WQ0000185_Monitoring - 06-2022_20220731

DWR - NonDischarge Monitoring Report Submittal y. •4 ..
NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0000185
Name of Facility:* Ocean Sands WWTP
Month:* June Year:* 2022
Report Information
Type* Upload Document*
GW-59 Ocean Sands 241.76KB
G W 59_07312022100413.p df
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:* Rod Holley
Signature:
Date of submittal: 7/31/2022
This will be filled in automatically
Initial Review
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0000185
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 8/22/2022

Enter date monitoring results were due.('7///z2.) Will this monitoring report(GW-59 and GW-59A) YES CND
be 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 I 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 'VO
identification plate,area overgrown,etc.)?If the answer is "Yes",contact the Regional Office for guidance.
4 Are any monitored constituents equal to or above the established standards? (YES NO
if the answer to question 4 is"NO", skip to section 8.
If the answer to question 4 is "YES"list the affected wells individually with constituent(s)and concentration(s)
exceeding standards in the space provided below:
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5 For the constituents identified in question 4 above, have standards been exceeded previously for the `YESJ 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
stand rds, concentration'-)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 maybe 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?
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. /�
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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.
l hereby acknowledge that the above information was evaluated and the information submitted in this
report(Compliance Report GW 59A)is trueand complete to the best of my knowledge
Signature of Permittee(or AA thorized Agent) Date

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUAUTY-INFORMarION PROCESSING UNIT
and.i copy to ;,
COMPLIANCE REPORT FORM 1s1TrinkL SERlcr CENTER RaiEIGy,NC 27699161 {Phone:[phone],
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (street) NC 27927 County Currituck ❑ Lagoon ❑Remediation: Infiltration Gallery
(city) (State) (Zip) ❑ Spray Field ❑Remediation:
Contact Person: Rod Holley Telephone#:[phone] LI Rotary Distributor El Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 El Water Source Heat Pump 0 Other: Infiltration
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW4 Date sample collected:6/23/22 FIELD ANALYSES: WAS
Well Depth: 17•6 ft. Well Diameter: 3 in. pH 00400:7.1 units Temp.00010: 24.2 °C DRY at
Mhos time of
Depth to Water Level 82546:6.8 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00694: to sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Tan/Cloudy here:❑
Samples for metals were collected unfiltered: 10 YES ❑ NO and field acidified: LI YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:6/23/22 Laboratory Name: Enviro Chem Certification No. 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 614 /100mL Nitrate(NO3)as N 00620 1.94 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 4.06 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 783 mg/L Al-Aluminum e11os mg/L
pH(Lab)00403 7.1 units Ba-Barium 01007 ug/L
TOC 00680 27.6 mg/L Ca-Calcium ants mg/L
Chloride 00940 280 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 uglL Lab Report Attached? ❑ Yes(1) El No(0)
Specific Conductance 00095 l.Mhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610 17.0 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NI13as N:Ammonia Nitrogen,Total) Mn-Manganese 01055 uglL -,method#
TKN as N 00625 mg/L Ni-Nickel 01067 ug/L ,method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by
DWO•cerltfied laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Rod Holley Wastewater Superintendent Trainee 1 ,11 7/30/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature o ermittee(or Authzed Agent) (Date)
GW-59 Rev.2/2010: 11J

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and d copyto DIVISION OF WATER QUALITY INFORMATION PROCESSING UNIT 1
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH NC 276991617 Phone; (919),733.3221
FACILITY INFORMATION, Please Pnnt Clearly or Type PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UiC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (street) NC 27927 County Currituck ❑ Lagoon ❑Remediation: Infiltration Gallery
(city) (Slate) (Zip( El Spray Field ❑Remediation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump ❑■ Other: Infiltration
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW5 Date sample collected:6/16/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.3 units Temp.ooato:25.1 °C DRY at
Mhos time of
Depth to Water Level 82546:4.2 ft.below measuring point Screened Interval: 12 ft, to 17 ft. Spec.Cond.00094: tt sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Clear here:❑
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:6/16/22 Laboratory Name: Enviro Chem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD o0335 mg/L Nitrite(NO2)as N 0os1s<0.02 mglL Pb-Lead 01051 uglt_
Coliform: MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 28.0 mglL Zn-Zinc 01092 mg/L
Coliform:MF Total 315a4 /100mL Phosphorus:Total as P 00665 0.71 mg/
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compotrids and Concentration Units):
Dissolved Solids:Total 70300 783 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 7.3 units Ba-Barium 01007 ug1L
TOC 00680 4.5 mg/L Ca-Calcium 00916 mglL
Chloride 00940 202 mg/L Cd-Cadmium 01027 ug1L
Arsenic 01002 ug1L Chromium:Total 01034 ug1L
Grease and Oils 00552 mg/L Cu-Copper 01042 mglL ORGANICS:(by GC,GC/MS, HPLC)
Phenol 32730 uglL Fe-Iron 01045 ug1L (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 o0os5 µMhos K-Potassium 00937 mg/L VOC 78732: , method#
Total Ammonia 00618 0.4 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NI-has N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug1L , method#
TKN as N 00625 mg/L Ni-Nickel 01067 ug1L , 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
DWO-certified laboratory. l am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Rod Holley Wastewater Superintendent Trainee 40,1 4, 7/30/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or AuthoriztO Agent) (Date)
GW-59 Rev.2/2010

I
SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: Mail original DEISIONONTATE COALI Y IN ONAATON RESOURCES
and 1 copy to DIVISION OF WATER QUALITY INFOR*'; ;-, PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER;RALEIGH,NC 27699 1617 Phone [phone],
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (afeeti NC 27927 County Currituck ❑ Lagoon ❑Remediation: Infiltration Gallery
(City) (State) (Zip) ❑ Spray Field ❑Remediation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump El Other: Infiltration
{from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW6 Date sample collected:6/16/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.3 units Temp.00010: 22.1 °C DRY at
Mhos time of
Depth to Water Level 82546:5.8 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Conc.00094: µ sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 4.0 gallons Appearance Clear here:❑
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:6/16/22 Laboratory Name: Enviro Chem Certification No, 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 rng/L Nitrite(NO2)as N o0615<0.02 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 3tet6<1 /100mL Nitrate(NO3)as N 00620 34.6 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 1100mL Phosphorus:Total as P 00665 1.00 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 730 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 7.3 units Ba-Barium 01007 ug/L
TOC 00680 3.2 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 263 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 uglL Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71000 ug/L Lab Report Attached? El Yes(1) ❑ No(0)
Specific Conductance owes µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
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 mg1L Ni-Nickel 01067 uglL ,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
DWO.cerli€ied laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for know,ng violations.
s
Rod Holley Wastewater Superintendent Trainee 4 d, w . 6, 7/30/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authooed Agent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and:4 copy to DIVISION OF WATER QUALITY INFORMATION PROCESSING UNIT ,
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER RALEIGHNC 2769916,17, Phone [phone],
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (street) NC 27927 County Currituck ❑ Lagoon ❑Remediation: Infiltration Gallery
(City) (State) (Zip) ❑ Spray Field 0 Remediation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump I]Other: Infiltration
(from Permit)
SAMPLING INFORMATION If WELL
WELL[D NUMBER(from Permit): MW7 Date sample collected:6/16/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.4 units Temp.00o10: 23.9 °C DRY at
Mhos time of
Depth to Water Level 82546:5.8 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: p sampling,
Measuring Point is 2 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 4.5 gallons Appearance Clear here:
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:6/16/22 Laooratory Name: Enviro Chem Certification No. 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 13.7 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 1.25 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 451 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 7.4 units Ba-Barium 01007 ug/L
TOC 00680 5.1 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 165 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L CJ-Copper 01042 mg/L ORGANICS: (by GC,GC/MS,HPLC)
Phenol 32730 uglL 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 78732: ,method#
Total Ammonia o0610<0.2 mglL Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen:NHyad 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%
1 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
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing;violations.
Rod Holley Wastewater Superintendent Trainee €0 ♦ /C 7/30/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authoized Agent) (Date)
GW-59 Rev.2/2010 ''

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT$NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING; DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
and 1 copy to ;
COMPLIANCE REPORT FORM 1617;MA[LSERVICECENTER RALEIGH;NC;276991617, Ihone (919)7334221,
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 741 Ocean Trail TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (street) NC 27927 County Currituck
❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) (Zip) ❑ Spray Field ❑Remediation:
Contact Person: Rod Holley Telephone#:[phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Ocean Sands No.of wells to be sampled: 5 ❑ Water Source Heat Pump El Other: Infiltration
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW9 Date sample collected:6/16/22 FIELD ANALYSES: WAS
Well Depth: 17.6 ft. Well Diameter: 3 in. pH 00400:7.5 units Temp.00010:22.2 °C DRY at
Depth to Water Level 82546:5.8 ft.below measuring point Screened Interval: 12 ft. to 17 ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: ft. Odor 00085; none check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance Clear here:Li
Samples for metals were collected unfiltered: ®YES ❑ NO and field acidified: 0 YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:6/16122 Laboratory Name: Enviro Chem Certification No. 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 01o51 uglL
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 11.8 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 1.34 mg/L
(Note: Use MPN method fdr highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 652 mg/L Al-Aluminum o11os mg/L
pH(Lab)00403 7.5 units Ba-Barium o1007 ug/L
TOC 00680 4.3 mg/L Ca-Calcium 00916 mglL
Chloride 0094o 268 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug1L Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mglL ORGANICS: (by GC,GC/MS, HPLC)
Phenol 32730 ug1L 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 ao937 mg/L VOC 76732: , method#
Total Ammonia o0610 5.1 mg/L Mg-Magnesium 00927 mglL , method#
(Ammonia Nitrogen:NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 010ss 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: mglL 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
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations:
Rod Holley Wastewater Superintendent Trainee 4 cJ I 7/30/22
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permidee(or Authoriz d Agent) (Date)
GW-59 Rev.2/2010