WQ0013921_Monitoring - 07-2022_20220815

SUBMIT FORM ON YELLOW PAPER ONLY
UNDWATER QUALITY MONITORING:
PLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or
Facility Name: G � (���
Permit Name (if different):
Facility Address: r li S ACIE' ant �U
act Person:
Location/Site Name:
-----...__ - -
I NT OF ENVOONMENTAt OUALITY - DIV, OF VVATE:R RESOURCEIU
INFORMATION PROCESSING UNIT
,1617 MAIL SERVICE CENTER, RALEIGH, NC 276094617
RMIT Numt
n-Discharge
31a, Expiration Date.
1` UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
County ' ❑ Lagoon ❑ Remediation: Intiltration Gallery
Q ❑ Spray Field ❑ Remediation:
Telephone#: J d i ^ 3 ❑ Rotary Distributor ❑ Land Applica ion of Sludge
No. of wells to be sampled: �_ ❑ Water Source Heat Pump Other.
SAMPLING INFORMATION 11\
WELL ID NUMBER (from Permit): tA➢ �� Date sample collected: � � � �01,
Well Depth: ft. Well Diameter: in.
Depth to Water Level 82546: ft. below measuring point Screened Interval: ft. to _ft
Measuring Point is ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: gallons
FIELD ANALYSES:
pH 0040o units
Spec. Cond. 00094
Odor 00085
Appearance
Ternp. 000lo: °C
rtMhos
If WELL
WAS
DRY at
time of
sampling,
check
here:
for metals were collected unfiltered:
®YES
❑ NO and field acidified:- ®YES
El NO
- -
❑Samples
LABORATORY INFORMATION
Date sample analyzed: " S —
C`kd "D, Laboratory Name E(\,,,j
Certification
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
No.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 ug/L
_
Coliform: MF Fecal 31616 ' Al/100mL
Nitrate (NO3) as N 00620
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
(Note. Use MPN method for highly turbid samples)
/100mL
Phosphorus: Total as P 00665
mg/L
�.... F—
Orthophosphate 70507
mg/L
Other (Specify Compounds and aticentrdfion It&):
)issolved Solids:Total 70300
mg/L
At - Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680
mg/L
Ca - Calcium 00916
m /L
g
e, a �,»
�t a4' � jsA
Chloride 00940
mg/L
Cd - Cadmium 01027
ug/LKy-/—_ _
N✓ iT;C' PvMJ't � ,, k0!
Arsenic 01002
ug/L
Chromium: Total 01034 .4 Jog/LII
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/ C
7 PANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
specific Conductance 00095
ItMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen, N113as N, Ammonia Nitrogen, Total)
Mn - Manganese o1o55
ug/L
method #
TKN as N 00626
rng/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%