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HomeMy WebLinkAboutWQ0011360_Monitoring - 07-2022_20220907.Af GW-59A COMPLIANCE REPORT FORM Permit # 1 0 n (Submit one each monitoring period with GW-59 forms.) 1 Enter date monitoring results were due. 4 6V O 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 NO IF the answer to question 1 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 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 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 stan rds in the space,�pprovided below: l , �i 3S, 3 I\J m 5 For the constituents identified in question 4 above, have standards been e)CC66ded 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 `tan as, co c ntration(s) reported, and sample collection date for each occurrence (for the last two years). ^ t - S S 4hh s " 1 -- oZ` S` 1 —c -k�3 VS—t n1 - 3-q-a� s,0 3-1--Pa Sr6 - - Is -is Are the monitoring wells listed in section 5 located at or beyond the review boundary? �S YES O If the answer is "YES", a groundwater quality problem may be occurring. CONTACT 1-14,E REGIONAL OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring5rells may Oe.Improperly located; contact the Regional Office. 7 Is the permittee implementing previously awoveNctions required by the DivQk,j� in ing� YES NO groundwater quality problem? If the answer to question 7 is "YES'; describe t1ldse actions in the space provided below. If the answer to question 7 is "NO", contacethe Regional Office within 90 days; an eva/u"'on maybe 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 ena/ties. (\f�C\c '- s:,e ``noses Fay•Z�` ccz. 8 The person complefirh is portion (GW- 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 acknowledge that the above kdorrnation was evaksated and the irdorma&a submifed in this report (Cam Report 6VI► 9Aj es to complete to the best of my krxnviedge 8- ��- Signature of Pe ittee (or Authorized Agent) Date GW-59A 12/8/2003 00 60 3- -QJ l-al to ao -c- o 30 M��Al ". C.1h �S,31 raw —If �D4 cl r) �k- S at c ') -C)- 9.1 57, r) o-orvn i rumm Ulv TtLLUW PAYER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM Facility Narne: Ta�h S \ PERMIT Number 401 I ?expiration Date: Qe Non -Discharge J UIC Permit Name (if different): NPDES Other Facility Address: 3 1 q TYPE OF PERMITTED OPERATION BEING MONITORED Countygoon ElRemedlation: infiltration Gallery ��'°Yl tNlal�l 1(�—gpPay Field❑Rernedlation: ontact Person: !wk\ Qf10e "telephone#:❑Rotary Distributor ❑Land Application of Sludge Nell Location/Site Name: S\ c O No. of wells to be sampled: S ❑ Water Source Heat Pump ❑ Other: WELL ID NUMBER (from Permit):' 1 Date sample collected: C C o� FIELD ANALYSES: Well Depth: ��' ft. Well Diameter: `r, in. pH 004001s J units Temp. 000i0A 0 °C Depth to Water Level s25as: 8 g ft. below measuring point Screened Interval: ft. to ft. Spec. Cond. 000oa EtNlhos Measuring Point is � t S ft. above land surface Relative M.P. Elevation: ft. Odor 000s5 S Volume of water ptlrrlped/bailed before sampling: Cn nl�� —D ^7- gallons Appearance lr4� qn i.. ..r_ maaara Ware wrrecleu unniterea: M YES LJ NO and field acidified: ® YES ❑ NO LABORATORY INFORMATION Q Date sample analyzed: I� Laboratory Name:J�� —Certification No. PARAMETERS NOTEVal es Id refleo diss01, d and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N OU615 mg/L Pb -Lead o1051 ug/L Coliforn: MF Fecal 31s•is C� m , /100L Nitrate (NO3) as N oos2o - ---.--.—_._ 3 my/L Zn - Zinc o i0g2 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P oo6(35 0 mg/L (Note. Use MPN method for highly turbid samples) ^ Orthophosphate 70507 mg/L. Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 _� mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TUC 00080 mg/L Ca - Calcium uo9•i6 mg/L Chloride 00940 �� ing/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 07045 uglL (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes 0) ❑ No (0) t pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7e73 ,method Total Ammonia ooeio Q t mg/L Mg - Magnesium 00927 (Ammonia Nitrogen. NNu3a$ N, Antntonia Nitrogen, Total) g/L method # Mn - Manganese 0io55 g/L , n-iethod # TKN as N 00625 mg/L Ni - Nickel 01067 - uglL _- method # For Rernedlation Systems Only (Attach Lab Reports): Influent Tntai Vnrr. WELL DRY at time of sampling, check here:E] VOC Removal% For Rernedlation Systems Only (Attach Lab Reports): Influent Tntai Vnrr. WELL DRY at time of sampling, check here:E] VOC Removal% SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: N�MWMWJ TAM COMPLIANCE REPORT FORM • (,� FACILITY INFORMATION Please Print Clearly or Type Facility Narne: CZ�� �fa(�Ci� PERMIT Number: 00113�Fdpiration Date Permit Name (if different): Non -Discharge UIC Facilit Add ess: NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED G4 County Rpl(�(� � goor"r ❑ Remedlation: Infiltration moray Field ❑ Renlediation: Gallery Contact Person: �2 Telephone#:9 � El Distributor ❑Land Application of Sludge e Well Location/Site Name: GQ S Q No. of wells to be sampled: ❑ Water Source Heat Pump ❑ Other: SAMPLING INFORMATION (�(� WELL ID NUMBER (from Permit): { `\lf� — pate le n C �� If WELL. Well Depth: 1 ft. sample collected: p 1 Well Diameter: in. FIELD ANALYSES: pH ooaoo writs fernp. oo010a� , O°C WAS DRY at Depth to Water Level 8^^2546: ft. below measuring point Screened Interval: ft. to ft. Spec. Cond. 00094 ftNthos time of Measuring Point is "l 1 ft. above land surface Volume of water S Relative M.P. Elevation: ft. Odor oo0s5 SLl sampling, check pumped/bailed before sampling: gallons Appearance � A � O� 2� here: Samples for metals were collected unfiltered: ® YES ❑ NO and field acidified ® YES El NO _ LABORATORY INf=nReee-rinnt Date sample analyzed:9 - (Z -9 ) 1 -11 1? 45 tT PARAMETERS NOTE: Val es sho Id refl ct diss r COD 00335 mg/L Coliform: IMF Fecal 31616 0 Cb /100mL Coliform: MF Total 31504 /100mL (NoteUse MPN method for highly turbid samples) issolved Solids:Total 70300 0Q 8 mg/L pH (Lab) 00403 units TUC ooeao mg/L Chloride 00940 _�rng/L Arsenic 01002 ug/L Grease and Oils 00552 mg/L Phenol 32730 ug/L Sulfate 00945r mg/L Specific Conductance 00095 _µMhos Total Ammonia 00610 1 mg/L (Amrtronia Nitrogen. NH, as N, Ammonia Nitrogen, Total) TKN as N 00625 rng/L For Remediatlon Systems Only (Attach Lab Reports): _tN-11, aboratory Name Certification No. and colloidal concentrations. Nitrite (NO2) as N ous15 mg/L Pb - Lead 01o51 ug/L Nitrate (NO3) as N 00620 a / mg/L Zn - Zinc 01092 n g/L Phosphorus: Total as P 006e5 __ Q / �G mg/L Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): Al -Aluminum ol1o5 mg/L Ba - Barium 01007 ug/L _ Ca - Calcium U0916 n1g/L — -- -- - Cd - Cadmium 01027 ug/L Chromium: Total 01034 ug/L Cu - Copper 01042 nrg/L ORGANICS: (by GC, GC/MS, HPLC) Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) fig •- Mercury 71900 ug/L Lab Report Attached? ❑ Yes ('I) ❑ No (0) K - Potassium 00937 mg/L VOC 7873 method # Mg - Magnesium 00927 mg/L method # Mn - Manganese 01055 ug/L method # Ni - Nickel 01067 ug/L method # Influent Total VOCs: mg/L Effluent Total VOCs: VOC Removal% SUBMIT FORM ON PAPER ONLY Date sample analyzed:_' -�l � --� r I-1Ir 9.I \� PARAMETERS NOTE: Vat es sho d refle t dissol e COD 00335 _ mg/L Coliform: MF Fecal 316-16� CO _/100ml Coliform: IVIF Total 3.1504 /'I00mL (Note: Use MPN method for highly turbid sample.) issolved Solids:Total Como Sg mg/L pH (Lab) 00403 units I-OC ooeso _ rng/L Chloride 00040 1 � mg/L Arsenic o 1002 ` ug/L Grease and Oils 00552mg/L Phenol 32730 ug/L Sulfate 00945 mg/L pecific Conductance 00095 µMhos Total Ammonia ooslo---mg/L (Ammonia Nitrogen; NH ,as N, Ammonia Nitrogen, Total) TKN as IV oos25 rng/L For Remediation Systems Only (Attach Lab Reports): GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION ple< Facility Name: \0,C Permit Name (if different): Facility Addre s: contact Person: /Veil Location/Site Name: C0... AA Y WELL ID NUMBER (from Permit):" Well Depth: ft. Depth to Water Level 825as:��ft. below measuring point IVleasuring Point is a, S ft. above land surface Volucz- me of water pumped/bailed before sampling. gallons Samples for metals were collected unfiltered: ® YES ❑ NO and field acidified: ® YES ❑ NO D,,Laboratory Name: and colloidal concentrations. Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o5t Nitrate (NO,) as N 00620 mg/L Zn - Zinc 0•1092 Phosphorus: Total as P 00665� ` �mg/L Orth h h or Type County Telephone#: No. of wells to be sampled: ration Date: Non -Discharge "" UIC NPDES _ Other TYPE OF PERMITTED OPERATION BEING MONITORED b-tagoon ElRemediation: Infiltration Gallery r ! P-Spray Field ❑ Rernediation. yl ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Fleat PumEp I Other: z Date sample collected: — � Q, oQ, Well Diameter: in. Screened Interval: ft. to ft. Relative M.P. Elevation: i- ft. FIELD ANALYSES: pH ooauo C r 3 units Ternp. 000to_o� Q t °C Spec. Cond. 000sq: µMhos Odor ooas5 Appearance d*G-L>,��,N---C� Certification IVo, q ug/L mg/L op osp ate 70507 mg/L Other (Specify Compounds and Concentration Units): Al - Aluminum o11o5 mg/L Ba - Barium o 1007 _ ug/L --- - -- - Ca - Calcium 00916 mg/L - --V- Cd - Cadmium 01027_ ug/L Chromium: Total 01034 -- ug/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Fe - lron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Hg - Mercury 71000 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) K - Potassium 00937 mg/L VOC 7873 method # Mg - Nlagnesium 00927 mg/L method # IVIn - Manganese o1o55 ug/L method # Ni - Nickel 01067 ug/L method # Influent Total VOCs: mg/L Effluent Total VOCs: If WELL DRY at time of sampling, check here:❑ SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: r COMPLIANCE REPORT FORM • ' FACILITY INFORMATION Please Pnnt C eaMEN rly r type PERMff Numher o �E�xpiration Date: Q Facility Name: �e�, �(�(�� 'yk m Non -Discharge t0 UIC Permit Name (if different): NPDES Other Facility Address: ( Q, c� TYPE OF PERMITTED OPERATION BEING MONITORED p� County 6 moon ,,.,,,, ,a�i . i ,��� ❑ Rentedlation: Infiltration Gallery moray Field ❑ Rernediatiorl: iontact Person: L0. 2,Q Telephone#:gly1' a 13 --3 y3 ❑ Rotary Distributor ❑ Land Application of Sludge Vell Location/Site Name: Q- No. of wells to be sampled: -__S- ❑ Water Source Heat Pump ❑ Other: -- -- -- •--. _.........�.. M 1,\ WELL ID NUMBER (from Permit): 1 \W �' Date sample collected: ` gyp" o _ FIELD ANALYSES: If WELL Well Depth: \ 3 ft. Depth Well Diameter: pH 00aoo units Temp. 00010: !� °C WAS DRY at to Water Level 82546:� ft. below pleasuring point Screened Interval: ft. to ft. Spec. Cond. 000sg µNlhos time of Measuring Point is �( S ft. above land surface Relative M.P. Elevation: ft. Odor 000e5 sampling,check Volume of water pumped/bailed before sampling: S gallons Samples for metals were collected unfiltered: ® YES ❑ NO and field acidified: ® YES ❑ NO Appearance �� hate:F—ry u LAt30RA7ORY INFORMATION f� Date sample analyzed: — — I -l��Palbbratory q — Name: PARAMETERS NOTE: Valu shou reflec dissolve rgm)\ and colloidal concentrations. Certification No. COD 00335 mg/L Coliform: MF Fecal 316-16/100mL Nitrite (NO2) as N 00615 mg/L Nitrate N Pb - Lead olo51 � /L u7 (NO3) as 00620 mg/L Zn -Zinc o-log2 n g/L Coliform: MF Total 3.1504 /100mL (Note' Use Phosphorus: Total as P 00665 Q mglL MPN method for highly turbid samples) issolved Solids:Total 70300 Orthophosphate 70507 mg/L Other (Specify Compounds and Concenhation Units): mg/L Al - Alurninum 01105 mg/L pH (Lab) 00403` units Ba - Barium o1o07 ug/L -- - - TOC 00680 mg/L —�rmg/L Ca - Calcium ooy•ls mg/L Chloride 00940 FFF--- Cd - Cadmium 01027 ug/L —`--- Arsenic o 1002 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 00045 mg/L pecific Conductance 00095 µMhos Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) Total Ammonia ooeto —mg/L K - Potassium 00937 mg/L Mg VOC 7873 method ` (Ammonia Nitrogen, NN,aa N. Anonie Nitrogen, Total) sn - Magnesium 00927 mg/L , method # TKN as N 00625 Mn -Manganese o1o55 uglL _ ,method # mg/L Ni - Nickel 01067 ug/L -- mettrod # For Remedlation Systems Only (Attach Lab Reports): ........ . .. Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VUC Rerr►ovaN/° SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: r ' ' F COMPLIANCE REPORT FORM %� i FJfr,'":i FACILITY INFORMATION PlaasePrint CleadyorTypa PERMIT Numbe Permit Name (if different : �Expiration Date Q - Facility Name:�0Sa��k���IT JHZ� �_ZL(1 Non -Discharge UIC NPDES Other Facility A\'n TYPE OF PERMITTED OPERATION BEING MONITORED County �� oc11 � :�r,l g [J Remediation: Infiltration Gallery ('��1 Q �'S�ray Field ❑ Reinediation: Contact Person: �0�� C Telephone#: -1 Ly y� l� ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: C� �e No. of wells to bet sampled: _ _ ❑ Water Source Heat Pump L1 Other from Permil -- SAMPLING INFORMATION - WELL ID NUMBER (from Permit): —`- _aa If WELL. Date sample collected: '� FIELD ANALYSES: WAS Depth: �ft. Well Diameter: in. pH 00400 units Temp. 00010: 3 °C DRY at Depth to Water Level s25as:��ft. below measuring point Screened Interval: ft. to ft, Spec. Cond. 0uos4: µNlhos time of Measuring Point is a, s ft. above land surface Relative M.P. Elevation: ft. i Odor noose sampling, 54 Volume of water pumped/bailedcheck before sampling: � gallons A earance 6 Samples for metals were collected unfiltered: ® YES El NO and field acidified: ® YES ❑ NO pp C0. Q_ here.� LABORATORY INFORMATION — Date sample analyzed: - �,&21e.t - �3 Laboratory Name: \y \ (� PARAMETERS NOTE: V ues s odi solved and colloidal concentrations. Certification No. _- COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead U1051 uIL Coliform: MF Fecal 31616 J - �_/100mL Nitrate (NO3) as N 00620 mg/L Zn - Zinc 01092 nIg/L Coliform: use Total hodfo /100mL Phosphorus: Total as P ooes5�y�_mg/L (Note- flee Mr'N method for highly luftd sample.) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300mg/L All - Alurninum o11o5 rng/L _ pH (Lab) 00403 units Ba - Barium o1oo7_ -- ug/L TUC 000eo mg/L Ca - Calcium 0091s n1g/L Chloride 00940 _ �V mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034ug/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 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance doom µMhos K - Potassium 00937 m /L VOC 7873 9 Total Ammonia ooslo method # mg/L Mg - Magnesium 00927 - (Anunonia Nitrogen, NH, as N, Anmronia Nitrogen, Tola mg/L , Mn - Manganese o1o55 ug/L method # method # TKN as N 00625 rng/L Ni - Nickel 01067 uglL method # For Rernedlatlon Systems y (Attach OnlyY Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% Lab \ Si!1�+ ill a (ur AuQt lzad Agana IVame a!"'I Title -�Please print o type GW-59 ev.05-07-2018 Si i T ��