WQ0001861_Monitoring - 09-2023_20231009

JUttl Nll l t'UtIVA UIV ZL-r r U_ r^r_tZM urvLl
ROUNDWATER QUALITY MONITORING:
OMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: -"It rY Y129Ir C Tht'10w•% C+OK,Qr•+y
Permit Name (if different):
Facility Address: IV Sec itA se eel�t r%
•n J
(Street) NC70,V!ftCounty Rr&y3r. e_jK
(City) (slab) (Z,P)
Contact Person: A r. 9vpill W VLF-- Telephone#: 'bp - A/- 7Z78
Well Location/Site Name: No, of wells to be sampled: _7
::•r '
1'
PERMIT Number: Expiration Date:
Non -Discharge Lott 000 /86/ 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:
ILL ID NUMBER (from Permit): M �''Z Date sample collected: i - 11
II Depth: V-4 ft. Well Dlameter: Z In.
3th to Water Level: "Jvg ft. below measuring point Screened Interval: R_ft. to 11-yft.
asuring Point is I* I ft. above land surface Relative M.P. Elevation: ft.
ume of water pumped/balled before sampling: _gallons
Wiles for metals were collected unfiltered: DYES ❑ NO and field acidified: ❑ YES ❑ NO
sample analyzed: IAA- t3 A q-IS f1-13 q--j0.
kMETERS NOTE: Values should reflect dissolved an,
COD mg/I
Coliform: MF Fecal /100ml
Coliform: MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total t-7 3 mg/1
pH (when analyzed)
units
TOC
mg/I
Chloride
mg/l
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
µMhos
Total Ammonia
mg/I
(Ammonia Nitrogen; NHaas N; Ammonia Nitrogen, Total)
TKN as N mg/I
FIELD ANALYSES:
pH SZ units
Spec. Cond. _
Odor
Appearance _
3 Laboratory Name: CW0 dins
colloidal concentrations.
Nitrite (NO2) as N mg/I Pb - Lead
Nitrate (NO3) as N mg/I Zn - Zinc
Phosphorus: Total as P _ mg/I
If WELL
WAS
Temp. y'6 eC DRY at
uMhos time of
Certification No.
mere: ❑
591
mg/I'� �, A
mg/I
0CTd02
Orthophosphate
/V j _mg/I
Other (Specify Compounds and Concentration Units):
Al - Aluminum
mg/I
Ba - Barium
mg/I
M $ A S = O. 07 / ^,%
ca - calcium
mg/I
Cd - Cadmium
m9/1
Chromium: Total
mg/I
Cu - Copper
Fe - Iron
mg/I
mg/I
ORGANICS: (by GC, GC/MS, HPLC) �
(Specify test and method #. ATTACH LAB REPORY[�T
Hg - Mercury
mg/I
Report Attached? %] Yes (1) ❑ No (0)
K - Potassium
mg/I
VOC = method # 6Ld0 B
Mg - Magnesium
mg/I
, method #
Mn - Manganese
mg/I
method #
Ni - Nickel
mg/I
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
runnmmo ue form n nl) rveme ana 1 ule - Flease print or type
GW-59 Rev.112007
signature of Permittee (or Authorized Accent) (Dale)
DJ
10

SUHMII- FUKM ON YELLOW PAPEK ONLY
• • PN IMENT ��t) VIRONMENTiB NATURAL RESOURCES'
GROUNDWATER QUALITY MONITORING: yQ(�Yn,��i�ORMATIO�(i'JY04�SSIN<3�UN4T
COMPLIANCE REPORT FORM t A't,IMA1 )SE` VGP) N RI`RAIEIGH, NC.'27699 1617, Phone.:°(919) 733=3221
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: ,my Pod'_P CA'p w.f-
Permit Name (if different):
Facility Address: _ IV gact re poA tit
Lt AM j (J1raa1) NC Count t
v Rrw�s�.,• K
(City) ''AA (5191") (zip)
A
Contact Person: r• QaNM:L Va kvAr Telephone#: 'bp ^ 6V/- 7Z78
Well Location/Site Name: No. of wells to be sampled: 7
PERMIT Number: Expiration Date:
Non -Discharge LVGt DOt7 /g6/ 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): Date sample collected: 17- `Z 3 FIELD ANALYSES:
Well Depth: 1—ft. Well Diameter: In, pH 53-units
Depth to Water Level: -)-Z ft. below measuring point Screened Interval; % ft. to 1-7 ft. Spec. Cond. _
Measuring Point is 2.1_ft. above land surface Relative M.P. Elevation: ft. Odor
Volume of water pumped/balled before sampling: _gallons Appearance _
Samples for metals were collected unfiltered: DYES ❑ NO and field acidified: ❑ YES ❑ NO
Date sample analyzed: q-1; - 94 4 . Y' 15 . Q - ZO -Z Laboratory Name: r-v ro F. 4 S
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
If WELL
Temp. 23.Y oC DRY at
µMhos time of
sampling,
Certification No. 5-9%
COD mg/I Nitrite (NO2) as N mg/I Pb - Lead mg/I
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I Zn - Zinc mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPN method for highly turbid samples)
OrthO hoS hate n/,� p p mg/I
Other (Specify Compounds and Concentration Units):
Dissolved Solids: Total 110 mg/I
AI - Aluminum
mg/I
pH (when analyzed)
units
Ba - Barium
mg/i
ADS = O. 9 P" a L.
TOC
mg/I
Ca - Calcium
mg/I
Chlorido
mg/l
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
ORGANICS: (by GC, GC/MS, HPLC)
Phenol
mg/I
Fe - Iron
mg/I
(Specify test and method # ATTACH LAB REPORT.)
Sulfate
mg/I
Hg - Mercury
mg/I
Report Attached? Y Yes (1) ❑ No (0)
Specific Conductance
µMhos
K - Potassium
mg/I
VOC : %VJD —,method # 6ta0 $
Total Ammonia
mg/I
Mg - Magnesium
mg/I
method #
(Ammonla Nitrogen; NH, as N; Ammonla Nitrogen, Total)
Mn - Manganese
mg/I
, method #
TKN as N
mg/I
Ni - Nickel
mg/I
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
GW-59 --Tl5e_v.1/2007

SUBMIT FORM ON YELLOW PAPER ONLY
ROUNDWATER QUALITY MONITORING:
OMPLIANCE REPORT FORM
Iran ITV 1A11-11n1111AT111P1 Please Print Clearly or
Facility Name: I-r"Igt—Y rQ04P CoMl'J»'fOw.�- GO�,ah.•+y
Permit Name (if different):
Facility Address: IV 1QQGiC%.sc eawe! y
Lw
- am (Sheol) NC 70 JPf f County RrL pr vi'e/�
(City) ''AA A R(Stele) (7,P)
A
Contact Person: r• oM":L Ala gjjj-- Telephonef/: �bp — ��• 7t78
Well Location/Site Name: No. of wells to be sampled:
91133-3221`
PERMIT Number: Expiration Date:
Non -Discharge WOt DDo /g6/ 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:
SAMPLING INFORMATION u
/y�
WELL ID NUMBER (from Permit): /nw- l
Date sample collected: ��%Z'�
FIELD ANALYSES:
If WELL
WAS
Well Depth: Z2• is ft.
Well Diameter: *_In.
pH 7- 4G units Temp. Z S• y °C
DRY at
Depth to Water Level: ft. below measuring point
/
Screened Interval: Z? U
to ft,
Spec, Cond. µMhos
time ofsampling,
Measuring Point is �• 1 ft. above land surface
•�_ft,
Relative M.P. Elevation: ft.
Odor
check
Volume of water pumped/balled before sampling: _gallons
Appearance
here: ❑
Sam les for metals were collected unfiltered: OYES ❑ NO
and field acidified: ❑YES El NO
late sample analyzed: IF B, K- 11,
qf-
ARAMETERS NOTE: Values should refl
COD
Coliform: MF Fecal
Coliform: MF Total
(Note: Use MPN method for highly turbid samples)
- W-73 Laboratory Name: EVr0 R. S
dissolved and colloidal concentrations.
Certification No. 591
mg/I Nitrite (NO2) as N mg/I Pb - Lead mg/I
-/100ml Nitrate (NO3) as N mg/I Zn - Zinc mg/I
/100ml Phosphorus: Total as P mg/I
Orthophosphate /\i_f) _mg/I Other (Specify Compounds and Concentration Units):
Dissolved Solids: Total 170 mg/I
Al -Aluminum
mg/I
pH (when analyzed)
units
Ba - Barium
mg/I
s 7 0.111 M IL
TOO
mg/I
Ca - Calcium
mg/I
Chloride
m0/1
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
ORGANICS: (by GC, GC/MS, HPLC)
Phenol
mg/I
Fe - Iron
mg/I
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate
mg/I
Hg - Mercury
mg/I
Report Attached? 5d Yes (1) ❑ No (0)
Specific Conductance
µMhos
K - Potassium
mg/I
VOC = NJ method # ;?CIO R
Total Ammonia
mg/I
Mg - Magnesium
mg/I
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese
mg/I
, method #
TKN as N
mg/I
Ni - Nickel
mg/I
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
Permitlee (or
Rev. 112007
- Please print or type
Signature of

GW-59A COMPLIANCE REPORT FORM Permit # 000 18`�
(Submit one each monitoring period with Gff-59 forms.)
1
Enter date monitoring results were due. O• Will this monitoring report (GW-59 and GW-59A)
YES
NO
be 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 we// 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 "Y'es ", contact the Regional Office for guidance.
Y
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
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).
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 "(ES", 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.
8
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 sutimltted jri.this ';7.
report (Compliance Report GIN-59A) Is true and complete to the best of my knowledge L
Qoyl•
Signature of Permittee (or Authorized Agent) Date
GW-59r1 12/8/2003

•
%Q, eurofins i
Environment Testing
ANALYTICAL REPORT
PREPARED FOR
Attn: Don Wells
Soil & Environmental Consultants PA
8412 Falls of Neuse Road
Suite 104
Raleigh, North Carolina 27615
Generated 9/28/2023 5:30:35 PM
JOB DESCRIPTION
Gregory Poole Equipment Co.
JOB NUMBER
680-240203-1

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