Ba-Barium 01007 ug/L
TOC 00680 2.1 mg/L Ca-Calcium 00916 mg/L
Chloride oo9ao 17 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 ug/L Chromium: Total 01034 ug/L
Grease and Oils oomsz 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 156 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ® No (0)
Specific Conductance o0095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia o0610 <0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH,as N;Ammonia Nitrogen,Total) Mn-Manganese Noss 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 possibilityty of fines and imprisonment for knowing violations.
Wally Hansen-Public Services Director /di/ ? �8r zeeC
Permittee(or Authorized Agent)Name and Title-Please print or type Signature Pe ittee(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) i:,tate, 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: 6/27/2022 FIELD ANALYSES: WAS
Well Depth: 22.2 ft. Well Diameter: 2 in. pH 00400: 5.2 units Temp. 000ic 22.5 °C DRY at
Depth to Water Level 82546: 13 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: 11.15 ft. Odor 00085: Icheck
Volume of water pumped/bailed before sampling: 4.22 gallons Appearance here:
Samples for metals were collected unfiltered: X YES E NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/27/2022 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 0.36 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):
)issolved Solids:Total 70300 18 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 5.16 units Ba-Barium 01007 ug/L
TOC 00680 0.9 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) ® No (0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia cos10 <0.2 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.
Wally Hansen-Public Services Director 7 2_ Z 0
Permittee(or Authorized Agent)Name and Title-Please print or type Ignature o Per i 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 'I 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
,— •',i,, X Spray Field E 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: 6/23/2022 FIELD ANALYSES: WAS
Well Depth: 18.3 ft. Well Diameter: 2 in. pH 00400: 5.6 units Temp. 000ic 21.7 °C DRY at
Depth to Water Level 82546: 9.2 ft. below measuringSpec. Cond. 00094: µMhos time of
point Screened Interval: 5 ft. to 15 ft. sampling,
Measuring Point is 3.04 ft. above land surface Relative M.P. Elevation: 6.16 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 4.37 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/23/2022 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 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 oos65 <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_ 127 mg/L Al-Aluminum oil05 mg/L
pH (Lab)00403 5.6 units Ba-Barium 01007 ug/L
TOC 00680 26.2 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 7 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01ooz _ ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron o1045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 7 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# SM 6200C
Total Ammonia o0610 <0.2 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.
Wally Hansen-Public Services Director ?/z. .o 2
Permittee(or Authorized Agent)Name and Title-Please print or type ignat re of P-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 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 E Remediation: Infiltration Gallery
X Spray Field E 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: 6/22/2022 FIELD ANALYSES: WAS
Well Depth: 23.2 ft. Well Diameter: 2 in. pH 00400: 4.8 units Temp. 000ic 22.7 °C DRY at
Depth to Water Level 82546: 16 ft. below measuring point Screened Interval: 10.5 ft. to 23.2 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.75 ft. above land surface Relative M.P. Elevation: 13.05 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 3.55 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/22/2022 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 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 64.5 mg/L Al-Aluminum o11os mg/L
pH (Lab)00403 4.84 units Ba-Barium 01007 ug/L
TOC 00680 0.7 mg/L Ca-Calcium 00916 mg/L
Chloride oos4o 23 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) ® No (0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia o0610 <0.2 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.
Wally Hansen-Public Services Director /mod 7/z Sr' z e z
Permittee(or Authorized Agent)Name and Title-Please print or type i�ure f Pe e (or Authorized Agent) (Dat 1
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
(C,ty) 1.:1i.1
X Spray Field 0 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: 6/22/2022 FIELD ANALYSES: WAS
Well Depth: 17.9 ft. Well Diameter: 2 in. pH 00400: 5.3 units Temp. 000ic 23.8 °C DRY at
Depth to Water Level 82546: 13 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: 9.5 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 2.50 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO i
LABORATORY INFORMATION
Date sample analyzed: 6/22/2022 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: ME 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 <0.2 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 50 mg/L Al-Aluminum o1105 mg/L
pH (Lab) 00403 5.31 units Ba-Barium 01007 ug/L
TOC 00680 10.8 mg/L Ca-Calcium o0916 mg/L
Chloride 00940 14 mg/L Cd-Cadmium 01027 ug/L
Arsenic 0100z 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 <5 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# SM 6200C
Total Ammonia o0610 1.08 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.
Wally Hansen-Public Services Director - 7 Z��ze.Z<__
Permittee(or Authorized Aoent)Name and Title-Please print or type ionatu of r ittee(or Authorized Aoent) (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 28.540 County Onslow ❑ Lagoon ❑ Remediation: Infiltration Gallery
X Spray Field El 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: 6/28/2022 FIELD ANALYSES: WAS
Well Depth: 15 ft. Well Diameter: 2 in. pH 00400: 4.9 units Temp. 000lc 22.2 °C DRY at
Depth to Water Level 82546: 3.7 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: 0.8 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: 6/28/2022 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 2.93 mg/L Zn-Zinc olosz 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 108 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 4.86 units Ba-Barium 01007 ug/L
TOC 00680 1.7 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 46 mg/L Cd-Cadmium 01027 ug/L
Arsenic olooz ug/L Chromium:Total 01034 ug/L
Grease and Oils o0552 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) ® No (0)
Specific Conductance 000ss µMhos K-Potassium 00937 mg/L VOC 7873 , method# SM 6200C
Total Ammonia 00610 <0.2 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. 7 ��
Wally Hansen-Public Services Director f z[ GoZ�
Permittee(or Authorized Agent)Name and Title-Please print or tvoe nature o` =hni e (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
Cry)
X Spray Field El 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: 6/28/2022 FIELD ANALYSES: WAS
Well Depth: 25 ft. Well Diameter: 2 in. pH 00400: 4.9 units Temp. 000ic 20.5 °C DRY at
Depth to Water Level 82546: 11 ft. below measuring point Screened Interval: 15 ft. to 20 ft. Spec. Cond. 00094: µMhos time of
sampling,
Measuring Point is 2.4 ft. above land surface Relative M.P. Elevation: 8.4 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 6.82 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/28/2022 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 0.24 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 70 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 4.92 units Ba-Barium 01007 ug/L
TOC 00680 1 mg/L Ca-Calcium oos16 mg/L
Chloride 00940 36 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 6 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# SM 6200C
Total Ammonia 00610 <0.2 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.
Wally Hansen-Public Services Director 7f l ZO2z
Permittee(or Authorized Aoent)Name and Title-Please print or tvoe na ure of Per ittee( r Authorized Aaentl (I-te)
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 :3540 County Onslow _ ❑ Lagoon ❑ Remediation: Infiltration Gallery
X Spray Field ❑ Remediation:
Contact Person: Amy Palaschak Telephone#: [phone] ❑ Rotary Distributor E 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: 6/28/2022 FIELD ANALYSES: WAS
Well Depth: 25 ft. Well Diameter: 2 in. pH 00400: 4.7 units Temp. 000lc 22.8 °C DRY at
Depth to Water Level 82546: 7.7 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: 5.8 ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 8.30 gallons Appearance here:
Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 6/28/2022 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 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 70.5 mg/L Al-Aluminum o1105 mg/L
pH (Lab)00403 4.67 units Ba-Barium 01007 _ ug/L
TOC 00680 _ 1 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 32 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 10 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# SM 6200C
Total Ammonia o0s10 <0.2 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L , method#
TKN as N o0625 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. 'J
Wally Hansen-Public Services Director ib 7/2 ZO ZZ
Permittee(or Authorized Agent)Name and Title-Please print or tvoe Si/ re of Per i ee r Authorized Agent) Date)
GW-59 Rev.8/2013