WQ0002571_Monitoring - 03-2021_20210504

GW-59A COMPLIANCE REPORT FORM Permit# A Q Q 000ZS 7/
(Submit one each monitoring period with GW-59 forms.)
1 Enter date monitoring results were due.(rinfle. /) Will this monitoring report(GW-59 and GW-59A) YES NO
be submitted after the established due date?
2 Was any required information missing on the GW-59 report forms? YES ye
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 jVQ
identification plate,area overgrown,etc.)?If the answer is "Yes",contact the Regional Office for guidance.
4 Are any monitored constituents equal to or above the established standards? YES yIf the answer to question 4 is "NO" skip to section 8.
If the answer to question 4 is "YES"list the affected wells individually with constituent(s)and concentration(s)
exceeding standards in the space provided below:
5 For the constituents identified in question 4 above,have standards been exceeded previously for the YES NO
same constituent(s)in the same well(s)in the last two years?
If the answer to question 5 is"NO", skip to section 8.
If the answer to question 5 is"YES", list in the space provided below, each well with constituent(s)exceeding
standards, concentration(s)reported, and sample collection date for each occurrence(for the last two years).
6 Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES NO
If the answer is "YES",a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe improperly
located;contact the Regional Office.
7 Is the permittee implementing previously approved actions required by the Division involving this YES NO
groundwater quality problem?
T
If the answer to question 7 is"YffS" describe those actions in the space provided below.
If the answer to question 7 is *Q.,contact the Regional Office within 90 days;an evaluation may be
required to determine the impactthe 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&Violation,
fines, and/or penalties. ` VC t�.`�
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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.
ignatur ermittee(or Authorized Agent) Date
GW-59A 12/8/2003

,
SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: Mail original'•EPARTMENTOF ENVIRONMENT&NATURAL RESOURCES
and 1 Copy to: •IVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 817 MAIL SERVICE CENTER,RALEIGH,NC 27899-1817 Phone:[phone]
FACILITY INFORMATION, Please Print Clearly or Type PERMIT Number: Expiration Date: 0 ep 24
Facility Name: Village Oaks MHP Non-Discharge WQ0002571 UIC
Permit Name(if different): NPDES Other
Facility Address: 164 Harris Creek Rd. TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ® Lagoon ❑Remediation: Infiltration Gallery
c`"o """ ® Spray Field ❑Remediation:
Contact Person: Allen W.Rhue Telephone#: [phone] ❑ Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name: Backside of lagoon No.of wells to be sampled: 3 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW- 1 Date sample collected: 31 Mar 21 FIELD ANALYSES: WAS
Well Depth: 13ft. Well Diameter: 2 in. pH 7.27 units Temp. 16.6 °C DRY at
Depth to Water Level: 6'10"ft.below measuring point Screened Interval: 8ft. to 13ft. Spec.Cond. µMhos time of
1.83 N/A sampling,
Measuring Point is ft.above land surface Relative M.P. Elevation: ft. Odor check
Volume of water pumped/bailed before sampling: 5gallons Appearance Clear here:
Samples for metals were collected unfiltered: OYES ❑NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: 31 Mar- 16 Apr 21 Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD mg/I Nitrite(NO2)as N mg/I Pb-Lead mg/I
Coliform: MF Fecal <1 /100m1 Nitrate(NO3)as N 0.13 mg/I Zn-Zinc mg/I
Coliform:MF Total /100m1 Phosphorus:Total as P 0.71 mg/I
(Note: Use MPN method for highly turbid samples) Orthophosphate mg/I Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 348 mg/i Al-Aluminum mg/I
pH(when analyzed) units Ba-Barium mg/I
TOC 1.8 mg/I Ca-Calcium mg/I
Chloride 12 mg/I Cd-Cadmium mg/I
Arsenic mg/I Chromium:Total mg/I
Grease and Oils mg/I Cu-Copper mg/I ORGANICS:(by GC,GC/MS, HPLC)
Phenol mg/I Fe-Iron mg/I (Specify test and method#.ATTACH LAB REPORT.)
Sulfate mg/I Fig-Mercury mg/I Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance µMhos K-Potassium mg/I VOC ,method#
Total Ammonia <0.2 mg/I Mg-Magnesium mg/I ,method#
(Ammonia Nitrogen:NH3as N;Anmonla Nitrogen,Total)
Mn-Manganese mg/1 ,method#
TKN as N mg/I Ni-Nickel mg/I ,method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
lgB y Gt)icid s aw,u �
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Permittee(or Authorized Agent)Name and Title-Please print or type Slgn= •e o 3. thee(or Authorized Agent) '-."� (Date) !S
GW-59 Rev. 1/2007

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: Mail original"EPARTMENTOF ENVIRONMENT&NATURAL RESOURCES
i IVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM and 1 Copy to: 017 MAIL SERVICE CENTER,RALEIGH,NC 27699-1017 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 31 ep
Facility Name: Village Oaks MHP Non-Discharge WQ0002571 UIC
Permit Name(if different): NPDES Other
Facility Address: 164 Harris Creek Rd. TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville NC 28540 County Onslow ® Lagoon 0 Remedlatlon: Infiltration Gallery
® Spray Field ❑Remedlatlon:
Contact Person: Allen W. Rhue Telephone#: [phone] ❑ Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name: Southside of Sprayfield No.of wells to be sampled: 3 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-3 Date sample collected: 31 Mar 21 FIELD ANALYSES: WAS
Well Depth: 27ft. Well Diameter: 2 In. pH 6.13 units Temp. 17.2 °C DRY at
Depth to Water Level: 813"ft. below measuring point Screened Interval: 17 ft. to 27 ft. Spec.Cond. µMhos time of
N/A sampling,
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Reddish here:—
Samples for metals were collected unfiltered: OYES ❑NO and field acidified: ❑YES 0 NO
LABORATORY INFORMATION
Date sample analyzed: 31 Mar* 16 Apr 21 Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD mg/I Nitrite(NO2)as N mg/1 Pb-Lead mg/I
Coliform:MF Fecal 1 /100m1 Nitrate(NO3)as N 0.04 mg/I Zn-Zinc mg/I
Coliform: MF Total /100m1 Phosphorus:Total as P 1.22 mg/I
(Note: Use MPN method for highly turbid samples) Orthophosphate mg/I Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 55 mg/I Al-Aluminum mg/1
pH(when analyzed) units Ba-Barium mg/I
TOC 0.9 mg/I Ca-Calcium mg/I
Chloride 10 mg/I Cd-Cadmium mg/I
Arsenic mg/I Chromium:Total mg/I
Grease and Oils mg/I Cu-Copper mg/I ORGANICS:(by GC,GC/MS,HPLC)
Phenol mg/I Fe-Iron mg/I (Specify test and method#.ATTACH LAB REPORT.)
Sulfate mg/I Hg-Mercury mg/I Report Attached? ❑ Yes(1) ❑ No(0)
Specific Conductance µMhos K-Potassium mg/I VOC ,method#
Total Ammonia <0.2 mg/I Mg-Magnesium mg/I , method#
(Ammonia Nitrogen;NH3ee N;Ammonia Nitrogen,Total) Mn-Manganese mg/I method#
TKN as N mg/I NI-Nickel mg/1 ,method#
For Remedlatlon Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
goBB y &1Ui cs Dw",s Air_ .27 4R -2/
Permlttee(or Authorized Agent)Name and Title-Please print or type Signature of P, •= or Authorized Agent) (Date)
GW-59 Rev. 1/2007

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: Mail original sEPARTMENT OF ENVIRONMENT a NATURAL RESOURCES
and 1 Copy to .IVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 617 MAIL SERVICE CENTER,RALEIGH,NC 27699.1017 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 31 eP '
Facility Name: Village Oaks MHP Non-Discharge WQ0002571 UIC
Permit Name(if different): NPDES Other
Facility Address: 164 Harris Creek Rd. TYPE OF PERMITTED OPERATION BEING MONITORED
Jacksonville (Street) NC 28540 County Onslow ® Lagoon ❑Remedlation: Infiltration Gallery
stato ® Spray Field 0 Remediation:
Contact Person: Allen W. Rhue Telephone#: [phone] Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name: Backside of Sprayfield No.of wells to be sampled: 3 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION. If WELL
WELL ID NUMBER(from Permit): MW-4 Date sample collected: 31 Mar 21 FIELD ANALYSES: WAS
Well Depth: 27 ft, Well Diameter: 2 in. pH 6.76 units Temp. 18.2 °C DRY at
time of
Depth to Water Level: 16'3"ft.below measuring point Screened Interval: 17ft. to 27ft. Spec. Cond. µMhos sampling,
Measuring Point is 2 ft.above land surface Relative M.P. Elevation: ft. Odor N/A check
Volume of water pumped/bailed before sampling: 5gallons Appearance Tan here:
Samples for metals were collected unfiltered: OYES 0 NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: 31 Mar- 16 Apr 21 Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD mg/I Nitrite(NO2)as N mg/I Pb-Lead mg/I
Coliform: MF Fecal <1 /100m1 Nitrate(NO3)as N <0.02 mg/I Zn-Zinc mg/i
Coliform: MF Total /100m1 Phosphorus:Total as P 2.10 mg/I
(Note: Use MPN method for highly turbid samples) Orthophosphate mg/I Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 350 mg/I Al-Aluminum mg/I
pH(when analyzed) units Ba-Barium mg/I
TOC 2.4 mg/I Ca-Calcium mg/l
Chloride 16 mg/I Cd-Cadmium mg/I
Arsenic mg/I Chromium:Total mg/I
Grease and Oils mg/I Cu-Copper mg/I ORGANICS:(by GC,GC/MS, HPLC)
Phenol mg/I Fe-Iron mg/I (Specify test and method#.ATTACH LAB REPORT.)
Sulfate mg/I Hg-Mercury mg/I Report Attached? 0 Yes(1) 0 No(0)
Specific Conductance µMhos K-Potassium mg/I VOC , method#
Total Ammonia <0.2 mg/l Mg-Magnesium mg/I , method#
(Ammonia Nitrogen;NH3 as N;Ammonia Nitrogen,Total)
Mn-Manganese mg/I , method#
TKN as N mg/I Ni-Nickel mg/l , method#
For Remedlation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
3088 V ttbaiJ4'irl S Owl . " .2 7 4Pg .2-
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of•:• fttee(or Authorized Agent) (Date)
GW-59 Rev.1/2007