WQ0005555_Monitoring - 07-2023_20230811 (2)

GW-59A COMPLIANCE REPORT FORM Permit# W00005555
(Submit one each monitoring period with GW-59 forms.)GW-59A
] Enter date monitoring results were due. (8/31/23)Will this monitoring report(GW-59 and GW-59A)be YES NO
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 Office 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:
5 For the constituents identified in question 4 above, have standards been exceeded previously for the same YES NO
constituent(s) in the same well(s) in the last two years?
If the answer to question 5 is"NO", skip to section B.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s)exceeding
standards, concentration(s)reported, and sample collection date for each occurrence(for the last two years).
6 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. CONTACT THE REGIONAL OFFICE
IMMEDIATELY FOR 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 may 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 Violation,
fines, and/or penalties.
g 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 acknowledge that the above information was evaluated and the information submitted in this report
(Compliance Report 59M is true and complete to the best of my knowledge.
Signature of Permittee(or Authorized Agent)
Date

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM • • • 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00005555 Expiration Date: 8/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
❑■ Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No.of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 4 Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 61.00 ft. Well Diameter: 2 in. pH 00400: 5.1 units Temp.000lo: 17.2 CDC DRY at
Depth to Water Level 82546:48.4 ft.below measuring point Screened Interval: ft. to ft. Spec. Cond.00094: 49.5 µMhos time of
sampling,
Measuring Point is 12.6 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 6.4 gallons Appearance clear here:❑
Samples for metals were collected unfiltered: 0 YES ❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:Beginning 7/19/2023 Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 <30 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 2 /100mL Nitrate(NO3)as N 00620 1.33 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.500 mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
issoived Solids:Total 70300 148 mg/L Al-Aluminum o11os mg/L Formaldehyde,Total <500 ug/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 1.21 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 1.17 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total o1o34 <5 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 ug1L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 <0.00020 ug/L Lab Report Attached? ❑ Yes(1) N No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732 method# 8260B
Total Ammonia oo6lo <.010 mg/L Mg-Magnesium 00927 mg/L method#
(Ammonia Nitrogen:NH3 asN: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: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Steve Kobelak,Mill Manager A /-0 2-
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00005555 Expiration Date: 8/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
❑■ Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No. of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Permd)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 5 Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 45.60 ft. Well Diameter: 2 in. pH 00400: 4.1 units Temp.000lo: 17.2 °C DRY at
Depth to Water Level 82546:37.9 ft.below measuring point Screened Interval: ft. to ft. Spec.Cond.00094: 14.2 µMhos time of
sampling,
Measuring Point is 1.0 ft.above land surface Relative M.P. Elevation: ft. Odor 00085 none check
Volume of water pumped/bailed before sampling: 3.6 gallons Appearance Clear here:❑
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:Beginning 7/19/2023 Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 <30 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 <2 /100mL Nitrate(NOD as N 00620 <0.200 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.500 mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
issolved Solids:Total 703oo 62 mg/L At-Aluminum 01105 mg/L Formaldehyde,Total <500 ug/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 1.16 mg/L Ca-Calcium 00916 mg/L
Chloride 00940<1.00 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total o1o34 <5 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 <0.00020 ug/L Lab Report Attached? ❑ Yes(1) ❑■ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732 method# 8260B
Total Ammonia 00610 <0.10 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 01067 ug/L method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that.to the best of my knowledge and belief,the information submitted in this report is true,accurate.and complete.and that the laboratory analytical data was produced using approved methods of analysis by a
.WO-certified
Steve Kobelak,Mill Manager
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Pennittee(or Authorized Agent) (Daft)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM • , , 161, MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00005555 Expiration Date: 8/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
❑■ Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No.of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Pennt)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 6 Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 57.00 ft. Well Diameter: 2 in. pH 00400: 5.0 units Temp.000lo: 17.1 eC DRY at
Depth to Water Level 82546:48.6 ft.below measuring point Screened Interval: ft. to ft. Spec.Cond.00094: 26.6 µMhos time of
sampling,
Measuring Point is 10.2 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 here:
❑
Samples for metals were collected unfiltered: 91 YES El NO and field acidified: ®YES El NO
LABORATORY INFORMATION
Date sample analyzed:Beginning 7/19/2023 Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 <30 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 <2 /100mL Nitrate(NO3)as N 00620 .864 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.500 mg/L
(Note- Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
issolved Solids:Total 70300 114 mg/L Al-Aluminum 01105 mg/L Formaldehyde,Total <500 ug/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680<1.00 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 <1.00 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 <5 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 o0945 mg/L Hg-Mercury 71900 <0.00020 ug/L Lab Report Attached? ❑ Yes(1) ❑■ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732 method# 8260B
Total Ammonia 00610 <.010 mg/L Mg-Magnesium 00927 mg/L 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%
I certify that,to the best of my knowledge and belief.the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Steve Kobelak,Mill Manager /Y/►
�o
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Penn or Authorized Agent) (D e)
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
• . DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM • 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00005555 Expiration Date: 8/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
❑■ Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No.of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 7 Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 60 ft. Well Diameter: 2 in. pH 00400 units Temp.000lo: eC DRY at
Depth to Water Level 82546:57 ft.below measuring Mhos time of
p g point Screened Interval: ft. to ft. Spec.Cond.000sa µ sampling,
Measuring Point is 3 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: 0 gallons Appearance here:
Samples for metals were collected unfiltered: m YES ❑ NO and field acidified: ®YES ❑NO 271
LABORATORY INFORMATION
Date sample analyzed:Beginning Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 /100mL Nitrate(NO3)as N 00620 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 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 At-Aluminum of im mg/L Formaldehyde,Total mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 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? ❑ Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: method# 8260B
Total Ammonia 00610 mg/L Mg-Magnesium 00927 mg/L 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%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate.and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Steve Kobelak,Mill Manager 14 2-
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permitlee(or Authorized gent) (Date
GW-59 Rev 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
• . DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY4NFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM •• • 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00005555 Expiration Date: 8/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
❑■ Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No.of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 8 Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 56 ft. Well Diameter: 2 in. pH 00400: units Temp.000lo: °C DRY at
Depth to Water Level 82546:53.8 ft.below measuring Mhos time of
p g point Screened Interval: ft. to _ft. Spec. Cond.0009a: µ sampling,
Measuring Point is 2.2 ft.above land surface Relative M.P. Elevation: ft. Odor 00085 check
Volume of water pumped/bailed before sampling: 0 gallons Appearance here:
Samples for metals were collected unfiltered: m YES ❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 /100mL Nitrate(NO3)as N 00620 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 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 Formaldehyde,Total ug/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium oo916 mg/L
Chloride oo94o mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total o1o34 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? ❑ Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732 method# 8260B
Total Ammonia 00610 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 01067 ug/L method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that.to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete.and that the laboratory analytical data was produced using approved methods of analysis by a
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Steve Kobelak,Mill Manager /0 12.
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(or Authorized Agent) (Date)
GW-59 Rev,2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY4NFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM • • 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WO0005555 Expiration Date: 5/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
0 Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No.of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 9 Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 58 ft. Well Diameter: 2 in. pH 00400 units Temp.000lo: °C DRY at
Depth to Water Level 82546:54.6 ft.below measuring point Screened Interval: ft. to ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 3.4 ft.above land surface Relative M.P. Elevation: ft. Odor 00085 check
Volume of water pumped/bailed before sampling: 0 gallons Appearance here:
Samples for metals were collected unfiltered: m YES ❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:Beginning Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead o1051 ug/L
Coliform:MF Fecal 31616 /100mL Nitrate(NO3)as N 00620 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 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 At-Aluminum 01105 mg/L Formaldehyde,Total ug/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 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? ❑ Yes(1) M No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732 method# 8260B
Total Ammonia 00610 mg/L Mg-Magnesium 00927 mg/L method#
(Ammoma 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%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Steve Kobelak,Mill Manager �n
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Permittee(i5Muthorizecl Agent) (DAW
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT t3 NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUAUTY4NFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM • , 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00005555 Expiration Date: 8/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
❑■ Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No.of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 10 Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 29.0 ft. Well Diameter: 2 in. pH 00400: 4.7 units Temp.000lo: 17.6 °C DRY at
Depth to Water Level 82546:21.2 ft.below measuring point Screened Interval: ft. to ft. Spec.Cond.00094: 36.3 µMhos time of
sampling,
Measuring Point is 7.8 ft.above land surface Relative M.P. Elevation: ft. Odor 00085 none check
Volume of water pumped/bailed before sampling: 4 gallons Appearance clear here:❑
Samples for metals were collected unfiltered: m YES ❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: Beginning 7/19/2023 Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 <30 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <2 /100mL Nitrate(NO3)as N 00620 1.72 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.500 mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
issolved Solids:Total 7o3oo 84 mg/L Al-Aluminum 01105 mg/L Formaldehyde,Total <500 ug/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680<1.00 mg/L Ca-Calcium 00916 mg/L
Chloride 0094o 3.15 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 5 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 <0.00020 ug/L Lab Report Attached? ❑ Yes(1) ❑■ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732 method# 8260B
Total Ammonia o0610<0.10 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 01067 ug/L method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that.to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
IDWQ-certified laboratory. I am aware that there are significant penalties forsubmitting false information,including the possibilitycif fines and imprisonment for knowing violations.
Steve Kobelak,Mill Manager 16
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of PermitteejVr Authorized Agent) ate)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT 8 NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM EM1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phonc:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00005555 Expiration Date: 8/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
❑■ Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No.of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW l l Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 48.0 ft. Well Diameter: 2 in. pH 00400: 4.5 units Temp.000lo 16.4 eC DRY at
Depth to Water Level 82546:31.8 ft.below measuring point Screened Interval: ft. to ft. Spec. Cond.00094: 30.2 µMhos time of
sampling,
Measuring Point is 16.2 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: None check
Volume of water pumped/bailed before sampling: 16 gallons Appearance Clear,no odor here:❑
Samples for metals were collected unfiltered: m YES ❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:Beginning 7/19/2023 Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 <30 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead olo51 ug/L
Coliform:MF Fecal 31616 6 /100mL Nitrate(NO3)as N 00620 <0.200 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <.500 mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
issolved Solids:Total 70300 94 mg/L Al-Aluminum oilo5 mg/L Formaldehyde,Total <500 ug/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 1.54 mg/L Ca-Calcium 00916 mg/L
Chloride 0094o 2.09 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 <5 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 <0.00020 ug/L Lab Report Attached? ❑ Yes(1) X No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732 method# 8260B
Total Ammonia 00610 <0.10 mg/L Mg-Magnesium 00927 mg/L method#
(Ammonia Nitrogen:NH,as N.Ammonia Nitrogen,Total)
Mn-Manganese 01055 uglL ,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%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods ofanalysis by a
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Steve Kobelak,Mill Manager /4
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Pennittee(or Authorized Agent) ( le)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM • 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00005555 Expiration Date: 8/31/2025
Facility Name: Weyerhaeuser NR Company Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: 524 Pride Way TYPE OF PERMITTED OPERATION BEING MONITORED
Elkin NC 28621 County Surry ❑ Lagoon ❑Remediation: Infiltration Gallery
X Spray Field ❑Remediation:
Contact Person: Dennis Atkinson Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:36 Deg 15.112N/80 Deg 47.447W No.of wells to be sampled: 9 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW 12 Date sample collected: 7/19/2023 FIELD ANALYSES: WAS
Well Depth: 50 ft. Well Diameter: 2 in. pH 00400: 4.9 units Temp.000lo. 17.7 °C DRY at
Depth to Water Level 82546:46.7 ft,below measuring point Screened Interval: ft. to ft. Spec.Cond.00094. 89.6 µMhos time of
sampling,
Measuring Point is 4 ft.above land surface Relative M.P. Elevation: ft. Odor 00085 none check
Volume of water pumped/bailed before sampling: 1.7 gallons Appearance Clear,no odor here:❑
Samples for metals were collected unfiltered: m YES ❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:Beginning 7/19/2023 Laboratory Name: Waypoint Analytical Certification No. 402
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 <30 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead oio5i ug/L
Coliform: MF Fecal 31616 8 /100mL Nitrate(NO3)as N 00620 3.46 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.500 mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
issolved Solids:Total 70300 130 mg/L Al-Aluminum 01105 mg/L Formaldehyde,Total <500 ug/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 0068o 2.45 mg/L Ca-Calcium 00916 mg/L
Chloride 0094o 3.37 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total o1o34 <5 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 <0.00020 ug/L Lab Report Attached? ❑ Yes(1) H No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732 method# 8260B
Total Ammonia 00610 <0.10 mg/L Mg-Magnesium 00927 mg/L method#
(Ammonia Nitrogen,NH3as NI 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%
I certify that.to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWO-cerfified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Steve Kobelak,Mill Manager
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of Pennittee(or Authorized Agent) I (bate)
GW-59 Rev.2/2010