WQ0000224_Monitoring - 03-2021_20210504

1.itilkilt I I-0km ON YELLOW PAPER ONLY
I GROUNDWATER QUALITY MONITORING:
. Mail Ori•inal DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
WATER QuAu-ry DIVISION,GROUNDWATER SECTION
•mil...........a‘•r•
Olt\ 1 COMPLIANCE F1EPORT FORM 1636 MAIL SERVICE CENTER
FACILITY INFORMATION Please Print Clearly or Type RALEIGH,NC 27699-1636 Phone:[phone]
Facility Name: PO(Air 1-7-PT 617:e A 1-0 tit 1-14.5 I PERMIT#: EXPIRATION DATE: irgi IQ I Win ? I
...
1 i Non-Discharge L.1,i CP coo°221i UIC
Permit Name(if different).
1 1
Paollit.L.",,t,i__r... A-ss: C O S r 5-.4i'RO R.P Npnr--c
C-MERAW .r.S .C-: (sue" ,7 - __it-courity TYPE OF PERMIT-TED-OPERATION BEING MONITORED
taw
Contact Person. tbebv FolifrAl (491 Telephone#: ____.-_,._.Lagoon __ Remediation:Infiltration Gallery
___Well-Locationl-Site-Narno: Mx-of-Welts to-be Sampled: 3 _______Spray-Held ____Ron-edi-ation:
qromPnn19 2 -2_____ __Land Application of Sludge Rotary Distnbutor
Weft tdentificabon Num inber(fro Permit): -1. For Groundwater Treatment Systems Other:Well Depth: ft. Well Diameter: in_ Check OneLc1 Influent (98)
Depth to Water Level below measuring point. "
Screened Interval: 0 f ‘egi.to fL
rirEffluent (Gm NOTE Values should reflect dissolved and .
r i
1 1,----,
colloidal -
Measuring Point(M.P.)is: 410 lit_above land surf . Relative tvl.P. Elevation,ry5.? A21
concentrations.
Gallons of water pum, 149Xpd before sampling: el Date sample collected,ili j Date sample analyzed:Field analysis:-- p-Pf----- J- :=ST:iel:ir-i"&--- - Ce---r----—- -- - - - -- - - Laboratory Name: a-Sivin-0-- 6--.....fier 4 (Ace le:.
Temp. °C.Odor Appearance 1 Certfication No. I 1
.,-ES
-PARAMERS-(Samples-formetais-were-collected-unfilteraci---- -Y -- - - NO— and field acidified YES NO) --
-COD-- --- --Co MF Fecal - / ---Trig/I Nitrite (NO2) as N maa Ni-Nickel mg/I
nf nform: /100m1 Nitrate(NO3)as N 0, )0,._, mg/I Pb- ..ea maii
Coorm: MF Total /100m1 Phosphorus: Total as P 0# q 7 mg/I Zn-Zinc mall
_
pp..:::::Us*"IPH,rnet:-.04 for hIghIy tar2.1.7:00 Orthophosphate mg/I Ammonia Nitrogen Z . t9' .1
Dissolved Solids: Total mg/I Al-Aluminum ingil -Other(Specify-Gompounds-and-ConcentratiorrUnits)-
pli-(whe aria-W
n ---- )------ ,.., 1.... units Ba-Barium rng/1 -
TOO be. 'O mg/I Ca-Calcium_.___ .
Chloride ' '1mg/I Cd-Cadmium VI/V FM3rft-frOPLi -
_ _u_ __ _
Arsenic mg/1 Chromim:Total . 1 •i
Grease and Oils mg/I eu=Copperifid Phenol mg/I Fe-iron ORGANICS: (GC,GC/MS,HPLC)
INFORMATION P
Sulfate mg/I Hg-Mercury ,1,.siml@pecify test and method#.Attach lab report.)
Specific Conductance uMhos K-Potassium mg/1 Report Attached? Yes (1) No (0)
Total Ammonia mg/I Mg-Magnesium ingii 'IOC'IOC : method 4'= _
TKrol as N mg/I ivin-Manganese mg/I : method#..-
. - nicIthnri#,
11777:It .- rt. 71°.:__ '' :: r..-7=.7_ .lPfti;_m_7sulmiltiedirriblErerscrtis:true,acouraterand Complete;-andthat the laboratoty analytical-data-was-produced
--7.;.---iii- ethal.. of_ailalv‘t,s-ia--Northfearelina-OWIaffen-itady-Eeti*cartified labOrciluty--ia-tiVtAfrtrartire-- Te-triPenarties-foiss-ubmit-tinglalse informatiOn:
-101arile-eossia •4-rii- ,..j.-' i; ' -..i si .. :. .-..,,*.• ,'.,.,.,. .-
- ---------gig=r---iiiiiiiiiiiiiiil
-
-tt or g d Title-Please print or type
GW-59 /2 912/Sign re of e tte or Authonzed Agent)
(Date)
Rev. 03/2000

�— — SUBMIT FORM ON YELLOW PAPER ONLY
IGROUNDWATER QUALITY MONITORING: Matt Original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
I COMPLIANCE ---�o-. WATER QUALIFY DIVISION,GROUNDWATER SECTION
REPORT FORM
1636 MAIL SERVICE CENTER
FACILITY INFORMATION RALEIGH,NC 27699-1636 Phone:[phone]
Please Print Clearly or Type
Facility Name: Po(NT 13, C=g A 0 t!(LEAS PERMIT#:
10 Permit Name (it different): EXPIRATION I]ATF�Ci; )240i1
rvon-Discharge wGf COO° l uiC
Facility Address: CO A5/ C U4 R Dj R r� I NPDES
to">I` ,� t � ounty A7-��Er TYP F P MI r t tr)OPERATION BEING MONITORED
Contact Person: PAN. F-QR�` " Telephone#: Lagoon
Well Location/Site Name: Remediation:Infiltration Gallery _ -_ _ _
No_of-Wells-to-be-Sampled�3 _. -. Spray-Feld --
(from pt,n,n� � Remedtation
Well Identification Number(fiom Permit): Lill, Rotary Distributor Land Application of Sludge
Well Depth: !�. ft. Welt Diameter: in For Groundwater Treatment Systems Other
Scr ened Interval: ft.to Check One: Influent (98)
p .7 / I ft.
Depth to Water Level: below measuring point. Effluent (99) I NOTE: Values should reflect dissolved and
Measuring Point(M.P.)is: ft_above Land surf colloidal concentrations.
Relative M.P. Elevation in -
Gallons of water pump,. iled before sampling: Date sample collected: Date sample anal , .
Field ana ts: H P o
P Specific Gq .�' �ta^ce s . ta�ior=Ivry G--- Name: 1ErL / � l�l/Temp. °C,Odor r A..
Appearance P / -[,cI/5h I Certification No. /'`
PARAMETERS(Samples for metals were collected unfiltered F� - ---- ��
COD YES NO and field acidified YES Npt/ )
Coliform: MF Fecal mg/I Nitrite(NO-2- as N —
.� / /100ml Nitrate (NO3) as N < O. C mg/I Ni- Leadl , mg/I
Coliform: MF Total /1OOm1 . Phosphorus: Total as P (Q, 0 mg/I Pb- Lead
m
(Note:Use MPN method for highly turbid sa piesi Ortl,, pi-i,,,,.hat mg/I Ammonia- n mg/1
Dissolved Solids: Total 5Vh "'phosp atz
mg/I Al -Aluminum mg/I Nitrogen �, �� m _1
(Specify-Compounds and Concentration U
pH (when_anal�rzed)- - '---- ---- - --units- m 1 Other
g�' 10 __ Ba - Barium mg/I
)
TOCri�e �`I, mg/I Ca - Calcium mgii
mg/i Cd- Cadmium mg/1
Arsenic mtg`i`i Chromium:Total
Grease and Oils mg/I
Phenol m -Cu- Copper- mg/I
hat mg/l Fe- Iron mg/I ORGANICS: (GC,GC/MS,HPLC)
Specific Conductance mg/I Hg- Mercury
uMhos K- Potassium mg/I Report
ty test and ? Yes
#_At lab report.)
Total Ammonia mg/I Mgmg/I Report Attached? Yes (1) No
-MN ac N- - Magnesium mgii (0)
mg/I Mn - Manganese g/I VOC : method#=mg/1
: method#_
: method#,
--1--certi fhat; o1riebest of in-.knowted•e_andbelief;tpeanformation-submittedirrlhi -report is true,accurate,and complete,and that the lab9Jato Ana
using approved methods of analysis by a North CarolinaD� Q(fore ry fytica data-was-pr•ny B�AII}certtfrediaboratoryrtam aware that there are significant penalties forsuhmlttiog;3lseanfarmatiorr;
including the possibility of fines and imprisonment for knowing-Violations--
.__.
Permit:- or Au •«zed Ag-nt Na •.. . d Title-,.tease rint or type
GW �9 /.'. /a.�'1 %�/'► I
Rev. 03/2000 Signature.-ermittee(or Auth.ri -:Agent)
(Date)

SUBMIT FORM ON YELLOW PAPER ONLY
Mail OriginalDEPARTMENT OF ENVIRONMENT RESOURCES
GROUNDWATER QUALITY MONITORING:
COMPLIANCE LiANCE REPORT FORM —tf7: WATERQUALM`DIVISION,GROUNDWATER SECTION
FACILITY INFORMATION 1536 MAIL SERVICE CENTER
Please Print Clearlyor Type
RALEIGH NC 27699-1636 Phone: [phone]
ty PO(tAi Lt1'
Faciii Name: T kL tl t L L c
PERMIT#: EXPIRATION DATE.
Permit Name (if di€terenrl- "
Non-Discharge UIC
Facility Address: Cr�� s% C.-Ls g� Ear I NPDES
i fXey(� f1 �L� :5�e;p
tG+r) �, :<", 1 q uCourq 7—, GT I TYPE. F pp
l r .._
Contact Person: �1.! 1� l'-e - , Mi< < D OPERA T ION BEING MONITORED
Telephone#: Lagoon Remedation:infiltration Gallery
Wet{ Location/Site Name: No.of Wells-to-be Sampled: Spray Feed
_lRemediation
Well identification Number((from Permit): r ✓$ 41' 'Perm
fj For Groundwater Treatment Systems Other
Distributor Land Application of Sludge
Well Depth: i �i _� ft. Well Diameter-. d in.
Screened Interval: Q/ ft. to ft. Check One Influent (98)
Depth to Water Level: / 0 ft below measuring poin. Effluent (9q) NOTE: Values should reflect dissolved and
Measuring Point(M.P.)is: `��€t.above land surfaop Relative M.P. Elevation in colloidal concentrations. _
Gallons of water pumpey bated before sampling: DDD Date sample collected:/ � ',� Date sar*r ! n
Ci8id anaiysrs.__.vH. .-.---•`° -(,� Specific _ P e analyzed: ,� 0t -
p �G Odor � _ _- -os Cabofa}.ory Name: - . � < • t, cf�i f r(e f{i�
Tem Appearance
I Certification No._ /
PARAMETI=RS(Samples for metals were collected unfiltered t YES—— ,
COO --- _ NO and.read acidified YES.
-- - / mg/I- _.:.Nitrite- NO as N ,L ��)
Coliform: MF Fecal L /100m1 Nitrate (NO3) as N sue,0 7 mg/I Ni- Nickel mg/I
Coliform: MF Total rr /I
1100m1 Phosphorus: Total as P fi
O. (o}� mg Pb- Lead i�tg
(Note:Use MPN method for highly turbid �99o� resl Orthophosphate
�� Zn -Zinc
Dissolved Solids: Total isoc o i mg/I Ammonia Nitrogen V. r►mg/I
mg/I Al -Aluminum g m
prl_(when analyzed) -- —
units Ba -Barium mg/I Other(Specify Compounds an�Concentration Units)
TOC � - - -_- _ mgh
T 1--:_r , O' mg/I Ca- Calcium mg/1
Chlo Arsenic mg/I Cd- Cadmium mn/i
mg,i Chromium:Total -
Grease and Oils mg/i
mg/I Cu--Copper _--
Phenol mg/I Fe- Iron mg/1
Sulfate mg/I ORGANICS: (GC,GC/MS,HPLC)
Specific Conductance m� Fig- Mercury
uMhos K- Potassium mg/i Report
test and ? Yes
#.Attach lab report.)
Total Ammonia mg/I Re ort Attached? Yes 1 i (0)
TKNo As N mg/1 Mg- Magnesium mg/I �, P ( , No
mg/I Mn - Manganese mg/I OC : method#-
method#
: method#
I certify that,to the best of my knowledge andhelief, einfor to#ion.-submitted in-this-teportis true,accurate,and complete,and that the laboratory anaydicatda
using approved methods of anal sis b a North Carorna f2WQ was PraGuce•
eM}ceriil'red taboratoryrtam aware that there 2re significanenatiiesoLsubmittiFlg fatsero> atiol>t
including the possibiliitV of fines and imprisonment fo_ (nowin• violations.:_
__-__-
Pe thorize. _ c/ _rt1e-Plgase print or type
` iriWi'✓' j,,�i
nRev 59O► '/ / �� l l
�) l
Rev. 03/2000 Signature of Permiltea(or Authorized Agent)
(Date,