WQ0000185_Monitoring - 09-2022_20221031 (3)

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * September
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 277.36KB
G W59_10312022105216. pdf
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
10/31 /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: 11/18/2022

Gam'-59A COMPLIANCE REPORT FORM Permit # D D D
6ribntit ane each monitoring period with GW-59 farms.)
1
Enter date monitoring results were due. ( t? Z Will this monitoring report (GW-59 and GW-59A)
YES
NO!
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
Z-0
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.)? f/'the answer is "Yes", contact the Regional Ojjice 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: W -� 7 m _ 9
m-w-� fnw-� - rn� �D5 —SZ7
i n5- 55 r F3S- 55� Jbs -s"5z
�3 A114-3- jr q N143- 27.3
5
For the constituents identified in question ,4 above, have standards been exceeded previously for the
YES
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
standards, concentrations) reported, and sample collection date for each occurrence (for the last two years)
b5 - `�� �`� '�1)5 - s�� iC)5- G
N1� trfl� - g► �a aU
6
Are the monitoring wells listed in section 5 loca ed at or beyond the review boundary?
YES
NO
If the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELYFOR GUIDANCE. if the answer is "NO", monitoring wells may be 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 maybe
required to determine the im act the waste disposal system is havingat the review and com liance
boundaries surroundingthis facility. Failure to do so may subject the ermittee o a Notice of Violation
fines, and/or penalties. r t
r M � rLt) '� � 1nJ C. � � s�, •�t�S
8
The person completing this portion (G W 59A) of the monitoring report should sign below and submit this
form with G W-59 forms for required wells to the address provided at the top of the current G W-59 form.
I,hereby,ackriowledge that the above irifnrrrtatEo was eyaluatetl and tfie information submttted �n 4hls
report (CompI�ance Report GW 59A) �s true and`compiete ka,the best of my knotin►ledge
Signature of Permittee (or Auth ized Agent) Date
GW-59 A 1218I2003

SUBMIT FORM ON YELLOW PAPER ONLY
EIEPAE2TMENT OF ENVIRONMENT 8'NATURAS RESOURCES
GROUNDWATER QUALITY MONITORING:
t3tViStflNOF1M1fATERRtIALITYINFORMATION'PROCESSINGUNl7.
COMPLIANCE REPORT FORM
IBi7MNLSEizicE_OENT,ER RACE[GH NGz7se fs3` Ptfone ;(s�9)7s332zt
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WO0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
1 acility Address: 741 Oc©an Trall
TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla s`""`' NC
27927 Currituck
County
❑Lagoon El Remediation: Infiltration Gallery
❑ 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 0 Other: Infiltration
{from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW4
Date sample collected: 9129/22
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.4 units Temp. 000lo: 24.4 °C
DRY at
Depth to Water Level 82546:6.6 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 00094: µMhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor aoos5: None
check
Volume of water pumped/bailed before sampling:
5.0
gallons
Appearance Clear
here:
❑
Samples for metals were collected unfiltered: RI YES
El NO and field acidified: El YES
El NO
LABORATORY INFORMATION
Date sample analyzed:9/29122
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mg1L
Nitrite (NO2) as N 00615 0.70
mglL Pb - Lead o1o51 uglL
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 0.11
mg1L Zn - Zinc 01092 mglL
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P oo665 4•32
mglL
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mglL Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 678
mglL
Al - Aluminum ol1o5
mglL
pH (Lab) 00403 7.4
units
Ba - Barium 01007
uglL
TOC oo66o 4.7
mglL
Ca - Calcium oo916
mglL
Chloride 0094o 211
mg1L
Cd - Cadmium 01027
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
uglL
Fe - Iron 01045
uglL (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg1L
Hg - Mercury 71900
uglL Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 000gs
µMhos
K - Potassium 00937
mglL VOC 78732: method #
Total Ammonia 00610 5.0
mglL
Mg - Magnesium aa927
mg1L method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese o1o55
ug1L , method #
TKN as N 00625
mglL
Ni - Nickel 01067
uglL 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
mg1L Effluent Total VOCs:
mglL VOC Removal%a
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT Or EPtVERaNtsA6Ni R NA7UkiAL RESptiFiu
GROUNDWATER QUALITY MONITORING:
DIYtStONOFWATERGWAt,ITY-iNFORMATI4NPROG)=SSINGIl1IT
COMPLIANCE REPORT FORM
1¢17M!41LSERVICECENTER R�IiEIGH,NC,27fi891697,,Phone,'(s99j733ti3221,,, ;'"
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: W00000165 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
El Lagoon El Remediation: Infiltration Gallery
Corolla `°' NC 27927 Currituck
County
❑ Spray Field El 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 © Other: Infiltration
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW5
Date sample collected: 9129/22
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 0040o: 7.3 units Temp. 000lo: 24.3 oc
DRY at
Depth to Water Level 82546:4.3 ft, below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 00094; µ
time ofMhos sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor oao85: None
check
Volume of water pumpediballed before sampling:
5.0
gallons
Appearance Tan
here:❑
Samples for metals were collected unfiltered: © YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:9129122
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 0.04
mg1L Pb - Lead o1o51 ug1L
Coliform: MF Fecal 31616 2
1100mL
Nitrate (NO3) as N 00620 <0.02
mg1L Zn - Zinc 01og2 mg1L
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P 00665 2,86
mg1L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg1L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 553
mg/L
Al -Aluminum o1105
mg/L
pH (Lab) 004o3 7.3
units
Ba - Barium 01007
ug/L
TOC oomo 15.4
mg/L
Ca - Calcium 00g16
mg/L
Chloride 00940 191
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug1L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug1L
Fe - Iron 01045
uglL (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mglL
Hg - Mercury 71900
ug[L Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00og5
µMhos
K - Potassium 00937
mg1L VOC 78732: method #
Total Ammonia 00610 18.4
mg1L
Mg - Magnesium 00927
mg1L method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn -Manganese o1o55
ug1L , 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 Agent) Name and Title - Please print or type
mg/L
Effluent Total VOCs:
mg1L
VOC Removal%
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
gEPArtTMENT OF ENVIRONMENT <NATi1RAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIV15IgN OF VJA7ER QUALITY INFORMATION PRDCESSIiVG UNIT
COMPLIANCE REPORT FORM
s
9617,MAILSERVICE,CNTER,RALEiGE1 NC27899 i61,7- Phone-t979jT33,;322i _,,,,
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 Addross: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
El Lagoon ❑Remediafion: Infiltration Gallery
Corolla` `' NC 27927 Currituck
County
�tata
;zip;
El Spray Field F1 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 Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW6
Date sample collected: 9129/22
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 0040o: 7.3 units '1 emp. 000lo: 23.7 °C
DRY at
Depth to Water Level 62546:5.6 ft. below measuring point Screened Interval: 12 ft. to
17 ft, Spec. Cond. 00094: [Mhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085: None
check
Volume of water pumped/bailed before sampling:
3.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: RI YES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:9/29/22
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 06335
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 <0,02
mg1L Zn - Zinc 01092 mg1L
Coliform: MF Total 31504
/100ml-
Phosphorus: Total as P 00665 1.52
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 556
mg/L
Al - Aluminum of tos
mg/L
pH (Lab) 00403 7.3
units
Ba - Barium oloo7
ug/L
TOC 00660 10.5
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 214
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
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
ug1L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug1L Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia 00610 27.3
mg1L
Mg - Magnesium 00927
mg1L method #
(Ammonia Nitrogen; NH, as 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%
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59
Rev. 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
E2EPARTMIENT OFBNVIRONM1ENT S, NATUf2A4, RESOURCES
GROUNDWATER QUALITY MONITORING:
,
i31+/ISISRATBR QUAE ITY tNFORMQrION 1'1tCiCES&ING KNIT
N OF
COMPLIANCE REPORT FORM
1617 ivi >tt seFyICE Pl5NTER, RALEl H NC2769%4617:' , Phone =(918)733.32�1
FACILITY INFORMATION
Please Pnnt Clearly or Type
PERMIT Number: WQOOOO185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocoon Trait
TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla • ``'"' NC
27927 County Currituck
❑Lagoon R Remediation: Infiltration Gallery
❑ Spray Field F1 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): MW7
Date sample collected: 9/29/22
FIELD ANALYSES:
WAS
Well Depth: 1 /•6 ft.
Well Diameter: 3 in_
pH 00400: 7.6 units Temp. 00010; 23.3 °C
DRY at
Depth to Water Level 82546:4.0 ft. below measuring point
Screened Interval:12 ft.
to 17 ft, Spec. Cond. 00094: µMhos
time ofsampling,
Measuring Point is 2 ft, above land surface
Relative M.P. Elevation:
ft, Odor 000m: 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:9129122
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 5.87
mg1L Pb - Lead o1051 uglL
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 <0.02
mg1L Zn - Zinc 01092 rng/L
Coliform: MF Total 31504
1100ml-
Phosphorus: Total as P oom5 1.04
mg1L
{Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mglL Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 527
mglL
Al - Aluminum o11a5
mglL
pH (Lab) 00403 7.6
units
Be - Barium 01007
uglL
TOC o06eo 5.1
mglL
Ca - Calcium 00916
mg1L
Chloride 00940 178
mglL
Cd - Cadmium 01027
uglL
Arsenic 01002
uglL
Chromium: Total 01034
uglL
Grease and Oils 00562
mg1L
Cu - Copper 01042
mglL ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug1L
Fe - Iron 01045
ug1L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mglL
Hg - Mercury 71900
uglL Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance o0095
µMhos
K - Potassium 00937
mg1L VOC 78732: method #
Total Ammonia on810 022
mglL
Mg - Magnesium 00927
mg1L method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
uglL , 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
Pemnittee (or Authorized Agent) Name and Title - Please print or type
mglL Effluent Total VOCs:
nature
mglL VOC Removal%
10/30/22
(Date)
GW-59 Rev.2/2010

SUBMIT FORD ON YELLOW PAPER ONLY
l)EPL4f2TMENT OF ENVIRONMENT & AIATtfRAL RESl3t1fCES
GROUNDWATER QUALITY MONITORING:
'
" '
ol►ns►or� of wrirER goal trr INFo>zM �TIAId eRocEsslNc uNlr
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER RALEtGIi,N,C 27699 1617 Phone ;(919j733-3221
FACILITY INFORMATION
Please Print Cleadyor 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 Occan Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
El Lagoon ❑ Remediation: Infiltration Gallery
Corolla 5`�''' NC 27927 County Currituck
'
❑Spray Field El Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sends
No. of wells to be sampled: 5
❑ Water Source Heat Pump X Other: Infiltration
(From Permit}
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW9
Date sample collected: 9/29/22
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.4 units Temp. 000io: 23.3 eC
DRY at
Depth to Water Level 82546:6.0 ft. below measuring paint 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:
Samples for metals were collected unfiltered: 0 YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:9129/22
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD o0335
mg/L
Nitrite (NO2) as N 00615 2.34
mg/L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 <0.02
mg1L Zn -Zinc 01092 mg/L
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P oo665 1.07
mg1L
{Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg1L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 703oo 552
mg/L
Al - Aluminum o11o5
mg1L
PH (Lab) 00403 7.4
units
Ba - Barium 01007
ug1L
TOC 0068o 7.0
mg1L
Ca - Calcium 00916
mg1L
Chloride 0094o 229
mg1L
Cd - Cadmium 01027
ug1L
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 3273o
ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug1L Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia 00610 1.1
mg/L
Mg - Magnesium 00927
mg1L method #
(Ammonia Nitrogen; NHyas N: Ammonia Nitrogen, Total}
Mn - Manganese oi055
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:
Rod Halley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
mg1L Effluent Total VOCs:
-_2 _l
Signature or Permittee (or Authorized
mg1L VOC Removal%
10/30/22
(Date)
GW-59 Rev.212010