WQ0004797_Monitoring - 11-2022_20230119

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
Type *
Revised - GW-59
WQ0004797
Clement Pappas NC LLC
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
Revised GW59 s.pdf 970.05KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Dale I Wolfe
1?Z-4 0?e
Reviewer: Gerald, Wanda
1 /19/2023
This will be filled in automatically

Is the project number correct?* WQ0004797
Is the monitoring report accepted?* Yes No
Regional Office* Asheville
Reviewer: _anonymous
Review Date: 2/9/2023

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILI T Y INFORMAI It, N
Facility Name: Clement Pappas
Permit Name (if different):
ac fty Address. 485 Brookside Camp Road
Hendersonville NC
Contact Person: Blake Kehoe
Woii Location/Site Name: Irrigation Area
pfeaso Pin t _v y` or
28792 County Henderson
Telephone#: [phone]
No of wells to be sampled: 6
DEPARTMENT OF ENVIRONMENTAL QUALITY -DIV.OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICECENNT, RA'LEIGK NC Z 99,1617
PERMIT Number: Expiration Date: 713112026
Non -Discharge W00004797 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
i ` Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
WELL ID NUMBER (from Permit): MW-4 Date sample collected: 1,1/8/2022
Well Depth 18.22 ft. Well Diameter. 2 in.
Depth to Water Level 82546: 9-35 _ft. below measuring point Screened Interval: 5 ft. to 15 ft.
Measuring Point is 2.43 ft. above land surface Relative M.P Elevation: 2063.77 ft.
Vourre of water pumped/bailed before sampling: 0.97 gallons
Samoes for metals were collected unfiltered: L7 YES ❑ NO and field acidified: hi YES ❑ NO
Date sample analyzed 11/912022 Laboratory Name: Pace Analytical Services
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Coliform: MF Fecal 31616 <1.0
/100mL
Nitrate (NO3) as N 00620 0.090
mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P oo665 <0.050
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
)issolved Solids:Total 70300 137
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oo6ao 3.2
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 10.3
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
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
$o c3fi° Conductance 00095
µMhos
K - Potassium 00937
mg/L
Total Ammonia 00610 <0.10
mg/L
Mg - Magnesium 00927
mg/L
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
If WELL
FIELD ANALYSES:
WAS
pH 0040o: 5.8 units Temp. 00010: 17.4 °C
DRY at
time ofsampling,
Spec Cond. 000sa- 212.0 µMhos
Odor 00085: none _
check
Appearance
here: El
Certification No. 37712
Pb - Lead o1o51 ug/L
Zn -Zinc 01092 mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? © Yes (1) ❑ No (0)
VOC 7873 method #
method #
method #
method #
mg/L Effluent Total VOCs:
mg/L VOC Removal%
Anthony Aponte, Plant Manager y 9/"
err " -. or P-,utrnarizea Agent) Name and Title - Pius - pmt or type « sxr� �' <....c3.=-f =. . on cd .q nt) g at [
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Cleaevor ==Y
Faci ny Name: Clement Pappas
Permit Name (if different):
aciilty Address: 485 Brookside Camp Road
Hendersonville - NC 28792
act Person: Blake Kehoe
Location/Site Name: Irrigation Area
County Henderson
Telephone#: [phone]
No. of wells to be sampled: 6
DEPARTMENT OF ENVMONM.ENTA. QUALITY-DIV,OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER.
PALEIGK NC 27�9�=1 17
PERMIT Number:
Expiration Date: 7/31/2026
Non -Discharge W00004797
UIC
NPDES
Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation: Infiltration Gallery
Em Spray Field
❑ Remediation:
❑ Rotary Distributor
❑ Land Application of Sludge
❑ Water Source Heat Pump
❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW-5 Date sample collected: 11/812022
Well Depth: 18.59 ft. Well Diameter: 2 in.
Depth to Water Level 82546: 10.07 ft. below measuring point Screened Interval: 9 ft. to 19 ft.
t leasuring Point is 3.00 ft. above land surface Relative M.P. Elevation: 2085.60 ft.
Vo=unne of water pumped/bailed before sampling: 0.83 gallons
Samples for metals were collected unfiltered: All YES ❑ NO and field acidified: R YES ❑ NO
FIELD ANALYSES:
pH 004Oo7 5.5 units Temp. 000lo: 17.5 oC
Spec. Cond. 00094: 221.9 µMhos
Odor 000s5: none
Appearance
If WELL
WAS
RY at
Dme of
sam P g,
check
here ❑
LABORATORY INFORMATION
Date sample analyzed:111912022
Laboratory Name: Pace Analytical Services
Certification No. 37712
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N oo61s
mg/L
Pb - Lead olo51 ug/L
Coliform: MF Fecal 31616 <1.0
/100mL
Nitrate (NO3) as N 00620 <0.040
mg/L
Zn -Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P oos65 <0.050
mg/L
(Note Use MPN mselhod i0r highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
lssolved Solids:Total 70300 132
mg/L
Al -Aluminum c11o5
mg/L
Tetrachloroethene - 152.0 pg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
Trichloroethene - 75.1 pg/L
TOC 0068o 2.3
mg/L
Ca - Calcium oo916
mg/L
Cis-1,2-dichloroethene - 96.5 pa/L
Chloride 00940 51.4
mg/L
Cd - Cadmium 01027
ug/L
Vinyl chloride - 1.1 pg+'L
Arsenic 01002
uglL
Chromium: Total 01034
ug/L
'Note MW-5 is background well so from unknown otf-site source
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 oo945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? A Yes (1) ❑ No (0)
pettafic Conductance 00095
µMhos
K - Potassium 00937
__ mg/L
VOC 7873 method #
Total Ammonia o0610 <0.10
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH2as N; Ammonia Nitrogen, Total)
Mn - Manganese o1o55 _
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:
Anthony Aponte, Plant Manager
Permittee(or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.06-07-2018
mg/L Effluent Total VOCs:
mg/L VOC Removal%

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Pleasc Print Clearly or Tvpa
Facility Name: Clement Pappas
Permit Name (if different)
Facility Address: 485 Brookside Camp Road
Hendersonville NC 28792
Contact Person: Blake Kehoe
Well Location/Site Name: Irrigation Area
County Henderson
Telephone#: [phone]
No, of wells to be sampled: 6
- F— ARTMENT0F EWtKONNENTAL QUALliry -Drtl OF YtATr:R RFSOURCES
INFORMATION d PROCESSING UMT
1617 A1L V!Cc-eeNT ,1�AL P. C 9-1617
PERMIT Number: Expiration Dater 7/31/2026
Non -Discharge W00004797 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
E Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW-6
Date sample collected: 111902022
Well Depth: 11 59 f .
Well Diameter: 2 in.
Depth to Water Level 82546: 6.40 ft. below measuring point Screened Interval: 5 ft to
10 ft.
Measuring Point is 3.00 ft, above land surface
Relative M.P. Elevation: 2061.17 ft.
�1011jrre of water pumped/bailed before sampling:
0.73
_gallons
Samples for metals were collected unfiltered [M—j YES
1_' NO and field acidified: ® YES ❑ NO
LABORATORY INFORMATION
Date sample any vaad_ 11/9/2022
Laboratory Name: Pace Analyrtic�-,I Ser
ce7s
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Coliform: IMF Fecal 31616 164.0
/100mL
Nitrate (NO3) as N 00620 0.40
mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 <0.050
mg1L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Xssotved Solids:Total 70300 85.0
mg/L
Al - Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 006so 2.0
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 9.5
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg1L
Cu - Copper 01042
mg/L
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
3pe;i, c Conductance 00095
µMhos
K - Potassium 00937
mg1L
Total Ammonia oo610 <0.10
mg/L
Mg - Magnesium 00927
mg/L
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese o1o55
ug/L
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
For Remediation Systems Only (Attach Lab Reports):
GW-59 Rev 06-07-2018
Influent Total VOCs
FIELD ANALYSES:
pH 0040o: 5.4 units
Spec. Cond. 00094: 140.
Odor 000a5: none
Appearance
Temp 00010: 18*0 oC
p µMhos
Certification No. 37712
Pb - Lead 01051 ug/L
Zn - Zinc 01092 mg/L
Other (Specify Compounds and Concentration Units):
Constituent resampled on 1215 due to suspected lab error
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? © Yes (1) ❑ No (0)
VOC 7873 method #
method #
method #
method #
Effluent Total VOCs:
mg/L VOC Removal%
if WELL
WAS
DRY at
time of
sampling,
check
here;❑

GROUNDWATER QUALITY MONITORING
COMPLIANCE REPORT WORT"
L. v t a I-;
L xi ity &'brie, f ,sr cd1i 1Rpa:.., ., ... ,. _.
£°Gp'tIIHpY q°1 ,1nIF (If 0!ofonl):--
w
1'Itrc'lrir=gwrlr�o-vi6lr;' ('14"; �fiC7
]-'Icr:ory f3 AG, KCl Uri
w°41'otOCiL �r..Plrlckr'rP�rv^01s M'IG9,ne rl,l,4Fon Artpp
SUBMIT FORM ON YEILI.OW PAPER ONLY
I"Mtq,lor'#.:tr tlrr rrWII
No f v,o]a to her Lamgidbla
DEPARTMENT O P" kN`v1R0 f N1 C, NTM. tlUALhY - ON, OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH. NO 27699.1617
PERMIT Number: Expiration Date riSp1 !
Non-Dsi.herge 14Q9004797 UIC.
NrDES Other
TYPE,,. OF PERMITTED OPERATION BEING MONITORED
Li Lagoon ❑ Remediatlon: Infiltralion Gallery
101, Field [J Remediation:
L.J Rotary Distributor L...) Land Applicat on of Sludge
Water Source Heat Pump ❑ Other:
PLIEVCS, ItJ,LgffMA9tM
'.II WELL
L ID NUMBER (frown Permit): MW-6
Dale sample collected: 12i512022
FIELD ANALYSES:
WAS
Depth: N/A M.
Well Diameter: 2 in
pH onion 5.3 units lemp. 000lo: 11.2 °C
DRY at
h to Water level 62546 5,713 ft. below measuring point
Screened Interval: S ft. to 10 ft.
,--_.....
Spec Cond. Uom i 155.0 Whos
-.---
time h
samphny.
;uring Point is 3.00 ft above land surface
Relative M.P Elevation: 2W61 17 ft.
Odor tto065 none
check
Tle of water pumpedlbailed before sampling: 0,71 gallons
Appearance _,_ .,,,,_
here ❑
nlas for metals were collided unfiltered: -W YES 1-1 NO
and field acidified' :11111 YES NO
Dale sample analyzed: 121612022
LaboialoryName Pace
_.....®.�,...
Analytical Services
�.�......... ...... _......................-....,. _.__..---.
Certification No 37712
PARAMETERS NOTE: Values should
reflect dissolved and colloidal concentrations
COD 00,135
mg/L Nitrite (NO,) as N oor,15
mg1L Pb - Lead e1o51
ug!L
Colifofm: MF Feral 31616 12 0
...w ...,,,,,._._....._._....�.
/100ml- Nilrate (NO,) as N 00620
�.m.
mg/L Zn - Zinc o1oa2
mg't.
Coliform: MF Total 31504
M00ml- Phosphorus: Total as P oosu
mm mg1L
(Nora. U 00,11 (10-1fmt1plylnr°:d%a0ro1eh)
Orthophosphate m5o7T
myll-
Other (Specily Compounds and Concen(mfien Units):
)i8sotved Solids:Total 70300,..._..,,.......__ �. _,..,....,
mg1L
At - Aiuminurn U11o' ..--
m91L
Note Rasen plehoanalysis an 1215 performed due to previous
pH (Lab) OD4U9
units
Ba -Barium oluei
T.., ug1L
suspeclod lab error
.... ..._ ,m�............. ...........-
TUC oom .
mglL
Ca - Calcium One IO
my!L
Chloride, 0094o
mg1L
Cd - Cadmium o1o27
ug1L
Arsenic oioo7
ugfL
Chromium: Total 0104
ug/1-
Grease and Oils 00552
mgiL
Cu - Copper OlN2
mg/
ORGANICS: (by GC. GC/MS, HPLC)
Phenol 3270o �_..
ugfL
F -Iron )tOls
ugfL
(Specify test and rnothod #. ATTACH LAB REPORT.)
Sulfate �0945
rngiL
Hg - Mercury'r Irioo
ugfL
Lab Report Attached? A Yes (1) ❑ No (0)
Specific. c Conductance obo9s ,I,Athol
(- Polasslum 0c937 �-
.. ..rn g c
VOC 7073 method # ....
- ..._
Total Ammonia oorto
mg7L
Mg - Magnesium Ocl%'7
mg/L
method it
ta11r„-r::.v,r :nqr NO,., N; Ao,r: no Nt uon,Tm°la......
Mn - Manganese oims
uc I_
lI
, mend #
lh
1KN as N 00625
_mg/L.
Ni - Nickel 01067
ugfL
, method #
y y ( Reports): L Effluent Total VOCs. mg1L VOC Removal%
For Rernedfatlon S stoms Only Attach Lab Re nets : n0ucnl Total VOCs: mgl
_� mm ____,
Anthony Aponte, Plant Manager
.............._....._._-...__._.-__....._.._.__m.._...............................
F'crrrlliee (ar Aulnharized 11penL) Name and 1 ille - nfuasc print or type
GW-59 Rev 06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
TM-tdT FF IRONMENTA.ai uALffv UP -I OFWATF-RRt=SOURCES
GROUNDWATER QUALITY MONITORING:
£ ,
INFORMATION PROCESSINGUNIr
COMPLIANCE REPORT FORM
- �
AILSER" CENTER. ' H" e s'T
FACILITY INFORMA tON please P=,F �a�� 1F o,Type
PERMIT Number: Expiration Date: 7131/2026
acility Name: Clement Pappas
Non-Dts+r ar0e WQ0004797 UIC
Permit Name (if different):
NPDES Other
Facility Address: 485 Brookside Camp Road
TYPE OF PERMITTED OPERATION BEING MONITORED
'-
Hendersonville NC 28792
County Henderson
ElLagoon ❑ Remediation: Infiltration Gallery
* Spray Field ❑ Remediation:
Cantat, Person: Blake Kehoe
Telephone#: [phone]
❑ Rotary Distributor El Land Application of Sludge
Well Location/Site Nary lr=aa=on AreaO
No. of wells to be sampled: 6
❑ Water Source Heat Pump El Other:
If WELL.
4MPLING INFORMATION
ELL ID NUMBER (from Permit): MW-7R Date sample collected: 111812022 FIELD ANALYSES:
'el.l Depth: 17.44 ft. Well Diameter: 2 in pH 00400: 4-9 units Temp. 00010: 16.8 gC
to Water Level 82546: 11.80 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cord. 000sa 365.7 µMhos
-pl
easrlrg Point is 3.00 ft. above land surface Relative M.P. Elevation: 2062.86 ft, Odorco08s: none
3hirne of water pumped/bailed before sampling 0.36 gallons Appearance
arrt es for metals were collected unfiltered: J YES ❑ NO and field acidified: Fig- YES ❑ NO
'" a c- sample analyzed-111912022 Laboratory Name: Pace Analytical Services
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Coliform: MF Fecal 31616 <1.0
/100mL
Nitrate (NO3) as N 00620 242
mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 <0-050
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mglL
)tssalvc-1 Solids:Total T0300 225
mg/L
Al - Aluminum ol1o5
mglL
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 1.0
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 31.4
mg!L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug1L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
Total Ammonia w610 <0.10
mg/L
Mg - Magnesium 00927
mg/L
(Ammonia Nitrogen, NH3asN: Ammonia Nitrogen, Total)
Mn - Manganese o1o55 _
_ ug/L
TKN as N 00625
mg/L
Ni- Nickel 01067
ug/L
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
Certification No 37712
Pb - Lead 01051 ug/L
Zn - Zinc 01092 mg/L
Other (Specify Compounds and Concentration Units).
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? X Yes (1) ❑ No (0)
VOC 7873 method #
_ method #
method #
method #
mg/L Effluent Total VOCs:
mg/L VOC Removal%
Anthony Aponte, Plant Manager ir�l 1 f
Permittee (or Authorized Agent) Name and Title - Please print or type 3igT.., 0,e of Pa, mit'lee, c. -,ahC Zed f.genn
GW-59 Rev.06-07-2018
DRY at
time of
here: 1-1

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please = err C_ rty or Type
FaciiinV Name: Clement Pappas
Permit Name (if different):
Faciy Address: 485 Brookside Camp Road
Hendersonville - NC 28792
act Person: Blake Kehoe
Location/Site Name: Irrigation Area
County Henderson
Telephone#: [phone]
No. of wells to be sampled: 6
OEPARTMEN7 OF EKVIRONME TA.L QUALITY -, OIV, OF WATER RESOURCES
INFORMATION PROCESSING ING UNIT
1617 MAIL SERVICE CENTER, RALEIGK NC 2769e 16i,'
PERMIT Number: Expiration Date: 7/31/2026
Non -Discharge W00004797 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other.
If WELL
AMPLJNG INFORMATION
TELL ID NUMBER (from Permit)_ MW-8
Date sample collected: 111812022
FIELD ANALYSES:
WAS
Jell Depth: 13.96 ft
Well Diameter: 2 in.
pH 00400: 6-6 units Temp. 00010; °C
DRY at
time of
epth to Water Level 82546:10.31 ft. below measuring point Screened Interval: 3 ft.
to 13 ft.
Mho
Spec. Cond. 00094: 577.7 _ µMhos
sampling,
leasurinC Point is 3.00 ft. above land surface
Relative M.P. Elevation: 2060.80
ft.
Odor Doom: none
Check
clum=e of water pumped/bailed before sampling:
1-3
gallons
Appearance
here.
El
arr�Ees for metals were collected unfiltered _ ;YES
El and field acidified: EYES ❑ NO
--- --
ABt RATORY INFORMATION
11
Laboratory Name: Pace Analytical Services
Certification No. 37712
ate sample analyzed- 91=021
ARAFETEIR NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N oo615
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1,0
/100mL
Nitrate (NO3) as N 00620 1.4
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P oos65 <0.050
mg/L
(Note' Use h4P14 method for higMy turbid samples)
Orthophosphate 70so7
mg/L
Other (Specify Compounds and Concentration Units):
s5ol ed Solids:Total 7030o 328
mg/L
Al - Aluminum 01105
_ mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 6.2
mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 12.2
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
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? 0 Yes (1) ❑ No (0)
-ecifc Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia ooslo <0.10
mg/L
Mg - Magnesium 00927
mg/L
method #
(Amnwnia Nitrogen; NH3asN; Ammonia Nitrogen, Total)
Mn - Manganese oloss
ug/L
, method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
GW-59 Rev.06-07-2018
Influent Total VOCs:
mg/L
Effluent Total VOCs:
mg/L VOC Removal%

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF Fr;VleR0k4 ENT7AL QUALITY - (DhlOF WATER RESOOR
GROUNDWATER QUALITY MONITORING: a s
INFORMATION PROCESSING UNIT
t
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER. RALEIGH, HC 27699-1617
FACILITY INFORMATIrOI Please i. t .° nyortype
PERMIT Number: Expiration Date: 713112026
Facility Name: Clement=-appas
Non -Discharge WQ0004797 UIC
Permit Name (if different):
NPDES Other
Facility Address: 485 Brookside Camp Road
TYPE OF PERMITTED OPERATION BEING MONITORED
Hendersonville NC 28792 County Henderson
❑ Lagoon ❑ Remediation: Infiltration Gallery
-
© Spray Field ❑ Remediation:
Con act Person: Blake Kehoe Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
I -Nell Location/Site Name: Irrigation Area No. of wells to be sampled: 6
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW-9 Date sample collected: 11/8/2022
Well Depth: 1B.o9 ft. Well Diameter: 2 in.
Depth to Water Level 62546:5.90 ft. below measuring point Screened Interval: 6 ft to 16 ft.
Measuring Point is 1.44 ft. above land surface Relative M P. Elevation: 2060.23 ft.
Volume of water pumped/bailed before sampling: 1.4 gallons
Samples for metals were collected unfiltered: Imo) YES ❑ NO and field acidified l YES ❑ NO
FIELD ANALYSES:
pH 00400: 5.3 units Temp. 00010: 18-2 °C
Spec. Cond. 00094: 98.2 µMhos
Odor 000m: none
Appearance
If WELL
WAS
DRY at
time of
time
check
h=are
LABORATORY INFORMATION
Gate sample analyzed: 11/9/2022
Laboratory Name: Pace Analytical Services
Certification No. 37712
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N oo61s
mg/L
Pb - Lead o1o5t ug/L
Coliform: MF Fecal 31616 <1.0
/100mL
Nitrate (NO3) as N 00620 1.9
mg/L
Zn - Zinc 01092 mg/L
Coliform: IMF Total 31504
/100mL
Phosphorus: Total as P oo665 <0.050
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
)solved Solids:Total 70300 81.0
mg/L
Al - Aluminum o1105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 0068o 2-8
mg/L
Ca - Calcium oo916
mgiL
Chloride 00940 8-7
mg/L
Cd - Cadmium 01027
uglL
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
mg/L
Hg - Mercury 71900
uglL
Lab Report Attached? Al Yes (1) ❑ No (0)
peafic Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia o0610 0.17
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen: NH3as N: Ammonia Nitrogen, Total)
Mn - Manganese of 05S
ug/L
_ _ , method #
TKN as N 00625
mg/L
Ni- Nickel o1067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports). Influent Total VOCs: mg/L Effluent Total VOCs:
Anthony Aponte, Plant Manager 7 _
Permittee (or Authorized Agent) Name and Title - Please print or type $Qnsiwe of Pennittee (or
GW-59 Rev.06-07-2018
mg/L VOC Removal%
/7-1/2 Ili Z
e,

GIN-59A COMPLIANCE 101 P(:)RT II'010M Permit # W40004797
(Strhip lit olle Loch nIolIitnl ing period n'ilh 611 -59 rm nta) _ n
-_.... Enter date...—. _. _ _ n.... ..
monitoring
the established
re were due,s ed dale date? � ) WIII this monitoring report (GW 59 and GW b9A)
be submittedaftYliS NO
2 1Yas any required information missing on the GW-59 report forms? YES TV
a175Werto _ues. .._ ,m. 1or 2is' in .... ....._....—_ ....--b---- — ...._.._ -_ mw.....,... ,..._.,,...,......�. . ,..„e... .. ...._......._....
G6on Y1=S List the space providedelow the well rdenliflcation numbers) and
explain the problems encountered in obtaining the required information
Are an of the monitor hells in need nrre air or 11mintennnce dania ed casing, unlocked or missin call, missing YES NO
3 5' p1 ( g �r � '• 1 r
identification plate, area overgrown, etc.)? if the unswe/• is "Yes" colonel the Regional Of,fice for guidance. X
Are an monitored constituents a uaht m„m, .. _,�,•
0 or above the established standards?- -.._.
�L Y q 1'JsS N O
.... .... _._.�.-.—..-.-- �....mm _.... __., ._._, ._.r .- _...,,_.._. _ ....... X �a
!f 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)
oxceedin p stand9rds in the splice �rovided below:
N1 Crate (2.. 1.0mg L): MW-7RG 4.2 m,/T,
Fecal col iform l2L = 1 CPU/ 100 MIA : MW-6W 164.0 CPU/100 mL ; re -Sampled VNI Gra 12,a CT1U/10a mL
•1'etrachlcroethene (2L - 0 7 y9,/0: MW-5W 152,0 ug/L
1•richloroethene (2L = 3 pg/L) : MVI- 50 75.1 p9/1,
Cis-1,2 dichloroethene M = 70 pg/L): MW-SCO 96.5 ug/L
5 For the constituents identified in question 4 above, have standards been exceeded previously for the YES NO
same constihlent(s) in the some well(s) in the last two years? X
answer to question 5 Is WO; skip to section 8,
!f the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentrationr(sj reported, and sample collection date for each occurrence (for the last two years),
Ili Crate Fecal o if.onn Tetrechluroethene Tr ichloroethene
MW-7R Img/L) NW-6 rCFU/p00rnL) N)W-5 (ug/L) M111-5 (ug/L)
OS/06/20: 22.5 05/06/20: ' 0 11/66/20: 0.00 1012g/21i 1.1.6
11/06/20: 13,C 11/06/20: J,O 10/25/21; 30.7
05/11/21: 40.1 05/11/21: 5,0
10/21/21: ?6.0 10/28/21: !IO
05/10/22: 31.0 05/10/22: Nu
,. .... ...e......._ --- ..__.-- ..,....,,_ .... .�..m.,m. .., .,m,,,-, .,- ..•,e,_.._..-,..�
Are the monitoring wells listed in section 6 located at or beyond the review boundary? 1) S NO
MW-5, MW-7R, and MW-8 are at or beyond the review boundary. X
�.� _._
if the answer is "YES", a groundwater quality problem maybe occurring, CONTACT THE REGIONAL
OFFICE IMMEDIATELYFOR GUIDANCE, Ifthe answer is WO", monitoring wells may be. improperly
located; contact the Regional Office.
7 Is t110 gscr"'Itteu Irrrp lenrlrxratkr)�q pre.vrotlsly approved actions requgred by Ole Division invatvincd this YES NO
groundwater quadrdy prablern
X
—.. _H. ffthe ,a2wer to (uo; fan 7 r ���rbsunbrfN,moa,iores fithrispace poridef srlrw
ift(o arswnr to question i "NO", b qdee t rMilliMillin ifi jL�
rrt crvarfri rtluwr) rrr.11.q'
required to dr-lorminf. the hlulpr t tlxe waste dis7.'asgl system as ��taro tPrGtm.��t ttamu_ �� vha� urrdl crorn fiance
fLrid is lrr rss .M� larrra.�ireiir rp 1 this 4°�r Arty. P aillife, M dr, so Loewy st t�rP tLaq pr �trl�t(ha�ta�� a1 Nertice of'Viol'atirw,¢��a,
firrtls�, lrai°dlt_,1_VM.,ultir�s.
f le^t0fed nr Tr,7Cm r,oneert -1kb.1mr•:9to I%Ply dl[ a IQ M01 r)r.r,qy ni ai chmaranaa a,trlaw en, ttu.v hrrend °n I41N7R, Juli ,1 t:b°cm aernur4 NrC4 evaWatlom
rl 5,loea Plh 20ZI,. Per rs„fiAmr,l ydalform from rvn kegimrltl cjffi<k'� 'F,d ofr,tW'IR wasf*rt'6,er m qd p617e ra t'ho
t o Icy 20V aani r m5r eve m rrtwwevpr aFe ri,rtrti-a; °iu^un1 rdw v° rmtole In IBre ymnp„le rullcntl l hi )V-, h4Vi-M dvr iny0 the F11h 2*21 T„mmp4r)rr evmt +t,ri„m nrd ahravh
bfx I p1Q4010 ,I t.t+taaret. 6hF mill rm , m IN outddi, M thet, aung anr.6 w;11 in Ihrs 5arA p /, k army ktr .r wlntm)q la tr'srti n41r(',gm 65 a'+gprum matter drroys.
Per n d4 uvm orrY rra rkerrrt,rg rho mP,ihs Ira 0, DrQ Hy Irrr,pu: ralc'i °Pa Y, 4"Qe Laaewty uery '1 'I/4'r 2022 regalae.n rrr.rttn4 and NM 'M 'ir, a 7r,ntrnm, rnsYeal
$ile person ecrrieta'ra fsporlran (' 51A) o°f fe monitoring re oll stmuflsign below and sub it thl's `
for'in with GfW59 forms for required uvrlli, to the address providod at the top of the curront C?W-59 form.
I hereby au till owledge that (ho above information was evaluated and the information submitted In this.
repoli (gain nonce Repord GW-59A 4"/true and d'tl iplete to the best of �my knowledge./ti
PAZ
5lun artare of Pei rnittoo er htuYlvrrr t, v.d Apmtl Mile
" ____ __ _.._._ __­1_­____ I — _
G1Y-59A 12/8121103