WQ0007283_Monitoring - 07-2023_20230829 (3)

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month:* July
Report Information
Type *
GW-59
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
WQ0007283
Town of Pollocksville
Year:* 2023
Upload Document*
MONITER WELLS JULY 2023.pdf 5.45MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Johnnie Chadwick
Reviewer: Wanda.Gerald
8/29/2023
This will be filled in automatically

Is the project number correct?* WQ0007283
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 9/12/2023

GW-59A COMPLIANCE REPORT FORM
Permit # W00007283
Ouhtnil one each monitoring period with GW- S9 formm.)
1
Enter date monitoring results were due. ( 8/3U/23 ) Will this monitoring report (GW-59 and GW59A)
YES
NO
be submitted after the established due date?
X
2
Was any required information missing on the G«'-59 report forms?
YE)(
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.)? ifthe answer is "Yes", contact the Regional t)fficefor guidance.
X
4
Are any monitored constituents equal to or above the established standards?
YES
ND
J�
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
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, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
G
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 maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE, If the answer is `NO", monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
if the answer to question 7 is "YES", describe those actions in the space provided 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.
MW 1 HAD GROUND HORNETS NEST UNABLE TO TAKE SAMPLE BY THE WA
POI
T
g
The person completing this portion (GIN--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 GW-59A).is true and complete to the best of my knowledge.
/"
8/28/23Date
nature or rermittee for Authorized Agent)
G W-,59A 12/8/2003

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
f
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617
FACILITY INFORMATION
Please Print Clearty or Type
PERMIT Number: Expiration Date: 3/31/2027
Facility Name: TOWN OF POLLOCKSVILLE
Non -Discharge WQ0007283 UIC
Permit Name (if different):
NPDES Other
Facility Address: 488 GOSHEN ROAD
TYPE OF PERMITTED OPERATION BEING MONITORED
POLLOCK SVILLE NC n 28573
County JONES
© Lagoon ❑ Remediation: Infiltration Gallery
® Spray Field ❑Remediation:
Contact Person: JJ. CHADWICK
Telephone*252-224-9831
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:#1 UPGRADIENT WEST LAGOON
No. of wells to be sampled: SIX
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW-1
Date sample collected: 7/3/2023
If WELL
FIELD ANALYSES: WAS
Well Depth: 21 ft.
Well Diameter: 2 in.
pH 00400: 0 units Temp. 000lo: 0 °C DRY at
Depth to Water Level 62546:0 ft. below measuring
point
Screened Interval: ft.
to
ft. Spec. Cond. 00094: µMhos time of
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085: sampling,
Volume of water pumped/bailed before sampling:
0
gallons
check
Appearance here:
for metals were collected unfiltered: © YES ❑
NO and field acidified: It YES ❑ NO
❑Samples
LABORATORY INFORMATION
Date sample analyzed:7/3/2023
Laboratory Name: WAYPOINT ANALYTICAL
Certification No. 420
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead c1o51 ug/L
Coliform: MF Fecal 31618 0
/100mL
Nitrate (NO3) as N 00620 0
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL Phosphorus:
Total as P 00665 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 0
mg/L
All -Aluminum o11o5
mg/L
pH (Lab) 00403
units
Be - Barium 01007
ug/L
Sample not taken due to GROUND HORNETS NEST
TOC 00680 0
mg/L
Ca - Calcium 00916
mg/L
at Well site
Chloride 00940 0
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 0104E
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 0009s
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia o0610 0
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese o1055
uglL
,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
Pew 0nm&A1a+inn Q­+..w.w ^-h. IA"—.&. , .� ft-- _.-
-, mgrL tmuent i otai vacs: mg/L VOC Removal%
JOHNNIE J. CHADWICK/ORC
Permittee (or Authorized Agent) Name and Title. Please print ortype
GW 59 Rev. 06-07-2018
8/28/2023
(Date)

SUBMIT FORM nN VFI I nvv PA=1r nw v
GROUNDWATER QUALITY MONITORING:
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
COMPLIANCE REPORT FORM
RIN
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617*
FACILITY INFORMATION
Please Print Clearty or Type
PERMIT Number: Expiration Date: 3/31/2027
Facility Name: Town of Pollocksville
Non -Discharge WQ0007283 UIC
Permit Name (if different):
NPDES Other
Facility Address: 488 Goshen Road
TYPE OF PERMITTED OPERATION BEING MONITORED
Pollocksville NC
28573 County Jones
® Lagoon ❑ Remediation: Infiltration Gallery
© Spray Field ❑ Remediation:
Contact Person: JJ. Chadwick
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:# 2 EAST SIDE REAR LAGOON
No. of wells to be sampled:
SIX
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW-2
Date sample collected: 7/3/2023
FIELD ANALYSES:
If WELL
WAS
Well Depth: 20 ft.
Well Diameter: 2
in.
pH 00400: 6.9 units Temp. 000lo: 24 oC
DRY at
Depth to Water Level 82546:10.33 ft. below measuring point Screened Interval:
ft. to
ft. Spec. Cond. 00094: µMhos
time of
MeasuringPoint is 2 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 000es:
sampling,
Volume of water pumped/bailed before sampling:
2.5
gallons
Appearance
check
here:❑
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: ® YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed.11tW2M 23
Laboratory Name: WAYPOINT
ANALYTICAL Certification No. 420
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1.0
/100mL
Nitrate (NO3) as N 00620 7.40
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 0.09
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 M-780
mg/L
Al -Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC ooe8o 14.30
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 82
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 o0095
µMhos
K - Potassium 00937
mg/L
VOC 7673 method #
Total Ammonia 00610 1.98
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Man Manganese o1os5
g
ug/L
method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
- 1-1—N,wuvn vyaLen:a vnry tMtwGn "0 M6por[3): Influent total VUGS:
JOHNNIE J. CHADWICK/ORC
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.06-07-2018
mg/L Effluent Total VOCs:
(or
mg/L VOC Removal%
8/28/2023

SUBMIT FORM ON YFI I nw paprrF rwi v
GROUNDWATER QUALITY MONITORING:
•
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
COMPLIANCE REPORT FORM
`
` ` `
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 3/31/2027
Facility Name: TOWN OF POLLOCKSVILLE
Non -Discharge W00007283 UIC
Permit Name (if different):
NPDES Other
Facility Address: 488 GOSHEN ROAD
TYPE OF PERMITTED OPERATION BEING MONITORED
POLLOCKSVILLE NC
28573
County JONES
❑■ Lagoon ❑ Remediation, Infiltration Gallery
N Spray Field ❑ Remediation:
Contact Person: JJ. CHADWICK
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: # 3 EAST SIDE LAGOON
No. of wells to be sampled: SIX
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW-3
Date sample collected: 7/3/2023
FIELD ANALYSES:
If WELL
WAS
Well Depth: 25 ft.
Well Diameter: 2 in.
pH 00400: 5.6 units Temp. 000lo: 27 °C
DRY at
Depth to Water Level 82546:13.60 ft. below measuring point
Screened Interval: ft.
to
ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft.
Odor o0085:
sampling,
Volume of water pumped/bailed before sampling:
2.0
gallons
Appearance
check
here:❑
Samples for metals were collected unfiltered: ® YES ❑ NO and field acidified: ® YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 7/3/2023
Laboratory Name:
Certification No.
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead oio51 ug/L
Coliform: MF Fecal 31816 < 1
/100ml-
Nitrate (NO3) as N 00620 1.43
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL Phosphorus: Total as P oo665 0.08
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mglL
Other (Specify Compounds and Concentration Units):
issolved Solids: Total 70300 M 18
mg/L
AI - Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOG oo68o <1.0
mg/L
Ca - Calcium oo916
mg/L
Chloride 0094o 4
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00652
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 C ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 000m
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia ooslo 0.11
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total)
Mn - Manganese o1os5
ug/L
method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
9: r oe.. 41 41..., e4....,.., f%..r.. iwu-_� r
......�..,a.,�„ vYaLonla vrny (MItAG�I L-du mepor[S): Influent I otal vVGS:
JOHNNIE J. CHADWICK
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%
8/28/2023

JUMVII I I-UKM UN YtLLUW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
or
Facility Name: TOWN OF POLLOCKSVILLE
Permit Name (if different):
Facility Address: 488 GOSHEN ROAD
NC 28573
County JONES
tact Person: JJ. CHADWICK Telephone#: [phone]
I Location/Site Name:# 4 UP GRADIENT EAST SPRAY No. of wells to be sampled: SIX
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27609.1617
PERMIT Number: Expiration Date: 3/31/2027
Non -Discharge WQ0007283 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:
WELL ID NUMBER (from Permit): MW-4 Date sample collected: 7/3/2023
Well Depth: 22 ft. Well Diameter: 2 in.
Depth to Water Level 82546: 17.50 ft. below measuring point Screened Interval: ft. to ft.
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling; 1.0 gallons
,Samples for metals were collected unfiltered: m YES ❑ NO and field acidified: ® YES ❑ NO
FIELD ANALYSES: WAS
pH 00400: 7.5 units Temp. coolo: 21 °C DRY at
Spec. Cond. 00094: µMhos time of
Odor 000ss: sampling,check
Appearance here:❑
Date sample analyzed 3/etPBf9 r%�� 3
Laboratory Name: WAYPOINT ANALYTICAL
Certification No. 420
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead oios1 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 1.11
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 5.25
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 M150
mg/L
Al - Aluminum oil o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 1.72
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 10
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
uglL
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 719oo
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia oo610 0.30
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese olos5
9
uglL
,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
Fnr RamarliMinn C.re+erne ekni rA"+ r, r wL n_-_tea.
rT Y/L Cmuent i otai VVGS:
mg/L VOC Removal%
JOHNNIE J. CHADWICK/ORC C>�%�,o. ������s 8/28/2023
Permittee (or Authorized Agent) Name and Title -Please print or type Signature of P�Pmittee (or Authorized Agent) (Date)
GW 59 Rev. 06-07-2018 e

SUBMIT FORM ON YELLOW PAPER ONI Y
GROUNDWATER QUALITY MONITORING:
•
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
COMPLIANCE REPORT FORM
• • •
•
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 3/31/2027
Facility Name: TOWN OF POLLOCKSVILLE
Non -Discharge WQ0007283 UIC
Permit Name (if different):
NPDES Other
Facility Address: 488 GOSHEN ROAD
TYPE OF PERMITTED OPERATION BEING MONITORED
POLLOCKSVILLE,NC 28573
County JONES
© Lagoon ❑ Remediation: Infiltration Gallery
Spray Field ❑ Remediation:
Contact Person: JJ. CHADWICK
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well LocationlSite Name:# 5 DOWN GRADIENT EAST SPRAY No. of wells to be sampled: SIX
❑ Water Source Heat Pump El Other:
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-5
Date sample collected: 7/3/2023
FIELD ANALYSES:
WAS
Well Depth: 21 ft.
Well Diameter: 2 in.
pH 00400: 7.5 units Temp. 000lo: 21 oC
DRY at
Depth to Water Level 82546: 9.92
p ft. below measuring point Screened Interval: ft. to
ft. Spec. Cond. 000sa: µMhos
time of
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 000e5:
sampling,check
Volume of water pumped/bailed before sampling:
2.5
gallons
Appearance
here:❑
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: ® YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 713/2023
LaboratoryName: WAYPOINT ANALYTICAL
Certification No. 420
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 31e16 <1
/100mL
Nitrate (NO3) as N 00620 <0,04
mg/L
Zn -Zinc 01092 mg/L
Coliform; MF Total 31504
/100mL
Phosphorus: Total as P ooe65 0.05
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 M 180
mg/L
Al - Aluminum oilo5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oo68o 1.95
mg/L
Ca - Calcium oos16
mg/L
Chloride 00940 9
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 7873 method #
Total Ammonia ooelo 0.30
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH�as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
U /L
9
,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
rvr Mcn]auiauuu ays►nnrti wily Imuzu" Lap Keports): Influent I otal vucs:
JOHNNIE J. CHADWICKIORC
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.06-07-2018
mg/L Effluent Total VOCs:
Signature of(Vermittee (or
mg/L VOC Removal%
8/28/2023

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
s •
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
COMPLIANCE REPORT FORM
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27099.1617
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 3/31/2027
Facility Name: TOWN OF POLLOCKSVILLE
Non -Discharge WQ0007283 UIC
Permit Name (if different):
NPDES Other
Facility Address: 488 GOSHEN ROAD
TYPE OF PERMITTED OPERATION BEING MONITORED
POLLOCKSVILLE,NC n 28573
County JONES
IN Lagoon ❑ Remediation: Infiltration Gallery
HE Spray Field ❑ Remediation:
Contact Person: JJ. CHADWICK
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:# 6 DOWN GRADIENT WEST SPRAY No. of wells to be sampled: SIX
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-6
Date sample collected: 7/3/2023
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400: 7.0 units Temp. 000lo: 20 oC
DRY at
Depth to Water Level 82546: 8.13 ft. below measuring point Screened Interval: ft. to
ft. Spec. Cond. 00094: µMhos
time of
MeasuringPoint is 3.0 ft. above land surface
Relative MR. Elevation: ft.
Odor 000ss:
sampling,
check
Volume of water pumped/bailed before sampling:
3.0
gallons
Appearance
here:
❑Samples
for metals were collected unfiltered: © YES
❑ NO and field acidified: ON YES El NO
LABORATORY INFORMATION
Date sample analyzed:at9f2029 %- 3 - 2.3
Laboratory Name: WAYPOINT ANALYTICAL
Certification No. 420
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00616
mg/L
Pb - Lead olo51 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 1.13
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P oo665 0.17
mg/L
(Note Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 M 260
mg/L
Al -Aluminum o1105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC omm 1.53
mg/L
Ca - Calcium oo916
mg/L
Chloride 0094o 25
mg/L
Cd - Cadmium 01027
uglL
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00652
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 7e73 method #
Total Ammonia 00610 0.14
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; N1­13as N; Ammonia Nitrogen, Total)
Mn - Manganese o1o55
ug/L
method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
t-or Remediation systems only (Attach Lab Reports): Influent Total VOCs:
JOHNNIE J. CHADWICK/ORC
Permittee (or Authorized Agent) Name and Title - Please print or type
mg/L Effluent Total VOCs:
(or A
mg/L VOC Removal%
8/28/2023
(Date)
GW-59 Rev.06-07-2018