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
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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
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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