WQ0003090_Monitoring - 07-2023_20230830 (2)

Monitoring Report Submittal
.....................................................
Permit Number#* WQ0003090
Name of Facility:* TOWN OF LIBERTY WWTP
Month: * July
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
G W-59
Year:* 2023
Upload Document*
JULY 2023.pdf 3.89MB
PDF Only
MW REPORT JULY 2023.pdf 3.01 MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * [e-mail]
Name of Submitter: * Elix Fike
Signature:
Date of submittal: 8/30/2023
This will be filled in automatically
Initial Review

Reviewer: Wanda.Gerald
Is the project number correct?* WQ0003090
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 9/13/2023

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617
FACILITY INFORMATION
Please Pnnt Clearly or Type
PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP
Non -Discharge W00003090 UIC
Permit Name (if different):
NPDES Other
Facility Address: P.O. Bx 1006
TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC
27298 County Randolph
❑ Lagoon ❑ Remediation: Infiltration Gallery
X Spray Field ❑ Remediation:
Contact Person: Tremaine Fike
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: MW 2
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW 2
Date sample collected: 7/18/2023
FIELD ANALYSES:
WAS
Well Depth: 30.4 ft.
Well Diameter: 2 in.
pH 0040o: 6.22 units Temp. 000lo: 19.6 oC
DRY at
Depth to Water Level 82546: 6.03 ft. below measuring point Screened Interval: ft. to
—
ft. Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085:
check
Volume of water pumped/bailed before sampling:
1.25
gallons
Appearance Clear
here: El
Samples for metals were collected unfiltered: ❑ YES
❑■ NO and field acidified: ❑ YES ❑■ NO
LABORATORY INFORMATION
Date sample analyzed:4QQ!Qeaa "7 ff� aaa
3
Laboratory Name: PACE ANALYTICAL LABS, INC. Certification No. #40 #633
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 <01.0
/100mL
Nitrate (NO3) as N 00620 0.35
mg/L Zn - Zinc 01092 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
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 <25.0
mg/L
Al -Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.0
mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 2.9
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
EtMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 <.10
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen, NH3as 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%
U W-5s
Kev. 06-0 /-2018

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617
FACILITY INFORMATION
Please Print ClearfyorType
PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP
Non -Discharge WQ0003090 UIC
Permit Name (if different):
NPDES Other
Facility Address: P.O. Bx 1006
TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC
27298 County Randolph
❑ Lagoon ❑ Remediation: Infiltration Gallery
Spray Field ❑ Remediation:
Contact Person: Tremaine Fike
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: MW 4
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW 4
Date sample collected: 7/18/2023
FIELD ANALYSES:
WAS
Well Depth: 30.63 ft.
Well Diameter: 2 in.
pH 00400: 6.38 units Temp. 000lo: 19.4 °C
DRY at
Depth to Water Level 82546: 5.55 ft. below measuring point Screened Interval: ft. to
—
ft. Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 000m:
check
Volume of water pumped/bailed before sampling:
1.5
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ❑ YES
NO and field acidified: ❑ YES ❑■ NO
LABORATORY INFORMATION
Date sample analyzed: a ",3 -7 1 t$ t a8a 3
Laboratory Name: PACE ANALYTICAL LABS, INC. Certification No. #40 #633
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 <01.0
/100mL
Nitrate (NO3) as N 00620 0.86
mg/L Zn - Zinc 01092 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
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7030o 53.0
mg/L
AI -Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.0
mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 12.4
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
EtMhos
K - Potassium 00937
mg/L
VOC 7873 method #
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%
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
• .
DEPARTMENT OF ENVIRONMENTAL QUALITY - DN- OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP
Non -Discharge WQ0003090 UIC
Permit Name (if different):
NPDES Other
Facility Address: P.O. Bx 1006
TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC
27298 County Randolph
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tremaine Fike
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: MW 5
No. of wells to be sampled:
5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW 5
Date sample collected: 7/18/2023
FIELD ANALYSES:
WAS
Well Depth: 27.15 ft.
Well Diameter: 2
in.
pH 00400: 6.84 units Temp. 00010: 20 °C
DRY at
Depth to Water Level 82546: 13.93 ft. below measuring point Screened Interval:
ft. to _ft.
Spec. Cond. 00094: µMhos
time of sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085:
check
Volume of water pumped/bailed before sampling:
3.25
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ❑ YES
X NO and field acidified: ❑ YES
A NO
LABORATORY INFORMATION
Date sample analyzed:a 'e r7 L S ( ao a 3
Laboratory Name: PACE ANALYTICAL LABS, INC. Certification No. #40 #633
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 0.90
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 0.087
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 191
mg/L
Al -Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 1.6
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 44.0
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 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)
Specific Conductance 00095
FtMhos
K - Potassium 00937
mg/L VOC 7873 method #
Total Ammonia 00610 <0.10
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen, N1,13as 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%
Scott Kidd Town Manager
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
• .
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIY. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP
Non -Discharge W00003090 UIC
Permit Name (if different):
NPDES Other
Facility Address: P.O. Bx 1006
TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC
27298 County Randolph
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑■ Spray Field ❑ Remediation:
Contact Person: Tremaine Fike
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: MW 6
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW 6
Date sample collected: 7/18/2023
FIELD ANALYSES:
WAS
Well Depth: 30 ft.
Well Diameter: 2 in.
pH 00400: 6.71 units Temp. 000lo: 19.7 °C
DRY at
Depth to Water Level 82546: 17.89 ft. below measuring point Screened Interval: ft. to
_ft.
Spec. Cond. 00094: µMhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085:
check
Volume of water pumped/bailed before sampling:
8.75
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ❑ YES
❑■ NO and field acidified: ❑ YES (] NO
LABORATORY INFORMATION
Date sample analyzed: 7/18/2023
LaboratoryName: PACE ANALYTICAL LABS, INC. Certification No. #40 #633
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 <1.0
/100mL
Nitrate (NO3) as N 00620 0.70
mg/L Zn - Zinc 01092 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
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 68.0
mg/L
Al -Aluminum oil o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.0
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 6.9
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 o0095
ILMhos
K - Potassium 00937
mg/L VOC 7873 method #
Total Ammonia oo610 <0.10
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen: NH3as 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%
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617
FACILITY INFORMATION
Please Print Cleariy or Type
PERMIT Number: Expiration Date: 8/31/2024
Facility Name: Town of Liberty WWTP
Non -Discharge W00003090 UIC
Permit Name (if different):
NPDES Other
Facility Address: P.O. Bx 1006
TYPE OF PERMITTED OPERATION BEING MONITORED
liberty NC
27298 County Randolph
❑ Lagoon ❑ Remediation: Infiltration Gallery
0 Spray Field ❑ Remediation:
Contact Person: Tremaine Fike
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: MW 7
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW 7
Date sample collected: 7/18/2023
FIELD ANALYSES:
WAS
Well Depth: 27.20 ft.
Well Diameter: 2 in.
pH 00400: 6.74 units Temp. 000lo: 19.8 °C
DRY at
Depth to Water Level 82546: 19.33 ft. below measuring point Screened Interval: ft. to
_ft.
Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085:
check
Volume of water pumped/bailed before sampling:
5.50
gallons
Appearance Clear
here: El
Samples for metals were collected unfiltered: ❑ YES
❑■ NO and field acidified: ❑ YES ❑■ NO
LABORATORY INFORMATION
Date sample analyzed: 7/18/2023
LaboratoryName: PACE ANALYTICAL LABS, INC. Certification No. #40 #633
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 5600
/100mL
Nitrate (NO3) as N 00620 0.83
mg/L Zn - Zinc 01092 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
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7030o 65.0
mg/L
Al -Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 <1.0
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 17.2
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? ❑■ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 7873 method #
Total Ammonia oo6lo <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%
GW-59 Rev.06-07-2018

(;W-59A COMPLIANCE, REPORTFORM Peftllit 9 WQ0003090
(.Sahnmt one each monitoring period i0th G19'-59 /i)rms.)
1
Enter date monitoring results were due. ( 07/31/2023 ) Will this monitoring report (GW-59 and GW-59A)
YES
NO
be submitted after the established due date?
X
2
Was any required information missing on the GN1'-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.)? Ifthe answer is "Yes", contact the Regional Of
Tce.forguidance.
X
4
Are any monitored constituents equal to or above the established standards?
Y S
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
YES
NO
same constituent(s) in the same well(s) in the last two years?
X
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).
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 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 surroundinq 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 GW-59A) is true and complete to the best of my knowledge.
Si ture of P mitte or Authorized Agent) Date
GNP'-59A 12/8/2003

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Pace Analytical Services, LLC
1377 South Park Drive
�Yace'- Kernersville, NC 27284
[phone]
Page 2 of 2
Sample: MW-7
Method Parameters
Lab ID: 92677764005 Collected: 07/18/23 09:37 Matrix:
Results Units Report Limit
Water
Analyzed Qualifiers
EPA 353.2 Rev 2.0 1993 Nitrogen, Nitrate
0.83
mg/L
0.040
07/18/23 16:54
SM 9222D-2015 Fecal Coliforms
5600
CFU/100 mL
1.0
07/19/23 15:30
EPA 300.0 Rev 2.1 1993 Chloride
17.2
mg/L
1.0
07/20/23 18:28
EPA 350.1 Rev 2.0 1993 Nitrogen, Ammonia
NO
mg/L
0.10
07/28/23 11:17
EPA 365.1 Rev 2.0 1993 Phosphorus
NO
mg/L
0.050
07/31/23 11:43
SM 5310B-2014 Total Organic Carbon
ND
mg/L
1.0
07/25/23 15:31
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804 South Carolina Laboratory ID: 99030
Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001
North Carolina Drinking Water Certification #: 37712 VirginiaNELAP Certification #: 460222
North Carolina Wastewater Certification #: 40
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Wastewater Certification #: 633
North Carolina Drinking Water Certification #: 37738 VirginiaNELAP Certification #: 460025
Page 2 of 4

AnaVical
ipany: Town of Liberty
Address:
Report To:
Copy To:
CHAIN -OF -CUSTODY Analytical Request Document
Chain -of -Custody is a LEGAL DOCUMENT - Complete al relevent fields
Billing Information:
To:
Site Collection Info/Address:
LAS USE oNLY- Affix workorder/Login Label Here or List Pace Workorder Number or
MTJ1L Log -in Number Here
ALL SHADED AREAS are for LAB USE ONI V
Container Preervat� -
:3=U 2 ! L a i,_� 4 92677-064
"Preservative Types: (1) nitric acid, J:
(6) methanol, M sodium bisulfate, (9)
(C) ammonium hydroxide, (D) TSP, (U)
Analyses
Customer Project Name Number'. State: County/City: Time Zone Collected*
JPT[ JMTJ ICT I I ET
Custody Seals Present/Intact Y'IN'lz�m
Custody Signatures Presentil_� Nh
Phone: S te/Facil ty I D 4: n: Compliance Motoring?
Yes ]NO
Collector signature Present N $A
Email: V11i"
Bottles Intact N Kh
Correct Bottles 9 NA
IN
Coll pr*nt)i," Purchase Order #: DW PWS 11) #:
Quote #: DW Location Code:
Sufficient Volume H NA
!Ice:
Samples R-teived on Ice NA
VOA - Headspace Acceptable
USDA Regulated Soils
Collected By {signatures: Turnaround Date Required: Immediatey Packon—on
yes NO
z
Samples in Folding Time xtAResidual Chlorine 11 y ONA
Cl. Strips R Ig
Sample Disposal: I Rush: Field Filtered (if applicab'e):
Dispose as appropriate ReturnSame Day Next Day � )Yes ]No
Sample pX NA
I Archrve: 2 Day 1 13 Day f 14 Day [ j 5 Day
Analysis:
0
PR stripazAcceotabie J A I At PI/W
j Hold: (Expedite Charges Apply)
z
I
Sulfide Present
Matrix Codes (insert! n Matrix box below): Drinking Water (DW), Ground Water (GW), Wastewater (WW).
Product (P), Soil/Solid (SQ, Oil (OL), Wipe (WP), Air (AR), Tissue (TS), Bioassay (B), Vapor (V), Other (OT) C)
Comp Jf Co.lected (or Reis
Composite End
Customer Sample ID Matrix • Grab Composite Start) C of
Ctns 0
Date, FT ---1 Date I -Time0- I >
7
1
"VM-
a 4 aw,
1
Customer Blue Dry (Y
Remarks/ Special Conditions/ Possible Hazards: fTypeofIceUsed: e� None SHORT HOLDS PRESENT (<72 hours NIA Lab Sample"remperature Info:
N Al
I Groundwater Monitoring
Relinquished by/Company-
mqulshed by/Company:
Lab Tracking #. Temp Blank Recea"'CV,
Therm ID4. TO Q
Cooler I Temp Upon Receipt: PC
y N NA samples received via Cooler I Therm Corr. Factor-. oc
FEDEX UPS Client -Courier Pace Courier. Cooler 1 Corrected Temp: oC
ny: (Signature) IDatefiire: - � MTJLiAf�_� comments*.
_ � 10S 0 Table tk
dJ�Y-4AA-t­A k, Acctnum: i
9 ature)
Date/Time: 'Rec�_"id by/C to te ime:
10114 Template: Trip Blank Received: Y N NA
Prelogin: HCL MeOH TSP Other
/T'
Date/Time: Received by/Company: (Signature) Datetme:
PM:
Non Conformance(s): Page:
YES / NO of,
Packing Material Used:
Radchem sample(s) screened (<500 p

Document Name:
Document Issued: November 15, 2021
7C
F AtlalyrlGai
Bottle Identification Form (sIF)
Page 1 of 1
Document No.:
Issuing Authority;
F-CAR-CS-043-Rev.01
Pace Carolinas Quality Office
*Check mark top half of box if phi and/or dechlorination is Project #1
verified and within the acceptance range for preservation
samples. L l
Exceptions: VOA, Coliform, TOC, Oil and Grease, DROJ8015 (water) DOC, LLHg
"Bottom half of box is to list number of bottles
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pH Adjustment Log for Preserved Samples
[Type of Preseative pH upon receipt Date preservation adjusted Time preservation Amount of Preservative tot fi
_,�rv._._� adjusted— added �..�._
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form —will sent to the North Carolina DEHNR Certification Office h.e.
Out of hold, incorrect preservative, out of ternp, incorrect containers.
Page 4 of 4

Weather
Town of Liberty
Clear 741F
Personnel Present
07/18/23 Glenn Price
Date
Monitoring Well No..
MW-2
MW-4
MW-5
MW-6
MW-7
Eff
Total Depth (FT.)
30.40
30.63
27.15
30.00
27.20
Surface Depth (FT.)
24.37
25.08
1122
12.11
7.87
Water Depth (FT.)
6.03
5.55
13.93
17.89
19.33
Diameter (IN.)
2"
2"
2"
2"
2-
Conversion Factor
0.16
0.16
0,16
0.16
0.16
Well Volume (GAL.)
0.96
0.89
2,23
2.86
3.09
Volume (GAL.) X 3
2.88
2.66
6.69
8.59
9,28
N Bails (L)
12
11
27
35
38
Purge Date
07 18:23
07'18/23
07i 18;23
OT 18.23
0718,23
Purge Time (hrs.)
0820
0839
0854
0950
0921
Purge Method
Bailer
Bailer
Bailer
Bailer
Bailer
Volume Removed (GAL.)
1.25-Dry
1.50-Dry
125-Dry
8.75
5.50-Dry
Sampling Date
07 r 1 8/23
0718,23
OT 19, 23
0718.23
07118/23
Sampling Time (hrs.)
0828
0847
0906
1008
0937
SamplingMethod
Bailer
Bailer
Bailer
Bailer
Bailer
Grab
pH (Standard Units)
6.22
6.38
6-84
6.71
6.74
Temperature (EC)
19.6
19.4
20.0
19,7
19.8
Conductivity (pmhos/cm)
Dissolved Oxygen (mg/L)
lObservaLion s/Sampling I