HomeMy WebLinkAboutWQ0002571_Monitoring - 11-2022_20230417SUBMIT 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 t ,PlleeasePrintClearlyorlTy/pee �J PERMIT Number: Expiration Date:��p
Facility Name: V i 1 ]tt , (J ai11—t? �L !/ / Non -Discharge ), Q_ a� / UIC
Permit Name (if different); � U NPDES Other
Facility Address: L Rare-;" e-;" TYPE OF PERMITTED OPERATION BEING MONITORED
r 1 County %pu7 19 Lagoon ❑ Remediation: Infiltration Gallery
(� Spray Field ❑ Remediation:
Contact Person:r T� Telephone#: ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: NI — l No. of wells to be sampled: ❑ Water Source Heat Pump ❑ Other:
[from Per""!
SAMPLING INFORMATION lit WELL
L ID NUMBER (from Permit): il�?
Depth: 2&ft.
i to Water Level 82548: ft. below measuring point
uring Point is ft. above land surface
ne of water pumped/bailed before sampling:
Nes for metals were collected unfiltered: L�1 YES ❑
Date sample collected:
Well Diameter: _min.
Screened Interval: ft. to _ft.
Relative M,P, Elevation: ft.
gallons
FIELD ANALYSES: WAS
pH ooaco: ` units Temp. Coolo °C DRY at
Spec. Cond. 00094: Ft Mhos time of
samplir
Odor 000a5: check
Appearance herei—
Date sample analyzed: // /A Z— Laboratory Name: L�yt V; r'OnM/.'A4 L ytLn , %nG Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations,
COD 00335 mg/L Nitrite (NO2) as N Cows el, a 4 mg1L Pb - Lead o1os1 ug/L
Col'f MF F I 131 1e Z . 71 1 ,
arm. eca a /100mL
Nitrate (NO3) as N 00820_
�Ci, � mg/L
n nc o 09 M11", ^� i
_�1
Coliform: MF Total 31504 /100mL
Phosphorus; Total as P Cows mg/L
K Ll,,
R
INme: use MPN method for 11ioNy tumid eampies)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units
"PR 17
)issolved Sohds:Total 70300 g't7) mg/L
At - Aluminum oilas
mglL
pH (Lab) 00403 units
Ba - Barium 01007
uglL
TOC ooseo , li mg/L
Ce - Calcium Cagle
mg/L
mc
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)
Phenof 32730 ug/L
Fe - Iron olo45
ug/L
(Specify test and method #. ATTACH LAB REPORT,)
SUlfate o0945 mg/L
Hg - Mercury 719oo
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
'Pacific Conductance 00095 ftMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia oo610mg/L
Mg - Magnesium 00927
mg/L
method #
(Amrwnfa Nitrogen NH;,as N. Armlonie Nitrogen, Total)
Mn Manganese o1055
ug/L
method #
TKN as N a0625 mg/L
Ni - Nickel o1o67
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
rw-Fa a> nA.manla
APR 17 2023
mg/L Effluent Total VOCs:
mg/L VOC Removal%
1
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GROUNDWATER QUALITY MONITORING: DEPARTMENTOFENVIRONMENTALQUALITY-DIV,OFWATERRESOURCES
rMI
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617
FACILITY INFORMATION Please PrInI Clearly of Type PERMIT Number. Expiration Date: . " j j ,Z
Facility Name: /v%h' l' Non -Discharge �y�7�'%i / UIC
Permit Name (it different):
INPD[S Other
Facility Address: Ir Lj l4q fr; ,r,,, 1— TYPE OF PERMITTED OPERATION BEING MONITORED
1 r _ County t')•2JZ7y,a �—S Lagoon ❑ Remediation: Infiltration Gallery
I /, y� Spray Field ❑ Remediation:
Contact Person: { [ �} ll ✓( JC— G4� Telephones✓: ,2-L 2 �50j -53. 0 `% i=1 Rotary Distributer ❑Land Application of Sludge
Well Location/Site Name: hrf �. - 3 No, of wells to be sampled: j ❑ Water Source Heat Pump ❑ Other.
WELL ID NUMBER (from Permit); M pate sample collected / /,?n f AX
��
Well Depth: ft Well Diameter: �" in.
Depth to Water Level a2546: h, below measuring point Screened Interval: ft. to ft,
Measuring Point is ft, above land surface Relative M.P. Elevatlon: ft.
Volume of water pumped/bailed before sampling: gallons
Samples for metals were collected unfiltered: Lk YES ❑ NO and field acidified: X YES ❑ NO
FIELD ANALYSES:
pH 0040o units Temp. ocolo k' °C
Spec. Cond. 00094: flMhos
Odor oocm: _
Appearance
n rrc�L
WAS
DRY at
time of
sampling,
check
here:D
LABORATORY INFORMATION
Date sample analyzed:
c
Laboratory Name
f Certification No
PARAMETERS NOTE: values should reflect dissolved and colloidal concentrations.
COD 00335 mg1L
Nitrite (NC2) as N oo615 < (' mo/L
Pb - Lead mo5+, ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO.) as N 00620 <L-512 mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P oc665 mg/L
(Nose: Use MPN melhod Tor highly airhid sanples)
Orthophosphate 70507 mg/L
Cther (Specify Compounds and Concentration Units):
ssolved Solids:Total 7o:roomg/L
At - Aluminum 01105 mg/L
PH (Lab) 00403 units
Ba - Barium 01007 ug/L
TOC oo6so _ 7 mg/L
Ca - Calcium oo916 mg/L
Chloride oog4o mg/L
Cd - Cadmium 01027 ug/L
Arsenic 01UO2 ug/L
Chromium: Total01034 ug/L
Grease and OII o
s 0s5z
mg/L
Cu - Capper 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 71000
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095
IIMhos
K - Potassium 00937
mg/L
VOC 7B73 method #
Total Ammonia a,Lj. 5— mg/L
Mg - Magnesium 00927
mg/L
method #
as
((Ammonia Nitrogen. NH, as N. Amnwnla Nitrogen. Tclap
Mn - Manganese oioss
ug/L
method #
TKN as N 00626
mg/L
Ni - Nickel o1o67
ug/L
method #
GW-59 Rev.06.07-2018
RURMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
e
ME
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617
FACILITY INFORMATION Plsnso Clearly orType
PERMIT Number: Expiration Date:
+Print
j
Facility Name: J) 1 i�/ �%i7�dZ',
�7
L�1 /
Non -Discharge t?,�J UIC
NPDES Other
Permit Name (it different):
Facility Address: jrd [(s 5 ir^tiGl!�
-
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon [IRemediation: Infiltration Gallery
1,.J ✓!`J �r County /`%2
Spray Field ❑ Remediation:
Contact Person: S- n It ✓1 �C �._JG —
Telephone#: �s iQj ;� 3jI `�
❑ Rotary D;stributo7 Land Application of Sludge
Well Location/Site Name: ti ty,,/
No. of wells to be sampled: 3
Water Source Heat Pump ❑ Other.
dram Pemwkti
If WELL
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): ���
Date sample collected' n 2
FIELD ANALYSES:
WAS
Well Depth �it.
Well Diameter: vein.
G
pH oonoo:_ units Tamp, °C
/p
DRY at
time of
Depth to Water Level 92546: ft, below measuring point Screened Interval:—ft, to _L'
Spec, Cond. =94: I tMhos
sampling,
Measuring Paint is ft. above land surface
Relative M.P. Elevation: ft.
Odor 000a5.
check
Volume of water pumped/bailed before sampling:
gallons
Appearance
here:[:]
Samples for metals were collected unfiltered: *1 YES
❑ NO and field acidified: F YES ❑ NO
LABORATORY INFORMATION J
�oZ�
GC 9
1'G7+d'1GC-2L�n 7 / Certification No.
Date sample analyzed 1J ro
Laboratory Name: nV, rt
G-41
. 1
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00336 mg1L
Nitrite (NO2) as N oos15 -� Ortj� mg/L Pb - Lead otn51 ug/L
Coliform: MF Fecal 31616 W <1 /100mL
Nitrate (NO.{) as N 00620 <mg/L Zn - Zinc 01092 _ mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P Doses mg/L
(Note Uao MPN method for hNghly tutbld samples)
Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units):
issoived Solids:Total 7o3oo f$�/v� mg/L
Al - Aluminum of 105 mg/L
pH (Lab) 00403 units
Be - Barium 01007 11
TOC oosao rj mg/L
Ca - Calcium oo916 mg/L
Chloride oosao 1{41 mg/L
Cd - Cadmium 01027 ug/L
Arsenic 01002 uglL
Chromium: Total olo34 ug1L
Grease and Oils 00562 mg/L
Cu - Copper 01042 mg/L
ORGANICS: (by GC, GCIIVS, HPLC)
Phenol 32730 uglL
Fe - Iron 01o4s 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)
oecific Conductance 000gs I,Mhos
K - Potassium 00937 mg/L VOC 7673 method #
Total Ammonia 0o610 ( mg/L
Mg - Magnesium 00927 mg/L method #
(Ammonia Miro(Jer. NH,, as N: Arnroama Nitrepen, Totai)
Mn - Manganese o1055 ug/L , method #
TKN as N oo625 moll-
NI- Nickel 01067 ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs.
Iris k4111jamG 1 Dtyner
Permitlee (or Authorizod Apart) Name and Title - Wlais8 p(irt or type
GW-59 Rev.06.07.2018
mg/L Effluent Total VOCs:
(or
ng(L VOc Removal%