WQ0000185_Monitoring - 07-2022_20220831

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * July
Report Information
Type *
GW-59
WQ0000185
Ocean Sands WWTP
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
Ocean Sands 251.35KB
G W 59_08312022144508. p df
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Rod Holley
Reviewer: Gerald, Wanda
8/31 /2022
This will be filled in automatically

Is the project number correct?* WQ0000185
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 10/3/2022

1
Enter date monitoring results were due. 741.1 Z 2 Will this monitoring report (GW-59 and GW-59A)
YES
N
be submitted after the established due dare?
Was any required information missing on the GW-59 report forms?
YES
IF the answer to question 1 or 2 is "YES", list in the space provided below the welt dentification 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
NO
identification plate, area overgrown, etc.)? If the answer is "Yes ", contact the Regional Officefor guidance.
4
Are any monitored constituents equal to or above the established standards?
YES
NO
If the answe- to question 4 is "NO,; skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with consUvent(s) and concentration(s)
exceeding standards in the space provided below,
Fl
A� W u ryl IQ k;;" /P W
a,5 -tog )��`i�l TW- 7"J7 T �^7&Z �O3 _ Vo,7
Anil n3`t A/03-/3.3 � R ,'D
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
rYES
NO
same constituents) in the same well(s) in the last two years?
If the answer to question 5 is "NO", skip to section a.
If the answer to question 5 is "YES", list in the space provided below, each weh with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
AV W" LJ fyl i� 1-� 1�'1 in 7 RO M Lo
-ro s ��3 S • 783 ifs S - 7 3-o
MAC IV 2-S-.0 dUO�. �N.�C joe,J,-z(.y
S. 1
11
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. C014TACT 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 oelow.
If the answer to question 7 is "NO" contact the Regional Office within 90 days; an evaluation maV 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 Violafian,
fines, and/or penalties. 1
Coe"( ! SSer 5 W P)P V
piS poss,b
G�B.1�U} �T �ti :,� „ol� f1.(��J� � �lZo C.r�SS r C,� of � n►ti''yN 1 ?Um-5 1-
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 ack' I -dge #hatthe above mfortnatian gas evaluated and the mf - cation submttteri m th"s
report (ContpUanc Report GW 59A} �s true an ,,, mplete to the best of;my hnow[edge;;
3�P - ZZ
Signature of Permittee (or Auth rized Agent) Date

SUBMIT FORM ON YELLOW PAPER ONLY
nmff
DEPARTMENT OF.ENVIRONMENT & NATURAI R.ESOURCkS
GROUNDWATER QUALITY MONITORING:
RIVISIQN OF WATER QUAL1TYdNFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
iGi1,MAltERI![LEGEN[`.ER RALf 1(�H JsfGli�iJe tiF E?h��id (9941) 03ji1x1
FACILITY INFORMATION
Please Print Clearlyor7ype
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
Permit Name (if different):
NPDES Other
Faclllty Address: 741 OoeaiiTrail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑Remediafion: Infiltration Gallery
Corolla (Streal} NC 27927 County Currituc&
(city) (state)
ON
❑ Spray Field ❑ Remediafion:
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 Pemtit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW4
Date sample collected: 7114/22
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 6.9 units Temp. 00010: 26.7 °C
DRY at
Depth to Water Level 82546:8.4 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 00094: [Whos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft, Odor o0085: slight
check
Volume of water pumpedlbailed before sampling:
5.0
gallons
Appearance Cloudy
here:❑
Samples for metals were collected unfiltered: © YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:7114122
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD oo335
mg1L
Nitrite (NO2) as N 00615 0,39
mg/L Pb - Lead olos1 ug/L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 8.67
mg1L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P oo665 1.47
mg1L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg1L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Tolal 703oo 640
mg1L
Al - Aluminum 01105
mglL
pi I (Lab) 00403 6•rJ
units
Da - Barium 0=7
uy1L
TOC oo66o 8.8
mg1L
Ca - Calcium 00916
mglL
Chloride o0940 193
mg1L
Cd - Cadmium oio27
uglL
Arsenic 01002
ug1L
Chromium: Total 01034
uglL
Grease and Oils 00552
mg1L
Cu - Copper 01042
mglL ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug1L
Fe - Iron 01045
uglL (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg1L
Hg - Mercury 71900
ug1L Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
p Mhos
K - Potassium 00937
mglL VOC 78732: method #
Total Ammonia omio 8.8
mg1L
Mg - Magnesium 00927
mglL method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug1L , method #
TKN as N 00625
mglL
Ni - Nickel 01067
ug1L method #
For Remediation Systems Only (Attach Lab Reports)
Influent Total VOCs:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
mglL
Effluent Total VOCs:
mg1L
VOC Removal%
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT 6 ENVIRONMENT $ NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
D[v1510�J OFYYATER QllALIiY INFORMATIbN'PROCESSING UNIT
COMPLIANCE REPORT FORM
rs�7,linntLsRvicECEtai1�;FLEfGH,7�991r done:;{sr9j7azzi
FACILITY INFORMATION
Please Print
CleartyorType
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIG
Permit Name (if different):
NPDES Other
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (street) NG
27927 CountyCurrituck
El Lagoon ❑Remediation: Infiltration Gallery
tcityl (slate)
(zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Halley
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 0 Other: Infiltration
(rmm Permil)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW5
Date sample collected: 7/14/22
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.1 units Temp. Ovo10: 27.6 °C
DRY at
Ilepth to Water I ovel n2mo-3 1 ft. below measuring point Screened Interval: 1? ft. to
17
ft. Spec. Cond. 00094. ILMhoc
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085: none
check
Volume of water pumpedlbailed before sampling: 5.0
gallons
Appearance Clear
here,
❑
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: El YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed.7114/22
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 <0.02
mg1L Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 8
I100mL
Nitrate (NO3) as N 00620 24.8
mg/L Zn -Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 0.88
mg/L
(Note: use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 703oo 794
mg/L
Al -Aluminum 01105
mg/L
pl I (Lab) 00403 7.1
units
Ba - Barium oiow
ug/L
TOC 006so 3.7
mg/L
Ca - Calcium 0o916
mg1L
Chloride 00940 539
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 M ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance oo095
uMhos
K - Potassium oa937
mg/L VOC 78732: method #
Total Ammonia 00610 <0.2
mg/L
Mg - Magnesium 00927
mg1L method #
(Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
, method #
TKN as N oo625
mg/L
Ni - Nickel o1o67
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
Rod Halley Wastewater Superintendent Trainee
Permittee (or Authorized Aqent) Name and Title - Please print or type
mg/L
Effluent Total VOCs:
mg/L VOC Removal%
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT 8 NATEJRAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER4UAt rlY-iNFORMATiOPf PROCE5$!NG UNIT
COMPLIANCE REPORT FORM
�6liTI(ASEf1L'ECE R%LEIGIi,NC2699i6E7 Pone,sfis733322I „,„
FACILITY INFORMATION
Please Print Cleadyor type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ucean Sands
Non -Discharge UIC
Permit Name (if different):
NPDES Other
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Rerfoedialion: Infiltration Gallery
Corolla (Streat) NC 27927 County Curdtuck
(City) (state)
(zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
ElRotary Distributor ElLand Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump K Other: Infiltration
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW6
Date sample collected: 7/14/22
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 6.8 units Temp. 000to: 24.2 °C
DRY at
Depth to Water Level 82640:4.8 fl. below rnua,�uiing puinl Swooned Intuival. 12 fit.
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:
3.5
gallons
Appearance Clear
he re:
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:7/14/22
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 a0.02
mg/L Pb - Lead oimi ug/L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 13.3
mg/L Zn - Zinc 01092 mg1L
Coliform: MF Total 31504
1100mL
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):
issolved Solids:Total 703oo 747
mg/L
Al - Aluminum o11os
mg/L
PH (Lab) 004W 0.8
units
Ba - Sarlum olow
ug/L
TOC om8o 6.0
mg1L
Ca - Calcium o0916
mg/L
Chloride 0094o 51
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
mg1L
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 00610 <0.2
mg1L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NHyas N: Ammonia Nitrogen, Total)
Mn - Manganese oio55
ug1L , method #
TKN as N 00625
mg1L
Ni - Nickel 01067
ug1L method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
Rod Holley Wastewater Superintendent Trainee
Permitlee (or Authorized Agent) Name and Title - Please print or type
mg/L
Effluent Total VOCs:
mg/L
VOC Removal%
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATERQURLETY INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
,lc
FACILITY INFORMATION
Please Pdnt Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (street) NC
27927 County Currituck
❑ Lagoon ❑ Remediation: Infiltration Gallery
airy} (state)
(Zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
ElRotary Distributor ElLand Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
El Water Source Heat Pump Other: Infiltration
(from Parrott)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW7
Date sample collected: 7/14/22
FIELD ANALYSES.,
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 0040o: 7.0 units Temp. 000lo: 27.1 °C
DRY at
Dopth to Wator Lovol 92fdo:3 3 ft, below measuring point Screened Interval: 12 ft.
to 17 ft. Spat,. Cond. 00094. ILMhos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor 000s5: 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:7114/22
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mg1L
Nitrite (NO2) as N 00615 0.02
mg/L Pb - Lead o1051 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 3.65
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 0.58
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 141
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 7.0
units
Ba - Barium oloot
ug/L
TOC 00680 6.2
mg1L
Ca - Calcium oos16
mg/L
Chloride 0094o 45
mg1L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mglL ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg1L
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 oo6lo <0.2
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L , method #
TKN as N 00625
mg/L
Ni - Nickel o1o67
ug/L method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
mg/L Effluent Total VOCs:
mg/L VOC Removal%
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENV1RONtIt1ENT & NATURAf_ RESOURCES '
GROUNDWATER QUALITY MONITORING:
DIVISEON OF WATER quALITY INFORMATfON PROCESSING UNIT
COMPLIANCE REPORT FORM
161,TMA[� SE`RIiCE,CN ER,RALEIGCI,NC47fi991817 Ph 17p e;[phone], .,,,.'
FACILITY INFORMATION
Please Pnnt Clearly or Type
PERMIT Number: WQ0000185 Expiration Dale: 6/30/2024
Facility Name: Ucean 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 CountyCurrituck
El Lagoon ❑Remediation: Infiltration Gallery
(city) (State)
lzipl
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
ElRotary Distributor ElLand 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): MW9
Date sample collected: 7/14/22
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.0 units Temp. 000lo: 24.6 °C
DRY at
Depth to Water Level 02540:4 fl ft. below meatstlrincd point 5croonod Intorvnk 12 ft.
Lo 17 It. Speu. Cund. 00004: µMhos
time of
sampling,check
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: none
Volume of water pumped/bailed before sampling: 5.0
gallons
Appearance Clear
here:
❑
Samples for metals were collected unfiltered: ® YES
El NO and field acidified: El YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:7114122
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mg1L
Nitrite (NO2) as N oa615 0.22
mg/L Pb - Lead oimi ug/L
Coliform: MF Fecal 31016 600
1100mL
Nitrate (NO3) as N 00620 40.7
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P o0665 1.39
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
Dissolved SOlids:Tofal 7030o 762
mg/L
AI -Aluminum olm5
mg/L
pH (Lab) 00403 7.0
units
Ba - Barlum 01007
ug1L
TOC 0068o 3.6
mg/L
Ca - Calcium oa916
mg/L
Chloride 0094o 260
mg/L
Cd - Cadmium 01027
uglL
Arsenic oloo2
uglL
Chromium: Total 01034
uglL
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug1L
Fe - Iron 01045
ug/L (Specify test and method M ATTACH LAB REPORT.)
Sulfate 00946
mg1L
Hg - Mercury 71900
uglL Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia oo610 3.9
mg1L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH�as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
uglL , method #
TKN as N 00625
mg1L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Aqcnt) Name and Title - Please print or type
mglL
Effluent Total VOCs:
mg/L VOC Removal%
GW-59 Rev.2/2010