HomeMy WebLinkAboutWQ0000185_Monitoring - 12-2023_20240131Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * December
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_01312024164407.pdf 265.63KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Rod. Holley@CurrituckCountyNC.gov
Rod Holley
Reviewer: Wanda.Gerald
1 /31 /2024
This will be filled in automatically
Is the project number correct?* WQ0000185
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 2/1/2024
GW-59A COMPLIANCE REPORT FORM Permit # 00 0000 / eV
(Submit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due, - 3 - 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
O
1F 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 Ojjicefor guidance.
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. b m M W c�
�t'r{fig -'Iy i �Z N7,q 7fls - b6Z - _ SNZ
3r
41tA3- 1"7. Z ®Jl� - J'�l.a N�3- l � b fV Y43 - S.Z
5
For the constituents identified in question 4above, 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).
ftW -y -s mw -
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 may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELYFOR 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
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 maybe_
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 subiect the permittee to a Notice of Violation,
fines, and/or penalties. F, 2, m A0,711 his otn,Ja p— /1
`� fttw'��{.� �ILi,gl imrn;,.l� co c f IV C� Gai, �r`rvY uf
cow. �2
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10/ctT
r S g rr Ttf'if? CAi n `�`p2 �rlc ��� rv9tl 2f! 1 rJi
P
soma P
g
The gerson completing this portion (GW--59A) of the monitoring report should sign below and submit this
form with G W-59 forms for required wells to the address provided at the top of the current G W-59 form.
°I hereby acknowledge that the above information was evaluated andthe information submitted in this
rep;;ort (Compliance Report GW 59A) is trtae and complete to the best of my knowledge.
)- 29 z V
Signature of Permittee (or Aut rized Agent) Date
GW-59A 12/8/2003
SUBMIT FORAM ON YELLOW PAPER ONLY
•
OEPARTMENTOP ENVIRONMENT-'8 NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617,MA(I SERVICE'CENTER; RALEIGH NG 27699-�617 'Phone (919)733 322,1 ;<
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
Corolla (Street) NC
27927 CountyCurrituck
El Lagoon El Remediation: Infiltration Gallery
(city) (Slate)
(zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑11 Other: Infiltration
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW4
Date sample collected: 12/12/23
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.4 units Temp, ortom 18.5 °C
DRY at
Depth to Water Level 82546:12.2 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point is 2 ft, above land surface
Relative M.P. Elevation:
ft. Odor o0085: None
check
Volume of water pumped/bailed before sampling:
4.5
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: R1 YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:12/12/23
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 ug1L
Coliform: MF Fecal 31616 2
/1 OOmL
Nitrate (NO3) as N 00620 0.13
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 6.21
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 614
mg/L
Al - Aluminum o1105
mg/L
pH (Lab) 00403 7.4
units
Ba - Barium 01007
ug/L
TOC 00660 5.0
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 188
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 0061017.2
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:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
mg/L Effluent Total VOCs:
Signature of Permittee (or
mg/L VOC Removal%
1 /29/24
GW-59 Rev.212010
SUBMIT FORM ON YELLOW PAPER ONLY
. .•
DEPARTMENT OP ENVIRONMENT &NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
•.
•
•
DIVISION OF WATER QUALITY INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617,MAICZERVI,CE CENTERf RALEIGH,=NC 27659,1617 Phone (919), 33-3221; „
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
El Lagoon ❑ Remediation: Infiltration Gallery
Corolla Istmet) NC 27927 CountyCurrituck
(cfty) (stale)
(zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No, of wells to be sampled: 5
❑ Water Source Heat Pump IN Other: Infiltration
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW5
Date sample collected: 12/12/23
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.3 units Temp. 000to: 17.6 °C
DRY at
Depth to Water Level 82546:5.7 ft. below measuring point Screened Interval: 12 ft. to
17
ft. Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: ft.
Odor 000m: None
check
Volume of water pumped/bailed before sampling:
5.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:12112/23
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 31616 <1
/100mL
Nitrate (NO3) as N 00620 0.08
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 2.55
mg1L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 542
mg/L
Al - Aluminum o11o5
mg/L
pH (Lab) 00403 7.3
units
Ba - Barium 01007
ug/L
TOC oo68o 6.6
mg/L
Ca - Calcium oo916
mg/L
Chloride 0094o 213
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
ug1L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia 0061014.0
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug1L
, method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug1L
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
GW-59
Rev. 2/2010
mg/L Effluent Total VOCs:
mg/L
VOC Removal%
SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT,OF ENVIRONMENT;& NATURAL RESOURCES -
GROUNDWATER QUALITY MONITORING:
•
•N
DIVISIO OF WATER QUALITY INFORMATION PROCESSING UNrr
COMPLIANCE REPORT FORM
1617 MAILSERVICE CENTER RALEIGH N,C 27fi99,1617,
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
Corolla (Slreot) NC
27927 CountyCurrituck
El Lagoon ❑ Remediation: Infiltration Gallery
(city) (Slate)
(zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump IN Other: Infiltration
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW6
Date sample collected: 12/12/23
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400; 7.4 units Temp. 000lo: 17.1 °C
DRY at
Depth to Water Level 82546:6.7 12
p ft. below measuring point Screened Interval: ft.
to 17 ft. Spec. Cond. 000s4: !A Mhos
time of
sampling,check
Measuring Point is 2 ft, above land surface
Relative M.P. Elevation:
ft. Odor 00085: None
Volume of water pumped/bailed before sampling:
3.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered; RI YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:12/12/23
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 uglL
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 2.49
mg/L Zn - Zinc olo92 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 5.72
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7030o 483
mg/L
All -Aluminum o11o5
mg/L
pH (Lab) 00403 7.4
units
Ba - Barium 01007
ug/L
TOC 00680 4.5
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 193
mg/L
Cd - Cadmium 01027
uglL
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
uglL Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia 00610 17.9
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NHaas N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
uglL method #
TKN as N 00625
mg/L
Ni - Nickel 01067
uglL method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify,tbat, to the best of my knowledge and belief, the informationsubmitted in this report is true accurate and complete, and that the laboratory analytical data was produced using approved methods of analysis by a
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
Rod Holley Wastewater Superintendent Trainee E10 1�,
Permittee (or Authorized Agent) Name and Title - Please print or type Signature of Permittee (or
1 /29/24
Agent) (Date)
GW-59 Rev.2/2010
SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL, -,,RESOURCES"`
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY INFORMATION PROCESSING UN1T
COMPLIANCE REPORT FORM
1617 iMAIL SERVICE CENTER, RALEIGH, NC,2769,9 fi17 Phone ,(9!8) 7333221 ;', _"
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
Corolla (street) NC
27927 CountyCurrituck
El Lagoon El Remediation: Infiltration Gallery
(city) (stale)
(zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
❑ 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): MW7
Date sample collected: 12/12/23
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.2 units Temp. 0oolo: 16.9 °C
DRY at
Depth to Water Level 82546:4.4 ft. below measuring point Screened Interval: 12 ft. to
17
ft. Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point is 2 ft, above land surface
Relative M.P. Elevation: ft.
Odor 000s5: None
check
Volume of water pumped/bailed before sampling:
4.5
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:12112/23
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 o1051 ug1L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 1.86
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/10omL
Phosphorus: Total as P 00665 1.37
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 703o0 562
mg/L
AI - Aluminum 01105
mg/L
pH (Lab) 00403 7.2
units
Ba - Barium 01007
ug/L
TOC oos8o 5.6
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 215
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)
pecifc Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia 00610 1.6
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:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Anent) Name and Title - Please print or type
mg/L
Effluent Total VOCs:
mg/L
VOC Removal%
GW-59 Rev.2/2010
SUBMIT FORM ON YELLOW PAPER ONLY
pEPARTMENT OF ENVIRONMENT &NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:andl
copy to:
DIVISION OF WATER QUALrrY INFORMATION PROCESSING 11NIT
COMPLIANCE REPORT FORM
1617 MAID SERVICE CENTER RALEIG,H ,NC 2i699,1§17 t?hone„{919) 7333227
FACILITY INFORMATION
Please Print
Clearly or Type
PERMIT Number: W00000185 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 (street) NC 27927 County Currituck
(City) (Stale)
(zip)
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: 252-232-6065
❑ 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): NtW9
Date sample collected: 12/12/23
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.2 units Temp. 000lo: 16.8 °C
DRY at
Depth to Water Level 82546:6.5 ft. below measuring point Screened Interval: 12 ft.
to 17
ft. Spec. Cond. 00094: µMhos
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:
5.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: I1 YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:12112/23
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 o1o5t ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 0.47
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P o0665 1.92
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 542
mg/L
Al - Aluminum o11os
mg/L
pH (Lab) 00403 7.2
units
Ba - Barium 01007
ug/L
TOC 0066o 4.6
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 199
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
uglL
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 00610 3.2
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 Aqent) Name and Title - Please print or type
GW-59 Rev.212010
mg/L
Effluent Total VOCs:
mg/L
VOC Removal%