WQ0000185_Monitoring - 11-2023_20231231 (3)

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * November
Report Information
Type *
GW-59
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
WQ0000185
Ocean Sands WWTP
Year:* 2023
Upload Document*
Ocean Sands GW59_12312023122237.pdf 2.58MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Rod. [e-mail]
Rod Holley
Reviewer: Wanda.Gerald
12/31 /2023
This will be filled in automatically

Is the project number correct?* W00000185
Is the monitoring report accepted?* Yes NO
Regional Office* Washington
Reviewer: _anonymous
Review Date: 1/24/2024

GW-59A COMPLIANCE REPORT FORM Permit # Ill! c7c7� !�S
(Subunit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due.( 1 )3- Z 3) Will this monitoring report (GW-59 and GW-59A)
be submitted after the established due date?
YES
NO
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 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
identification plate, area overgrown, etc.)? If the answer is "Yes ", contact the Regional Office for guidance.
YES
UO
4
Are any monitored constituents equal to or above the established standards?
YE
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)
exceedin standards in the space provided below: m J ..7 W -
rn tn; - �j� w -s rv►= i 0 S S y3 ; Ip s- 5 y
TOS 527 ,Os - 5/0 i0S -'5i0 '
/1(1Q -I /y /4 - 1 � - ,5 - 31,1 N 11f3 -2. b N � � 3 - -5,
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same well(s) in the last two years?
S
NO
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, concentrations) reported, and sample collection date for each occurrence (for the last two years).
mw-q Ml^) �_ mW-tom Mw-7 rn_=
-
iiJS iAS N1 3 N143
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 may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells may be improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
YESI
NO
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 may subject the Dermittee to a Notice of Violation
fines, and/or penalties. 1 �
�p Co �'INt1IN� �JL2�C. dtV �� to/5
9 I,c.AA 4 C F-- Q �- P 1 H-ry Pczz y2►7m f-A, 4 � C.o -ZQ,6 rX V OV 5
S" cl 1 kA aS$—CV/JA , la c Od' JAydK�st L)i1 Gap
-ltl� �-. a, m N 1002 .tN ;Aoiu C.012elp o orvs <
y
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 submitted in this
report (Compliance Report GW-59A) is true and complete to the best of my knowledge.
4 A �L V�� / ?— /Z YL IZ3
Signature of Permittee (or At orized Agent) Date
GW-59A 12/8/2003

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITYtNFORMATIONPROCESSING UNIT
COMPLIANCE REPORT FORM
�
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Rhone: [phone]
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Corolla NC 27927 County Currituck
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump X Other: Infiltration
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW4
Date sample collected: 11/9/23
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft,
Well Diameter: 3 in.
pH 00400: 7.4 units Temp. 000lo: 23.9 °C
DRY at
Depth to Water Level 82546: 10.3
p ft. below measuring
point Screened Interval: 12 ft.
to 17
ft. Spec. Cond. 00094: µ Mhos
time of
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085: None
sampling,
check
Volume of water pumped/bailed before sampling:
4.5
gallons
Appearance Tan
here:
Ll
Samples for metals were collected unfiltered: © YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:l1/9/23
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 <0.02
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 4.96
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 517
mg/L
Al - Aluminum ollo5
mg/L
pH (Lab) 00403 7.4
units
Ba - Barium 01007
ug/L
TOC 0068o 5.9
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 194
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 78732: method #
Total Ammonia 00610 18.6
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%
Rod Holley
Permittee (or Authorized Ag(Tnt) I
GW-59 Rev.2/2010
Wastewater Superintendent Trainee
me and Title - Please print or type
Signature of Permittee (or

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT 8 NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY4NFORMATION PROCESSING UNI[T
COMPLIANCE REPORT FORM
�1617
MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
Permit Name (if different):
NPDES Other
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Corolla NC 27927 County Currituck
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑■ Other: Infiltration
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW5
Date sample collected: 11/9/23
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400. 7.2 units Temp. 000lo: 23.7 °C
DRY at
Depth to Water Level 82546:6.2 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. o0094: µMhos
time
sampling,
Measuring Point is 2 ft. above land
surface
Relative M.P. Elevation:
ft. Odor 00085: None
check
Volume of water pumped/bailed before sampling: 5.0
gallons
Appearance Clear
here: ❑
Samples for metals were collected unfiltered:
RI YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11 /9/23
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 0.06
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 3.42
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 703oo 510
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 7.2
units
Ba - Barium 01007
ug/L
TOC 0068o 8.5
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 214
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 78732: method #
Total Ammonia oo6lo 18.5
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%
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
ittee (or Authorizep Agent)
12/28/23
(Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DSPARTMENTOF,ENVIRONMENT &,NATURAL RESOURCES ;:
GROUNDWATER QUALITY MONITORING:
oivi§ioty OF.:INAT@Rai.A�UT`YaNFORMATIOo PRbC�SSiNG°.uNrr ,.,.
COMPLIANCE REPORT FORM
• •
1fi17 MAIL SERVICE, CENTER, RALEpH, NC 2709A617 Ptiorle _(979), 733 32,21
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
El Lagoon ❑Remediation: Infiltration Gallery
Corolla 5'` '" NC 27927 County Currituck
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#. [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump ■❑ Other: Infiltration
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW6
Date sample collected: 11/9123
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.6 units Temp. 000lo: 23.2 °C
DRY at
Depth to Water Level 82546:7.2 ft. below measuring
p g point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. oo0s4: µ Mhos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: None
check
Volume of water pumped/bailed before sampling:
3.5
gallons
Appearance Clear
here: ❑
Samples for metals were collected unfiltered: © YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:11/9123
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead olo5i ug1L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 <0.02
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 4.37
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 703oo 510
mg/L
Al - Aluminum oilo5
mg/L
pH (Lab) 004o3 7.6
units
Ba - Barium oioo7
ug/L
TOC 0068o 6.5
mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 192
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
ugll_ (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug1L Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia oo6io 31.1
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn -Manganese o1a55
uglL ,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports)
Influent Total VOCs
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
mg/L
Effluent Total VOCs:
mg/L
VOC Removal%
GW-59 Rev.2/2010

SHRMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: Ocean Sands
Permit Name (if different):
Facility Address: 741 Ocean Trail
Corolla
Contact Person: Rod Holley
Well Location/Site Name: Ocean Sands
NC
Please Print Clearly or Type
27927
County Currituck
Telephone#: [phone]
No. of wells to be sampled: 5
WELL ID NUMBER (from Permit): MW7 Date sample collected: 11/9/23
Well Depth: 17.6 ft. Well Diameter: 3 in
Depth to Water Level 82546:5•2 ft. below measuring point Screened Interval: 12 ft.
Measuring Point is 2 ft. above land surface Relative M.P. Elevation:
Volume of water pumped/bailed before sampling: 5.0 gallons
Samples for metals were collected unfiltered: W] YES ❑ NO and field acidified: ❑ YES
DEPARTMENT OF ENVIRONMENT 8, NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
PERMIT Number: W00000185 Expiration Date: 6/30/2024
Non -Discharge 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 X Other: Infiltration
to 17 ft
ft.
FIELD ANALYSES:
pH 00400: 7.8 units
Spec. Cond. 00094:
Odor 00085: None
Appearance Clear
WAS
Temp. 000lo: 22.8 oC DRY at
µMhos time of
here: ❑
Date sample analyzed:11/9/23
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 0.02
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 1.50
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 1.33
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 703oo 543
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 7.8
units
Ba - Barium 01007
ug/L
TOC 0068o 6.1
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 233
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 78732: method #
Total Ammonia 00610 2.6
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 I otal VUCs: mg/L vu�, Kemoval7o
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Aqent) Name and Title - Please print or type
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
MEMEMDEPARTMENT
bF ENVIRONMENT &NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY4NFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2024
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Corolla NC 27927 County Currituck
❑ Spray Field ❑ Remedlatlon:
Contact Person: Rod Holley
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump N Other: Infiltration
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW9
Date sample collected: 11/9/23
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.1 units Temp. 000lo: 21.5 °C
DRY at
Depth to Water Level 82546:7.1 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 000sa: µMhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: None
check
Volume of water pumped/bailed before sampling:
5.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: 0 YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:ll/9/23
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31516 <1
/100mL
Nitrate (NOA as N 00620 0.75
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 1.82
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 703oo 508
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 7.1
units
Ba - Barium 01007
ug/L
TOC 0068o 4.7
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 200
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)
pecific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia 000lo 3.6
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:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
Totalmg/L Effluent
iplete, and that the laboratory analytical data
possibility of fines and imprisonment for knc
vlllllr
mg/L VOC Removal%
12/28/23
(Date)
GW-59 Rev.2/2010