HomeMy WebLinkAboutWQ0003067_Monitoring - 07-2022_20220811SUSMtT FORM ON YELLOW PAPER ONLY
•
DEPARTMENT OF ENVIRONMENT 8 NATURAL RESOURCES
TER QUALITY MONITORING:
DIVISION OFWATEP.RESOURCES-INFORMATION PROCESSING UNIT
[GROUNDWAMPLIANCEREPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 77699-1617 Phone:9-I o6
CILIYYINFORMAT)
easePnn
ea Tyrpret
PERMIT NumbeT7 ) E iration Date_
'
a
Facifity Name: !? ,
/
l/(%Gy�� 0�
Non -Discharge tJIC
NPDES Other
Permit Name (if differen
Facility Address:
",TYPE
OF PERMI- TED OPERATION BEING MONUORED
❑ Lagoon 13 Remediation: Inflttiation Gallery
County
-
/
�j� (�f,.,
Telephone_��7 z0
PSpray Feld ❑ Remediatlon:
❑- Rotary Distributor ❑LandAp cation of Sludge
Contact Persor .
etC!_ocation/Site Name:No_
of wells to be sa pled:
❑ Water Source Heat ❑Other
SAMPIjNG INFORMATION
01'/A (% f
2Z
IF WELL
WAS DRY
IU-NLiMBER (from rmiti;
g—T
Date sample collected:
1 I
FIELD ANALYSES:
nn
'! 17units Temp_ `C
at time of
Well Depth: // tt
Well Diameter_
In_
pH oo4w- i oomo-
sampling
()
Depth to Water Level a25ae 1 R below measuring point
Screened Interval:
fL to
iL Spec_ Cond. 00094:
check
here:
Measuring POlnt 3S fL above Land surface
Relative UP- Elevation:
tL
Odor 000as: ¢j�Qi
olume of water pumped/bailed before sampling-
gallons
Appearance
Samples for metals were collected unfiltered: EYES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORYINFORMATIQN i��
/1�i
E � h
Qp
(�
Certification No_ br/
Date sample analyzed- (J�
O(�{
Laboratory �/V VjiM]li�m
-F-
.JiUG -
PARAMETERS NOTE Values should reflect dissolved and
colloidal concentrations_
p
COD om3s
mg/L
Nitrite (NO2) as N owls
mg/L
Pb - Lead 01051 i
Coliform: MF Fecal3161s
/100mL
Nitrate (NO,3).as N oo62o •
mg/L
Zn - Zinc 01092 mg/L r
Coliform: MF Total 31s04
c uu aRaN ea" for r�ynry moa wes)
/1 OOmL
Phospl`—: Total as P -0165 0 , 62 mg/L
Orthophosphate 7o5o7 mg/L
r s1
Other (Specify Gompo rids and Concentration Unitsr_ : , §fj
-mg/L
Dissolved Solids:TotalZo3oo `
mg/L
Al -Aluminum o11os
pH (Lab) ooaos
units
Ba -Barium moo?
use
TOG omzo mg/L
Ca -Calcium W916
mg/L
Chloride oaw
mg/L
Cd - Cadmium o1027
ug/L
Arsenic olo02
ug/L
Chromium: Total o1o3a
ug/L
Grease and Oils ooss2
mg/L
Cu - Copper mo42
mg/L
ORGANIC;,: (byGC. GUMS, HPLC)
Phenol 3273o
ug/L
Fe - Iron moos
ug/L
(Specify test and method#_ ATfACH LAB REPORT_')
Sulfate oosas
mg/L
Hg -Mercury 71goo -
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance:000ss
mhos
K - Potassium oo937
g g/L
VOC 78732 aW #
Total Ammonia oo610
mg/L
Mg - Magnesium 0o9z7
mg/L
. method #
(�rt�gr�a"NtiogrJC.NH;as It mia KAM9M Total)
Mn -Man anew moss
q
uglL
�
TKN as N,00625
mg1L
Ni - Nickel mos7
ng/L
method #
GW-59 Rev.8/2013
SUBWT FORM ON YELLOW PAPZR ONLY
UNDWATER QUAL11Y MONITORING:
PLIANCE REPORT FORM
• DEPARTMENT OF EWRONMENT 8 NATURAL RESOURCES
OWISION OF WATER RESOURCES - INFORMATION PROCESSING UNrT
4617.NAIC SERVICE C RALFIGH, NC 27 . 1617 Phones 3tS 81
PERMIT Number• ;ration Date_
Name_ C/C fN. /
`
NoDischarge
t3lC
Name {rf drtferentj_
1 ES ^
S
Outer
Address_
OF PERMITTED OPERATION BEING MONITORED
co I
Lagoon
® 'Remediation_ lafittsafmGaflery
iE,/�(
nSprayFietdrPerson
Telephona�Z0R
L)isiributor
Ootary. LandApp6ca6on ofSledge
CatiortLSrte Name �1(`w`r
No: of Wel(sib;besampled
Water.Soucce Heat f:,,
�. Other
.ING'tNEORMATION.
tD NUMBER (fram Perm tj
y'ti<rrteo ' /
Date saarripJecotleded- '
,
K
If WELL . ,.
-
WeB.)iameter cL
P H ooaoo- a (� uiiiis TerrtR o0ot� eC
to Water Level 82zsa6: .ft below measud g point
Sexeened intervah ft to
ft Spec- Dona_ 000sa: E
e
Measuring Point is fL above land surface
oI-- of water before
Retative M P_ EfevatiorL ft
Odor 00085-
Isere
pumped/bailed sar;I- gaflons
Sam 'tes,ior rnetats were colfecfed:,urtfilte _ � YES. Q NO
and field addsfied: Q YES. C3 NO
Q-
LD80R%kT0[Zl'aNFOE3M Ai70tif
_
- ..'
Date sample analyzed: LaboratoryName Jai V �• i ( {� [7 Gerfifx afhornI i 0
PARAMETERS NUTS'llatt es sFceatV zef:ew dissa.'ed aid cot.oidat concerilraiiorrs. t
COD oa33s mg2 Nitrite (NO0:as.N.0'06'i5 mglL Ft— Leadvrosi ug2
Cofifomr MF Feca43>6i6 /100ML• Mdrate (NO3).as N oo620 nxyL 7� - T�nc mo92 n,g/L
Cotifonrr_ IUtF Total.'sysoa _ 1t00mL. [�itosp'tor= Totab,as.Poos6s:.
ENoec ttsi ►sPlvmeu;oajor.rril� acC�S rti�1�
D �. •• s.e or /e/e �
� a
1 e.
� �
O . O 0 / . IG ►
1 0.,
8���/ UI �� ��
1 � � , ���I��j
® eo. :•1 •' a
,-a.. /IJ
°
-
/ 01/
e o ►. 1 IC •
•:�
lit• of
a .. a •//
e
®
a >al. s o ar. e• //la• a.
•ar,� el•c
a
9 ♦
-1 oe
•, ee
/ 11
1 00
a 1 1•:/
-1 •s
11110
x�e'fii8+ar.•totliet�essofmytcabur{ed5zariaDetEet,:tbe•a�forma<roesubmsaeo+,sihisreaosin:zry�-arara:e;ar�q•eo+rip►e�;'ar��a>:ibe'taeorarorgarsaRE
DL'JR•eesfrfieC•fabbraiay..f "x
' a(aa��na§ar�oirceesisiri".
�
odedineVt
�?P2t,
nf` i' - .
arra by a' ^.,
as>! aivaretsat"tRere
ae s SiSifigr penat5esforsutimilfngtafselifoiRzron:•ireti:2m9
•. •
beRcss�lr4'fr�
•.:
«cesa:iim kr"ot�rn
I®
,01.�561�5'?�SRtOeq`t0i82i0lfy•�
. . _a4s
"v :... -+i;
'-i'. '' r.
. ys,s
.'N'. ':?`'{-.•.^.:.,.. ::'c;:''i%':."'„�,
sGW-59 Rev 82O?3
0. W ,
t:hO_zPWLW
WeH Diameter. iri_
pH ooaoo- units
Temp. 000io_teve(:s2yrs:
sampling.
�Q ft below measuring point
Screened Interval: tt to ft
Spec- Cond_ oo(9a:
tiNlfios
che6*
Measuring Point: is ttatiove.fandsurface
Relative M_PElevation: .._ ._.,_.....:fit
Odoroeotss_
here:
Votirreof`Yai—pr. pewn--&;Ied'� re5di2Nuixy_
.
( jo(}$
Appearance
Sam les,for.imtais were.cotiected :unfiltered: YESEj
NO and field acidified: ;YES E) NO
.
n
LA.SORATOf21!:5.}FQP.IIiRT!Q:+1 Date s$m i�
^�
.
-
Ple analyzed;
Wboratory'Name: _
Certification No.
CL.l
PARAMETERS NOTE: VWues'.should reflect dissolved and'cOIWKL.Concentrations_
CODo03a5 mg/L
Nitrite.(NO2.asKowis mg/L
Pb Leadiwesi
uglL
Coliform: MF Fecal:334616 /100mL
jas Mtrate:(NOs N 00620 t mg/L
Z. - zinc:oios2
mg2
Coliform:.MF Total stsoa. /100mL
(N t= u :e WN Fz)�noaW.-,"t :bd )
Dissci SolidsTotal> oioo_ 0 mg2
pH (Lab, units
TOC 00680 Q r mg/L
Chloride 06940 mg/L
Arsenicoloo2 uglL
Grease and Oris:wss2 mg/L
Phenol 3z73o ug/L
Salfate:oosas M911-
Specific Gonductanee:00095 EiNilhos
total Ammontaroos�o m91L
(/>ua rOgen; lV-f�ast� Aaiaiaria rwvgeri 7ota1)
t KN as N oos2s mglL
>r Rer kediatSortS sterns Oniy (Attach !ab Repai#sj_
x type
Phosptwus: Total as P 00665 10 Z9 mg2
Orthophosphate 70507
mg/L
Odwr(SpecifytCompounds and Concentration Units):
Al -Aluminum moos
m91L
Ba- Barium 01007
ug/LZiiK
t
Ca - Calcium oo916
mSn-
Cd - Cadmium oto27
ug/L
Chromium: Total otoss
ug/L
Cu-Copper mote
mg/L
ORGANICS.(byGC,GUMS, HPLC)
Fe - Iron 01045
ug/L
(Specfify test and method #: ATTACF# IAS:REPORT-)
H9-:Mercx 71900
ug/L
Lab Report Attached? 0 Yes(t) El No (0)
K- Potassium o0937
rng/L
VOC 7373z'. _ ._ . method:#
Mg -Magnesium oo927
_ mg/L
method
Mn. _ MarKjanerse 01055
ug/L
method #
Ni- Nickel mo67
ug/L
method # 1
t
Influent Total VOCs_
rnglL ETLf ent Tbtai VOCs` mg/L VOC Reinoval.r6
--- -- Sig:a:JDf Pe=i` ee (Dr A_ L_ cec Agent) (Date)
GW-59 Rev_ 812013