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HomeMy WebLinkAboutWQ0001048_Monitoring - 10-2023_20231204GW-59A COMPLIANCE REPORT FORM Permit #k4bcoiC49 (Submit one each monitoring period with GW-59 forms.) I Enter date monitoring results were due.( 1 Z3 ) Will this monitoring report (GW-59 and GW-59A) YES NO be submitted after the established due date? L 2 Was any required information missing on the GW-59 report forms? YES kO X 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. y 4 Are any monitored constituents equal to or above the established standards? 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: +.�52►� � Ic-i� -z3 �mmc���cc. t--���4•�rc�j��1 � �;�rr-t.�1L 11 1h (p-K -Z3 -b1u1 Chtom ur'Yl i � �� 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 pv_M constituent(s) exceeding standards, concentration(s) reported, and sample collection date for each occurrenc�_(for e last two years). 21 IJulI1 t ld-ZD TCC i1•Z2mWL i0 7L-ZI —166ICh cMIUm ZC, U I L i0-I�-22 }alb r�u� IQL9/L o� -n N W Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES N) x 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 mav sub'ect the permittee to a Notice of Violation fines, and/or penalties. 1 hC T0.- I e%� e It L]1 .rl fl t l 11') i)i �a (Nlz .A:j in nt: (for-t'�r e (t � ICI Grc;�r�+� I�frx z,v>et l r� r-C i I1 ,�rcl July, ZC✓iR .>j-t »✓hlghe�Cl�rDr� urn C a-)C=en 4a-140A_5 O N� h w9 rc__) qua wi�l+'�h� k�ej'-1c�(iL�(c41�y indvt�cmrDla✓.5 0 �c�+�i5I�u� „ PiC�w'Q-IAJ20 *6a�,s4c N O 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 herEpy aclCnoinrledge that the above irifoErrtatron was evaluated'and the mfQirrt7atio� submitted In tfis \\ report.(CompJia port GW-59q) is true and complete to tf�e'.best of my knowledge I- - Signature of Permittee (or Authorized Agent) Date GW-59A 12/8/2003 SUBMIT FORM ON YELLOW PAPER ONLY MILE=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 e or T Clearly t Cl i P Please Print Type FACILITY INFORMATION PERMIT Number: Expiration Date: Facility Name: Ccnt'ff4ntCA.,1116_D Non -Discharge ZajCr�r- 4,9 UIC NPDES I�Ca) 32Cj-)7 Other Permit Name (if different): 5 fGLnL� D Facility Address: Cl(�j� Lit � [� r r) � t(1 � IGf O �(*Q TYPE OF PERMITTED OPERATION BEING MONITORED (Str et) H County Pi � ❑ Lagoon ❑ Remediation: Infiltration Gallery (City) (state) (zip) ❑ Spray Field ❑ Remediation: Contact Person: (nLAc &-`f lik)(A )I C, Telephone#: Z�jl SLu L� ❑ Rotary Distributor Land Application of Sludge Well Location/Site Name: No. of wells to be sampled: �( _ ❑ Water Source Heat Pump ❑ Other: from Permit SAMPLING INFORMATION Ci If WELL WAS WELL ID NUMBER (from Permit): Date sample collected: Ir,-i�3- Z3 FIELD ANALYSES: Well Depth: qft. Well Diameter:7.in. pH 00400:4j- t. units Temp. 00010: zj °C DRY at Depth to Water Level 82546: O- 2 ft. below measuring point -, Screened Interval: 3 ft. to Q ft. Spec. Cond. 00094: µ time ofMhos sampling, Measuring Point is 7.15 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: nonf check Volume of water pumped/bailed before sampling: J gallons Appearance cl tan f here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: X YES ❑ NO LABORATORY INFORMATION A-)L Certification No. 10 Date sample analyzed: IC�-1� Z3 Laboratory Name: ;, Ay�I�� 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 < t /100mL Nitrate (NO3) as N 00620 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 -I /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 0(') mg/L Al -Aluminum 01105 mg/L pH (Lab) 00403 4•�G units Ba - Barium 01007 ug/L TOC 00680 13. q13 mg/L Ca - Calcium 00916 mg/L Chloride 00940 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 < 5 Q ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 CQ: CJ I 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? X Yes (1) ❑ No (0) Specific Conductance 00095 I J L. µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 1 • ('1 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3asN; 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 Pleas ePrint Clearly orType FACILITY INFORMATION PERMIT Number: Expiration Date: -31-ZC ^^ ,,� Non -Discharge V-jp ' j UIC Facility Name: ronf e FN > ct.- Mi )D NPD►�4ES fIC)a, l�D_i Other Permit Name (if different): + Zt-01- b- Facility Address: q(iD ( �1 I rL't# ���u�� TYPE OF PERMITTED OPERATION BEING MONITORED (Street) C Z�Fj County 214+ ❑ Lagoon ❑ Remediation: Infiltration Gallery (City) (State) (zip) ❑ Spray Field El Remediation: Person: Ci &1I l0_VJ C1L Telephone#: 75% 24-4) El Rotary Distributor Lq-Land Application of Sludge Contact YACJ Well Location/Site Name: 45 a r el CA ALi No. of wells to be sampled: (1 ❑ Water Source Heat Pump ❑ Other: from Permit SAMPLING INFORMATION WELL ID NUMBER (from Permit): I C) If WELL Date sample collected: FIELD ANALYSES: WAS Well Depth: ft. Well Diameter: Z in. pH 00000: q-� units Temp. 000lo: ZI °C DRY at time of Depth to Water Level 82546: I G ft. below measuring point Screened Interval: ft. to Mhos ft. Spec. Cond. 00094: <�j C> µ sampling, Measuring Point is __ft. above land surface Relative M.P. Elevation: ft. Odor 00085: Mile check Volume of water pumped/bailed before sampling: gallons Appearance Ci elaIr here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: 0 YES ❑ NO LABORATORY INFORMATION Date sample analyzed: I -Iq= Z3 I� LaboratoryName: LL` C�.�intA 1QL�( Certification No. I 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 < I /100mL Nitrate (NO3) as N 00620CJ 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 C) • G-) mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 5 1 mg/L Al -Aluminum 01105 mg/L pH (Lab) 00403 LA • �_ units Ba - Barium 01007 ug/L TOC 00680 7 mg/L Ca - Calcium 00916 mg/L Chloride 00940 2 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 d ug/L Grease and Oils 00552mg/L Cu - Copper 01042 <0•010 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 00945mg/L Hg - Mercury 71900 ug/L Lab Report Attached? Yes (1) ❑ No (0) Specific Conductance 00095< :5D µMhos K - Potassium 00937 mg/L VOC 7873 method # rilt'O S 7.L Total Ammonia 00610 0.13 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3asN; 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% C;I�a (I �,5 4'�1 5m,�k; tC� /D►��1.� i C-� f�iGl�cx.� �' 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 - 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 Clearly or Type PERMIT Number: Expiration Date. Facility Name: Non -Discharge LLQMj(QLrR UIC Permit Name (if different): Cliff�� - lt�-'J NPDES �37L)_) ) Other Facility Address: L) u_�, TQ ( i TYPE OF PERMITTED OPERATION BEING MONITORED - (l f - (street) Zv' County ❑ Lagoon ❑ Remediation: Infiltration Gallery (City) (state) (zip) ❑ Spray Field ❑ Remediation: Person: ��CICYII (- Telephone#: Z'1Z'�JZ4-U ❑ Rotary Distributor UlLand Application of Sludge Contact H IW Well Location/Site Name: U { j I� No. of wells to be sampled: Lp_ ❑ Water Source Heat Pump ❑ Other: from Permit SAMPLING INFORMATION WELL ID NUMBER (from Permit): ( 4 Date sample collected: L FIELD ANALYSES: If WELL WAS Well Depth: �q 1.1_ft• Well Diameter: Z in. pH 00400: • Z units Temp. 000lo: Zd °C DRY at Depth to Water Level 82546: ft. below measuring point _ g p Screened Interval: (� ft. to j �jft. Spec. Cond. 000sa: ?� µ Mhos time sampling, Measuring Point is _ft. above land surface Relative M.P. Elevation: ft. Odor 000m: cr, check Volume of water pumped/bailed before sampling: gallons Appearance Oo here:❑ Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: X YES ❑ NO LABORATORY INFORMATION Date sample analyzed: I0_ lq--Z3 Laboratory Name: IIJ,�C`I(it ilG1Iy� (2" Certification No. 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 C /100mL Nitrate (NO3) as N 00620 I 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 • G 5 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 5 Cl) mg/L Al -Aluminum ol1o5 mg/L pH (Lab) 00403 Jr. Z. units Ba - Barium 01007 ug/L TOC 00680 Z• 4'3 mg/L Ca - Calcium 00916 mg/L Chloride 00940 4 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 <ri.(5 ug/L Grease and Oils o0552 mg/L Cu - Copper 01042 <Q , O I C 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? lt� Yes (1) ❑ No (0) specific Conductance 00095 '�� µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 �< �j�j 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 - 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 Clearly or Type PERMIT Number: Expiration Date: Facility Name: eck_ Non -Discharge ( I((J4$ UIC Permit Name (if different): n+ -ne_o pq NPDES j2(j�-% Other Facility Address: j ob(1 Ln-) TYPE OF PERMITTED OPERATION BEING MONITORED i (street) 36 County t ❑ Lagoon ❑ Remediation: Infiltration Gallery (city) (state) Clip) El Spray Field El Remediation: tom' Person: jV Telephone#: 7�j7-5Zt{- J�f ❑ Rotary Distributor Land Application of Sludge Contact y�C-- Well Location/Site Name: Ink-f6(2Ct P / -� IQ IQ No. of wells to be sampled: El water Source Heat Pump El Other: from Permit SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): j d5 Date sample collected: FIELD ANALYSES: WAS Well Depth: ft. Well Diameter: L in. pH 00400: q.Cj units Temp. 000lo: Z °C DRY at Depth to Water Level 82546; u.-5 ft. below measuring point Screened Interval:�ft. to ft. Spec. Cond. 00094: �,5 _µ Mhos time of sampling, P 9, Measuring Point is Z 5 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: In on check Volume of water pumped/bailed before sampling: 15 gallons Appearance 1EZA , here:❑ Samples for metals were collected unfiltered: X YES ❑ NO and field acidified: ❑■ YES ❑ NO LABORATORY INFORMATION Date sample analyzed: is l ~L Laboratory Name: Xirt Analq} 4CCA`i Certification No. j 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 i /100mL Nitrate (NO3) as N 00620 <O, O4 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 cj. Ole mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 G mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 L}.�-{ units Ba - Barium 01007 ug/L TOC 00680 j 3 mg/L Ca - Calcium 00916 mg/L Chloride 00940 3 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002ug/L Chromium: Total 01034 I Z ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 <Q. (510 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? 16 Yes (1) ❑ No (0) Specific Conductance 00095 to's µMhos K - Potassium 00937 mg/L VOC 7873 method # 6-n L-L)_D Total Ammonia 00610 "' 3� 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 Clearly or Type PERMIT Number: Expiration Date: Facility Name: (j't(1te1`f�IC�.�is�1� Non -Discharge UIC Permit Name (if different): ta, NPDES M�CCC5ZC, Other /� Facility Address: G O(J l tJi l� r-si?(t_,b 1-0 � 4-0 TYPE OF PERMITTED OPERATION BEING MONITORED -t . (Street) Z -__S() County NI`+ ❑ Lagoon ❑ Remediation: Infiltration Gallery (City) (State) (zip) ❑ Spray Field ❑ Remediation: Contact Person: U'IUCL 6f`f11(p"11,0iC,IL Telephone#: Z�2-�jZ4- C� ❑ Rotary Distributor C4 Land Application of Sludge Well Location/Site Name: f. (b l'i Ml Flebt ICi No. of wells to be sampled: _ ❑ Water Source Heat Pump ❑ Other: from Permit SAMPLING INFORMATION WELL ID NUMBER (from Permit): ► Date sample collected: Z3 FIELD ANALYSES: If WELL WAS Well Depth: qft. Well Diameter: Z in. pH ooa00:� units Temp. 000lo: Z6 °C DRY at Depth to Water Level 82546: 3. (0 ft. below measuring point Screened Interval: � ft. to � ft. Spec. Cond. 00094: 5� µ Mhos time of sampling, Measuring Point is -Z• 3 3 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check Volume of water pumped/bailed before sampling: gallons Appearance (-I e-a Il' here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: X YES ❑ NO LABORATORY INFORMATION Date sample analyzed: 1O'Ig-Z3 Laboratory Name: i _ aq Q1 f-Tt ,4(lQ(S44-1 CGi Certification No. 1 �` 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 I /100mL Nitrate (NO3) as N 00620 C). oL4 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 Q. 13 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 '76 mg/L Al -Aluminum 01105 mg/L pH (Lab) 00403 U .g units Ba - Barium 01007 ug/L TOC 00680 3. mg/L Ca - Calcium 00916 mg/L Chloride 00940 3 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 19 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 < CjL7IC) mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730ug/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? K Yes (1) ❑ No (0) Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 O - 13 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3asN; 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% Cha(I>G� rn bm i)w� cY.-I� r - /D r naCa Permittee (or Authorized Agent) Name and Title - Please print or type UVV-by Kev. UU-of-zuio 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 Please Print Clearly or Type FACILITY INFORMATION PERMIT Number: Expiration Date: -!LC Facility Name: �'(li-Cfl�-1�LL�- M,�_D Non -Discharge (J C4 UIC NPDES 3�C�Z Other Permit Name (if different):��m to Facility Ad ress: q•W (,l�l jbn5 � TYPE OF PERMITTED OPERATION BEING MONITORED (I �,^ -C <13 (street) (�4C County i�'i , 44,(Z ❑ Lagoon El Remediation: Infiltration Gallery (City) (State) (zip) ❑ Spray Field ❑ Remediation: Contact Person: (�hiai`i I:�11)Ih1t�lC'IL Telephone#: ��j� ��t{�51� ❑ Rotary Distributor X Land Application of Sludge Well Location/Site Name: W 0� rl E�CJ I No. of wells to be sampled: _ ❑ Water Source Heat Pump ElOther: from Permit SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): Date sample collected: 1()-I19--Z3 FIELD ANALYSES: WAS Well Depth: I vyft. Well Diameter: in. pH ooaoo: 4.9 units Temp. 000lo: Z& °C DRY at Depth to Water Level 82546: 4• 3 ft. below measuring point Screened Interval: �J ft. to I 0 ft. Spec. Cond. 00094: 15D µMhos time ofsampling, Measuring Point is Z ft. above land surface Relative M.P. Elevation: ft. Odor 000es: i� check Volume of water pumped/bailed before sampling: h gallons Appearance d r here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: ❑■ YES ❑ NO LABORATORY INFORMATION Date sample analyzed: I & 15-z � Laboratory Name: r-lit A rIAIy�b CGL Certification No. � 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 L I /100mL Nitrate (NO3) as N 00620 <C„ C)u 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 I 1 d mg/L AI -Aluminum 01105 mg/L pH (Lab) 00403 Q 19 units Ba - Barium 01007 ug/L TOC 00680 . Di mg/L Ca - Calcium 00916 mg/L Chloride oosao j 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 0 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 C? µMhos K - Potassium 00937 mg/L VOC 7873 method # �51 �4ZWD� Total Ammonia 00610 6 A 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% �►�ri r,� r�- ���i-�1c�ic�T, �7�.�i c�-�'(lcv'b�q-�� Permittee (or Authorized Agent) Name and Title - Please print or type GW-59 Rev.06-07-2018 (2) Waypoint ANALYTICAL 114 OAKMONT DRIVE GREENVILLE, NC 27858 CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 28530 PARAMETERS Fecal Coliform (MIF), /100 Mls Ammonia Nitrogen as N, mg/l Ammonia Nitrogen as N, mg/l Nitrate Nitrogen as N, mg/l Total Organic Carbon, mg/I Chloride, mg/l Total Dissolved Residue, mg/l Total Chromium, ug/l Copper, ug/l Conductivity (at 25c), uMhos/cm Total Ortho-Phosphate as P, mg/l Drinking Water ID: 37715 Wastewater ID: 10 PHONE (252) 756-6208 FAX (252) 756-0633 ID#: 416 DATE COLLECTED: 10/18/23 DATE REPORTED : 10/27/23 REVIEWED BY: / 4r Well #9 Well #10 Well #14 Well #15 Well #17 Analysis Method Date Analyst Code < 1 < 1 < 1 < 1 < 1 10/18/23 HMV 9222D-15 1.67 0.53 10/23/23 BMD 350.1 112-93 0.13 0.35 0.13 10/24/23 BMD 350.1 112-93 <0.04 0.75 0.18 <0.04 0.04 10/19/23 ADR 353.2 112-93 3.83 3.25 2.48 13.79 3.38 10/24/23 BLV 531OC-14 3 2 4 3 3 10/23/23 ADR 4500CLB-11 M 70 M 51 M 50 M 92 M 75 10/19/23 HMV D5907-13 <5.0 5.0 <5.0 12 8 10/23/23 MTM EPA200.7 < 10 < 10 < 10 < 10 < 10 10/23/23 MTM EPA200.7 136 <50 78 65 59 10/19/23 BNC 251OB-11 0.04 0.07 0.05 0.06 0.13 10/19/23 BLV 450OPE-11 All 4C requirements were not met: M Blank result exceeded method constant weight criteria. Waypo*nt.�. ANALYTICAL 114 OAKMONT DRIVE GREENVILLE, NC 27858 CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 28530 PARAMETERS Fecal Coliform (NfF), /100 Mls Ammonia Nitrogen as N, mg/1 Nitrate Nitrogen as N, mg/1 Total Organic Carbon, mg/l Chloride, mg/l Total Dissolved Residue, mg/l Total Chromium, ug/1 Copper, ug/l Conductivity (at 25c), uMhos/cm Total Ortho-Phosphate as P, mg/1 Well #18 Analysis Method Date Analyst Code < 1 10/18/23 HMV 9222D-15 0.19 10/23/23 BMD 350.1 R2-93 <0.04 10/19/23 ADR 353.2 112-93 8.92 10/24/23 BLV 531OC-14 3 10/23/23 ADR 4500CLB-11 M 110 10/19/23 HMV D5907-13 <5.0 10/23/23 MTM EPA200.7 < 10 10/23/23 MTM EPA200.7 150 10/19/23 BNC 251OB-11 0.03 10/19/23 BLV 450OPE-11 Drinking Water ID: 37715 Wastewater ID: 10 PHONE (252) 756-6208 FAX (252) 756-0633 ID#: 416 DATE COLLECTED: 10/18/23 DATE REPORTED : 10/27/23 REVIEWED BY: All 4C requirements were not met: M Blank result exceeded method constant weight criteria. Waypoint `i' ANALYTICAL PHONE (252) 756-6208' FAX (252) 756-0633 114 OAKMONT DRIVE GREENVILLE, NC 27858 ACCT) CLIENT ID: 416 CLIENT: CMSD (SLUDGE & WELLS CONTENTNEA METRO. SEWAGE DIST. ANALYST: JAP MS. RENEE PRIDGEN DATE COLLECTED: 10/18/23 Page: 1 P.O. BOX 477 DATE REPORTED: 10/27/23 GRIFTON, NC 28/5J3300 BY: �lY' REVIEWED VOLATILE ORGANICS STD. METHODS 8260D Date Analyzed: 10/24/23 10/24/23 10/24/23 10/24/23 Well #14 Well #15 10/: 5/23 Well #17 Well #9 Well #10 PARAMETERS, ug/1 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 1. Benzene <0.50 <0.50 <0 50 <0.50 <0.50 2. Bromobenzene 3. Bromochloromethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 4. Bron ichloromethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 5. Bromoform <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 6. Bromomethane <0.50 <0.50 <0.50 <0.50 <0.50 7. N-Butylbenzene <0.50 <0.50 <0.50 <0.50 <0.50 8. Sec-Butylbenzene <0.50 <0.50 <0.50 <0.50 <0.50 9. Tert-Butylbenzene Carbon Tetrachloride <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 10. 11. Chlorobenzene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 12. Chloroethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 13. Chloroform <0.50 <0.50 <0.50 <0.50 <0.50 14. Chloromethane <0.50 <0.50 <0.50 <0.50 <0.50 15. 2-Chlorotoluene <0.50 <0.50 <0.50 <0.50 <0.50 16. 4-Chlorotoluene 17. Dibromochloromethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 18. 1,2-Dibromo-3-Chloropropane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 19. 1,2-Dibromoethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 20. Dibromomethane <0.50 <0.50 <0.50 <0.50 <0.50 21. 1,2-Dichlorobenzene <0.50 <0.50 <0.50 <0.50 <0.50 22. 1,3-Dichlorobenzene <0.50 <0.50 <0.50 <0.50 23. 1,4-Dichlorobenzene Dichlorodifluoromethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 24. 25. 1,1-Dichloroethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 26. 1,2-Dichloroethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 27. 1,1-Dichloroethene Cis-1,2-Dichloroethene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 28. 29. trans -1,2-Dichloroethene <0.50 <0.50 < 0.50 < 0.50 < 0.50 <0.50 < 0.50 <0.50 30. 1,2-Dichloropropane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 31. 1,3-Dichloropropane <0.50 <0.50 <0.50 <0.50 <0.50 32. 2,2-Dichloropropane <0.50 <0.50 <0.50 <0.50 <0.50 33. 1,1-Dichloropropene <0.50 <0.50 <0.50 <0.50 <0.50 34. Cis-1,3-Dichloropropene <0.50 <0.50 < 0.50 <0.50 <0.50 35. trans-1,3-Dichloropropene < 0.50 < 0.50 < 0.50 <0.50 < 0.50 36. Ethylbenzene 37. Hexachlorobutadiene < 0.50 <0.50 < 0.50 <0.50 <0.50 <0.50 <0.50 <0.50 38. Isopropylbenzene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 39. 4-lsopropyltoluene 40. Methylene Chloride <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 41. Naphthalene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 42. Propylbenzene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 43. Styrene 44. 1,1,1,2-Tetrachloroethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 45. 1,1,2,2-Tetrachloroethane <0.50 < 0.50 <0.50 <0.50 < 0.50 <0.50 46. Tetrachloroethene < 0.50 < 0.50 < 0.50 47. Toluene Waypol11t.Mvr ANALYTICAL 114 OAKMONT DRIVE GREENVILLE NC 27858 CLIENT ID; PHONE (252) 756-6208 FAX (252) 756-0633 416 CLIENT: CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. ANALYST: JAP MS. RENEE PRIDGEN DATE COLLECTED: 10/18/23 Page: 2 P.O. BOX 477 DATE REPORTED: 10/27/23 GRIFTON, NC 28530 REVIEWED BY: VOLATILE ORGANICS STD. METHODS 8_ 2 6 0D 10/25/23 Date Analyzed: 10/ 10/24/23 Well #10 10/24/23 10/24/23 Well #14 Well #15 Well #17 Well #9 PARAMETERS, ug/1 <0.50 <0.50 <0.50 <0.50 <0.50 < 0.50 < 0.50 <0.50 48. 1,2,3-Trichlorobenzene <0.50 < 0.50 <0.50 <0.50 <0.50 49. 1,2,4-Trichlorobenzene <0.50 <0.50 <0.50 <0.50 <0.50 50. 1,1,1-Trichloroethane <0.50 <0.50 <0.50 <0.50 51. 1,1,2-Trichloroethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 52. Trichloroethene <0.50 <0.50 <0.50 <0.50 <0.50 53. Trichlorofluoromethane <0.50 <0.50 <0.50 <0.50 <0.50 54. 1,2,3-Trichloropropane <0.50 <0.50 <0.50 <0.50 <0.50 55. 1,2,4-Trimethylbenzene <0.50 <0.50 <0.50 <0 50 <0.50 55. 1,3,5-Trimethylbenzene <0.50 <0.50 < 1.00 < 1.00 <1.00 56. Vinyl Chloride < 1.50 < 1.00 <1.00 <1.00 <1.00 58. Total Xylenes < 1.00 < 1.00 59. Methyl Tert Butyl Ether Wa point..`'" ANALYTICAL 114 OAKMONT DRIVE GREENVILLE, NC 27858 CLIENT: CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC/�30 REVIEWED BY: PHONE (252) 756-6208' FAX (252) 756-0633 CLIENT ID: 416 ANALYST: JAP DATE COLLECTED: 10/18/23 Page: 3 DATE REPORTED: 10/27/23 VOLATILE ORGANICS STD. METHODS 8260D Date Analyzed: 10/25/23 Well #18 PARAMETERS, ug/l < 0.50 1. Benzene <0.50 2. Bromobenzene <0.50 3. Bromochloromethane <0.50 4. Bromodichloromethane <0.50 5. Bromoform <0.50 6. Bromomethane <0.50 7. N-Butylbenzene <0.50 8. Sec-Butylbenzene < 0.50 9. Tert-Butylbenzene <0.50 10. Carbon Tetrachloride < 0.50 11. Chlorobenzene <0.50 12. Chloroethane <0.50 13. Chloroform <0.50 14. Chloromethane < 0.50 15. 2-Chlorotoluene < 0.50 16. 4-Chlorotoluene < 0.50 17. Dibromochloromethane <0.50 18. 1,2-Dibromo-3-Chloropropane < 0.50 19. 1,2-Dibromoethane < 0.50 20. Dibromomethane <0.50 21. 1,2-Dichlorobenzene < 0.50 22. 1,3-Dichlorobenzene < 0.50 23. 1,4-Dichlorobenzene <0.50 24. Dichlorodifluoromethane <0.50 25. 1,1-Dichloroethane <0.50 26. 1,2-Dichloroethane < 0.50 27. !,I-Dichloroethene < 0.50 28. Cis.1,2-Dichloroethene <0.50 29. trans- 1,2-Dichloroethene < 0.50 30. 1,2-Dichloropropane <0.50 31. 1,3-Dichloropropane 1-0.50 32. 2,2-Dichloropropane < 0.50 33. 1,1-Dichloropropene <0.50 34. Cis- 1,3-Dichloropropene <0.50 35. trans -1,3-Dichloropropene <0.50 36. Ethylbenzene < 0.50 37. Hexachlorobutadiene < 0.50 38. Isopropylbenzene <0.50 39. 4-Isopropyltoluene < 0.50 40. Methylene Chloride <0.50 41. Naphthalene <0.50 42. Propylbenzene <0.50 43. Styrene 44. 1,1,1,2-Tetrachloroethane < 0.50 <0.50 45. 1,1,2,2-Tetrachloroethane <0.50 46. Tetrachloroethene <0.50 47. Toluene Waypoint 1%w ANALYTICAL 114 OAKMONT DRIVE GREENVILLE, NC 27858 CLIENT: CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 285 0 REVIEWED BY: PHONE (252) 756-620E� FAX (252) 756-0633 CLIENT ID: 416 ANALYST: JAP DATE COLLECTED: 10/18/23 Page: 4 DATE REPORTED: 10/27/23 VOLATILE ORGANICS STD. METHODS 8260D Date Analyzed: 10/25/23 Well #18 PARAMETERS, u9/1 48. 1,2,3-Trichlorobenzene < 0.50 < 0.50 49. 1,2,4-Trichlorobenzene < 0.50 50. 1,1,1-Trichloroethane <0.50 51. 1,1,2-Trichloroethane < 0.50 52. Trichloroethene < 0.50 53. Trichloronuoromethane <0.50 54. 1,2,3-Trichloropropane <0.50 55. 1,2,4-Trimethylbenzene < 0.50 56. 1,3,5-Trimethylbenzene < 0.50 57. Vinyl Chloride < 1,00 58. 59. Total Xylenes Methyl Tert Butyl Ether < 1.00