WQ0018708_GW Monititoring_20101229

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SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FLQiLITY fNFORMATiON Please Print clearly or Type
Facility Name A v % <e /i} <<S
Permit Name (if differe t):
Facility Add(e sS: 3-3 &, f3 A c4 � s a_
Count
Co217.
ntact Person: SE-40 !-nf Telephone
Well Location/ Site Name Tl� �. No. of Wells to be Sampled: /_
Well Identification Number (from Permit): 4 For Groundwater Treatment Systems
'Well Depth: -2 $, T — ft. Well Diameter: z " in, Check One: ❑ Influent (98)
~
Screened Interval: Q Effluent 99
Depth to Water Level:ft. below measuring point. n ( ) Measuring Point (M.P.) is: It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: �d49 Date sample collected: 11,21- 10
Field analysis: pH--- �r s � , Specific Conductance' uMhos
Temp./-._ .6_._-°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAiL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge W!? UIC
NPDES —
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field -- - Remediation: - — --
Rotary Distributor Land Application of Sludge
Other:
NQTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: // a9-- -'
Laboratory Name:
Certification No. s1 �.
PARAMETERS- (Samples for metals were collected unfiltered- YES
NO and field acidified
COD
Coliform: MF Fecal 41
mg/l -
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/1
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as Pr mg/1
(Note: use MPN method for highly turbid samples)
Dissolved Solids: Total 4 y,0-
mg/I
Orthophosphate
Al -Aluminum
mg/I
Mg/1
pH (when analyzed)
units
Ba - Barium
mg/l,
TOC /, L
mg/I
Ca - Calcium
mg/I
Chloride
mg/I
Cd - Cadmium
" -� +',` mg/I
Arsenic
mg/I
Chromium: Total
- mg/I
Grease and Oils
Mg/I
Cu - Copper A-02011
mg/l
Phenol
mg/I
Fe - Iron
- mg/I
Sulfate
m 9 /I
H - Mercu rY �r'` �````: '� `�: n '� �n�Y m /l
9 -�;- --�- -� 9
Specific Conductance
uMhos
K - Potassium
mg/l
Total Ammonia 4'.', 2 0
mg/I
Mg - Magnesium
mgll
TKN as N
mg/1
Mn - Manganese
mg/I
YES NO)
Ni - Nickel mg/l
Pb - Leari mg/I
Zn - Zinc mg/i
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes —(I) No (0)
VOID : method # =
method # =
method ff
GW-59

UBMIT'FQRM�QN,
GROUNDWATER QUALITY MONITORINGA 6YIA;ll Silo 3 �(
COMPLIANCE REPORT FORM
FACILITY INFORMATION PleasF��tn'f �lrrc'�yr�rnv'�'Lurnt,c
Facility Name: /4
Permit Name (if differe t);
Facility Address:-- AIIQ
(Strcei} Pre
,a a <''s <& I "rf County d�
aly) Isi lzio}
Contlact Person: Telephone #: 9/.O' w `!
Well Location/ Site Name: Il No. of Wells to be Sampled:,,__ -"
� /-_,,,
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: 7_1 `I ft. Well Diameter 2. in. -CheckOne: 0 Influent (98)
Screened Interval: ft. to ft. [j Effluent (99)
Depth -to Water Level: _ 7. 0 ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 14 1?— Date sample collected:
Field analysis: pH Specific Conductance uMhos
Temp.. 16-2 °C, Odor Appearance
ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: t EXPIRATION DATE:
Non -Discharge 574, s- UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NQ E;, Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 3 g' i�'
Laboratory Name:4/4C'r R'
Certification No. 4�4 2 L
PARAMETERS (Samples for metals were collected unfiltered YES NO and field Acidified
COD mg/l Nitrite (NO2) as N � mg/I
Coliform: MF Fecal < 1 /100ml . Nitrate (NO3) as N 4 • `1 mg/I
Coliform: MF Total /100ml PhosDhorus: Total as P /_ . o S- mnll
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total Yo
mg/I
pH (when analyzed)
units
TOC 1� 73
mg/I
Chloride _ �,
mg/I
Arsenic
mg/I
Grease and Oils'
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia _ _
mg/I
TKN as N
mg/I
.-Y
Orthophosphate
mg/I,
Al - Aluminum
mg/l
Ba - Barium '
mg/I. -
Ca - Calcium '
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron __-_
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/i
YES NO)
Ni - Nickel
rng/I
Pb - Leac
mg/I
Znz-,Zinc r ' '
mg/I
'-Ammonia-'(Vitrogen-
mg/I
Ott- r ( peci %mpounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes . (1) No (0)
VOC ; method # =
method #
or rype
method'# =

413MIT PQR ON1,.YEL OW P
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM FN12_Gnv�rrintt
FACILITY INFORMATION '�"'c
Facility Name: 4 v ,-e- /4 /C,$
Permit Name (if differed*_
Facility Address:— 3 .3 � • `i 1
-a& ee I( N, (Street) d+.0 � / County
_.
(City) (Sla hP)
Contact Person: Slaes�°°� a�"���. _ Telephone #: 4/ca- L/32..
Well Location/ Site Name: No. of Wells to be Sampled: L/ , __
Well Identification Number (from Permit): sb// For Groundwater Treatment Systems
Well Depth: IF; d"S'— ft. Well Diameter.. in. Check 0ne: ® Influent (98)
Screened Interval: ,s—ft. to It. ® Effluent (99)
Depth to Water Level: _—ft. below measuring point.
Measuring Point (M.P.) is: - ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: /,0 2 Date sample collected: 3 -
Field analysis: pH Liz K , Specific. Conductance' ' uMhos
Temp. 14, i °C, Odor Appearance
ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non-Discharge_C-) 1 0,31 57-5� V UIC
' NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and.
colloidal concentrations.
Date sample'analyzed:
Laboratory Name:
Certification No.
PARAMETERS (Samples for metals were collected unfiltered YES
NO and field acidified
COD
mg/I -
Nitrite-(NO2) as N ,
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
- .-, S-7 mg/I
(Note: Use MPN method for highly turbid samples)
`4',
Orthophosphate
mg/I
Dissolved Solids: Total
mg/l
Al - Aluminum
mg/I
pH (When analyzed)
units
Ba - Barium
mg/I.
TOC L IV
mg/I
Ca - Calcium
mg/I
Chloride J
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/1
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron`
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium
mg/I
TKN as N ___
mg/I
Mn : Manganese
mg/I
YES NO)
Ni - Nickel
mg/I
Pb - Lead
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen - Y 2
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method #
method #
GW-5

GROUNDWATER QUALITY MONITORIN
COMPLIANCE REPORT FORD
FACILITY INFORMATION
Facility Name: 0
Permit Name (if differe
Facility Address:
Contact Person:?
Well Location/ Site
A A,.p
n;goP) ,5
f°ir�t "'"'
OFFICE
S &P KSA,. E�ede- 1,2d.
(Sireetj e_o C_ I ry County 9 1r�
�L�
(S�a (zip) �y
Telephone #:`�-
�1 No, of Wells ,to be Sampled: „ e
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: P' '07, 3 it. Well Diameter, in. Check One: 0 Influent (98)*
Screened Interval: ft. to ft. ® Effluent (99)
Depth to Water Level: 7 & ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: rDate sample collected: s-o
Field analysis: pH - & 2- , Specific Conductance ' uMhos
Temp./ r f , °C, Odor Appearance
ONLY
'DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge -� �� �� s- UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray -Field Remediatlon:
Rotary Distributor Land Application of Sludge
Other: -----
NUj�j Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
Laboratory Name: —
Certification No.
PARAMETERS (Samples for metals were collected unfiltered YES
NO and field acidified
COD
mg/I -
Nitrite (NO2) as N
mg/I
Coliform: NIF Fecal /
/� OOmI
Nitrate (NO3) as N
6 mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P_
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total ?
mg/1
Al - Aluminum
mg/I
pH (when analyzed)
units
Ba - Barium
mg/I. ,
TOC
mg/I
Ca - Calcium
mg/I
Chloride 7_0
mg/l
Cd --Cadmium
mg/I
Arsenic
mg/l
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
YES NO)
Ni - Nickel
rng/l
Pb - Lead
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen 4_ . a mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC;GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes —(I) No (0)
VOC : method # =
method # =
method # =
4 GW-5 _ - - -

. 17 ra.
JBMIT FORM ON
GROUNDWATER QUALITY MOMTORINGe
COMPLIANCE REPORT FORM DEIti'R�fAYEfiEViLLEREGIONALOFFi%r
FACILITY INFORMATION Please Print Clearly or Type
Facility Name:
Permit Name (if diffe
Facility Address:....._
Contact Person: -1
Well Location/ Site
/4 /k-'p
(Sheet( s F�` County y
Telephone It: 9/0-ja�f �-
�^- �! No. of Wells to be Sampled: ,,__
PAPER ONLY
Well Identification Number (from Permit): 4.Q 1/ '�" 3 For Groundwater Treatment Systems
WeII.Depth: L V 9 ft. Well Diameter: __-__ in. Check One: O Influent (9'm;
Screened Interval: ft. to ft. ®Effluent (99)
Depth -to Water Level: it, below measuring point.
Measuring Point (M.P.) is: ft. above land surface.Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: //; J_ Date sample collected:
Field analysis: pH L I - _Specific Specific Conductance ' uMhos
Temp./ •®2- °C, Odor Appearance
_i®
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #:
EXPIRATION DATE - 32
-Non-Discharge e,>Q
UIC .
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon
Remediation: Infiltration Gallery
Spray Field
Remediatlon:
Rotary Distributor
Land Application of Sludge
Other:
NQTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name:
Certification No.
PARAMETERI (Samples for metals were collected unfiltered YES
NO and leld acidified
COD
mg/I '
Nitrite (NO-2) as N
mg/I
Coliforrn: MF Fecal I
A 00ml
Nitrate (NO3) as N
e. ® Z mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as
P . /3 mg/I
(Note: Use MPN method for highly turbid samples)
7
Orthophosphate
mg/I
Dissolved Solids: Total
mg/I
Al - Aluminum
mg/l
pH (when analyzed)
units
Ba - Barium
mg/l.
TOC - >
mg/l
Ca - Calcium
mg/l
Chloride 7
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/l
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance
-uMhos
K o Potassium
mg/l
Total Ammonia
mg/I
Mg - Magnesium
mg/I
TKN as N __ - _ _
mg/I
Mn - Manganese
mg/I
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen Z. z e mg/1'
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC) --,
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method #
method -# =
method # =

N
Will his monit_o,ring_______
i=nter date monitoring results were due. ( t , 'report (GVV-59 and GVV-59A)
be submitted after the established due date?
YES.
iepl
a.s any required information missing oil t'll.c (;W-59 report fornis! W
IF the answer to question 1 or 2 is "YES" list in the space provided below Me weft identification nuinber(s) and
2
ES
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of'repair or maintenance ((I.1111:10'ed casing, unlocked or missing cap,, missing Go
identification plate, area overgrown, etc.)? I/ i1j, ".
YES
NO
es co".1act Ihe
4,
Are any monitored constituents equal to or —above theestablished—stand--
rds?
YES
N
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 will? constituent(s) and concentration(s)
i exceeding standards in the space provided below:
I 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
YES
NO
years?
If the answer to question 5 is "NO", skip to sectioTi
If the answer to question 5 is "YES", list in the space provide(] below. each v.!ell with constituent(s) exceeding
standards, concentration(s) reported. and sample collection, date for
each occurrence (for the last two years).
G,
Are the monitoring wells listed in section 5Tc�A`ated at or beyondthethe review boundary?
YES
YES JS
NO
lem may be occurring. &ONTj&_ '
If the answer is "YES", a groundwater qu'ality p_rob­_­_.__— CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO". monitoring wells may be improperly
located; contact the Regional Office.
Is the permittee implementing previously a--pp-roved actions required by the Division involving this
YES
NO
40
groundwater quality problem?
If the answer to question —7is "YE-S—",.-d—e-s—cri-b.-e—those actions it) 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 subject the permittee to a Notice of Violation,
fines, and/or penalties.
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.
'SCdnatljrp of Pprmittpp fr%r A11th—i—A A­fl

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATE13 QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFQRMATION Please Print Clearly or Type
Facility Name: 08,4 V e,c e- /4 ��ft
Permit Name (if differe t)
Facility Address: 3 3 40. f3 A �t t i S C_
Shorn
,a ��-t / Prom) c�T— �.ir`izIP County !
lc lyi �� ��ta
Contact Person: ST ?v .1N Telephone M 9/v y32-
Well Location/ Site Name: y. No. of Wells to be Sampled: L/
(1rom- Perm11l _
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth -211'• C_ 2- it. Well Diameter: a in. Check One: ❑ Influent (98)
Screened Interval: ft. to It. ® Effluent (99)
Depth to Water Level: 7. / r ft. below measuring point.
Measuring Point (M.P.) is: It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: � Date sample collected: //,2-4-1,
Field analysis: pH `/ Sr , Specific Conductance uMhos
Temp./, L 6- °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT It: EXPIRATION DATE:
Non -Discharge W Q d� 1 �_?'o V UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: infiltration Gallery
e Spray Field Remediatlon:
Rotary Distributor Land Application of Sludge
Other:
N T Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: /O Z9-
Laboratory Name: U�a�
Certification No.
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified
COD mg/1 - Nitrite (NO2) as N mg/I
Coliform: MF Fecal 4 r /100mi Nitrate (NO3) as N mg/I
Coliform: MF Total /100ml Phosphorus: Total as P ed•a T- ma/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total G `/®
mg/I
pH (when analV
units
TOC
mg/l
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/l
Phenol
mg/l
Sulfate
mg/l
Specific Conductance
uMhos
Total Ammonia t v, a ®
mg/l.
TKN as N
mg/I
Orthophosphate
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/l.
Ca - Calcium
mg/I
Cd Cadmium R �`_ Q 7 `' I i
mg/l
Chromium: Total
mg/i
Cu - Copper JAN 0 9 2011
mg/I
Fe Iron - -
mg/I
Hg Mercury ���
�,r,., in r,rncCi11 —� nit
mg/l
K Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/l
YES NO)
Ni - Nickel mg/I
Pb Lean mg/l
Zn - Zinc mg/l
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method It. Attach lab report.)
Report; Attached? Yes —(I) No (0)
VOC method #
method # =
: method It
GW-59

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: R V ,-c a ABC
Permit Name (if differe t);
Facility Address, 3 3 4.1. 13AA,4 2 ►' 4 t N
l5voeq
-,We6A­e S N yy�gCounty �c
tchy)t vt
Contact Person: zf Telephone
Well Location/ Site Name: No. of Wells to be Sampled:,_„
Well Identification Number (from Permit) -'J'- 2 For Groundwater Treatment Systems
Well Depth: ?mac. 6 ft. Well Diameter: in. Check0ne: Cl Influent (98)
Screened Interval: ft, to It. C7 Effluent (99)
Depth to Water Level: r. r�' ft. below measuring point.
Measuring Point (M.P.) is: It. above (and surface. Relative M.P. Elevation in ft.:
Gallons of water pumped bailed before sampling: /0•03 Date sample collected: //• i
Field analysis: pH 4• , Specific Conductance UMhos
Temp. /9. 9_°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE'
Non -Discharge edQ -Ots l UIC
NPDES
TYPE -OP PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
•''� Spray Field Remedlation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: •' Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: / l � Z 9, >'
Laboratory Name:yni.
Certification No. iz� Z Z
PARAMETER$ (Samples for metals were collected unfiltered YES NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal /
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total Rio
mg/I
Al - Aluminum
mg/I
pH (when analyzed)
units
Ba - Barium
mg/l.
TOC
mg/l
Ca - Calcium
mg/I
Chloride
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
rng/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia • o
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/l
Mn --Manganese
mg/l
YES NO)
Ni - Nickel mg/1
Pb - Lead mg/1
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GCiMS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method # =
method #
method #
r c,millutr %Dr Mulrlu(IZuu ^ymuy 11wnu ww ' ma ' r ivaan Nnm yr ryyu
GW59

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: —
Permit Name (if di
Facility Address:_
Well Location/ Site
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
e'e e. /4 A
County 14 cy-""
Telephone #: ��•
No. of Wells to be Sampled:
2-
Well Identification Number (from Permit): 3 For Groundwater Treatment Systems
Well Depth: .19' 20 It. Well Diameter., __'2_ in. Check One: ❑ Influent (98)
Screened Interval: ft. to It. 0 Effluent (99)
Depth to Water Level: G- 67 ft. below measuring point.
Measuring Point (M.P.) is - ft. above land surface. Relative M.P. Elevation in ft.
Gallons of water pumped/balled before sampling://.a,Z Date sample collected: i /1 a 4-1'
Field analysis: pH <<`r , Specific Conductance uMhos
Temp:'9. 5::_°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:•'
Non -Discharge _ov 1 UIC
NPDES
TY_PF OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: /i - 2 S- 'f
Laboratory Name: vR �"�"'
Certification No. z2? Z Z
PARAMETERS (Samples for metals were collected unfiltered —YES NO and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal { / /100ml Nitrate (NO3) as N d• dS° mg/I
Coliform: MF Total /100ml Phosphorus: Total as P G • o mg/I
(Note: Use MPN method for highly turbid sates)
Dissolved Solids: Total `_/m
mg/I
pH (when analyzed)
units
TOC 2 2- 0
mg/I
Chloride 7.7
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia moo. z °
mg/I
TKN as N
mg/I
urtnopnospnate
mgn
Al - Aluminum
mg/I
Ba - Barium
mg/l.
Ca - Calcium
Mg/l
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
`mg/I
Mn - Manganese
rng/l
YES NO)
Ni - Nickel
mg/I
Pb - Lead
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes(1) No (0)
VOC method #
method # =
method if

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: A V
Permit Name (if differe t):
Fide'Address: 3 3 _ 1 i� %�
)SUeel)
-- County r
Contact Person: sd�a� Ze, Telephone #:
Well Location/ Site Name: No. of Wells to be Sampled:,,L�__,,
Well Identification Number (from Permit): -6� S For Groundwater Treatment Systems
Well Depth: 7-'F- y ft. Well Diameter- ... in. Check One. 13 Influent (98)
Screened Interval: It. to ft. C) Effluent (99)
Depth to Water Level: 2.0 ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling. /®• 2—Date sample collected:
Field analysis: pH _ y 7 , Specific Conductance ' uMhos
Temp. / ir. K °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge 4-1Q $ UIC
NPOES
TYPE OF PERMrTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
e Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: // 2 S- ' o
Laboratory Name: t/r�
Certification No. e 2-
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal i
/100mi
Nitrate (NO3)-as N s"Z
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P moo- s'
mg/I
tNote: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total />o y
mg/1
Al - Aluminum
mg/I
pH (when analyzed) --units
Ba - Barium
mg/l
TOC 3.22
mg/I
Ca - Calcium
mg/I
Chloride g 2-
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/l
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/l
Fe -Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance...
uMhos
K - Potassium
mg/I
Total Ammonia /- / mg/I
Mg - Magnesium
mg/i
TKN as N
mg/1
Mn - Manganese
mgA
YES NO)
Ni - Nickel
mg/1
Pb - Lead_
mg/I
Zn - Zinc
mg/1
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No — (0)
VOC method # =
method #
method If

1
Enter date monitoring results were due. (/2.31-lo y Will this monitoring report (GW-59 and GW-59A)
YES
NQ
be submitted after the established due date?
2
Was any required information missing on the Gw-59 report forms?
YES
NO
�C
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.)? 1J the answer is '' i'es ", c•orrtac•t the llcgional Office for guirlauce.
4
Are any monitored constituents equal to or above the established standards?
YES
NO
If the answer to question 4 is "NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below:
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) in the last two years?
if the answer to question 5 is "NO", , skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES", a groundwater quality problem 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.
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 may subiect the permittee to a Notice of Violation
fines, and/or Penalties.
g
The person 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 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.
L. z j7. i�P
Signature of Permittee (or Authorized Agent) Date

GROUNDWATER QUALITY MONITORING: SEA 2G''`I
COMPLIANCE REPORT FORM
RACILITY INFORMATION
Facility Name: ' A 5 / �e
Permit Name (if differe trf ):
Facility Address:-
- (cily) S�t
Contact Person: --a 4fi'
Well Location/ Site Name: A
Pleas rr ar Type
(zip) County
it
. _ Telephone #: �/0 AVE `/ �1 —
No. of Wells to be Sampled: L/
PAPER ONLY
Well Identification Number (from Permit): .0 For Grounkater Treatment Systems
Well Depth: 25d, S2- ft. Well Diameter: 4 " in. gheckOne: 0 Influent (98)
Screened interval: _ ft. to ft. ®Effluent (99)
Depth to Water Level: �G p $$ it. below measuring point.
Measuring Point (M.P.) is: it. above land surface. Relative M.P. Elevation in It.:
Gallons of Water pumped/bailed before sampling: sd• 79 Date sample collected:
Field analysis: pl-I `, Specific Conductance _- uMhos
Temp. °C, Odor __ ___.__e Appearance
,'f®
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE.,
Nan -Discharge CO!? 001 $r UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Aernedialion: Infiltration Gallery
Spray Field Remediatlon:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: 7- 2-11 7- Z S- 7=3•, 7
Laboratory Name:�4T
Certification No. W-2 2
PABAMETERB (Samples for -metals Were collected unfiltered YES
NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliforrn: MF Fecal
/100ml
Nitrate (NO3) as N
Z. ° 2- mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
tea- s" mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total y®
mg/I
Al - Aluminum
mg/I
pH (when analyzed)
units
Ba - Barium
mg/I
TOC /. G !
mg/l
Ca - Calcium
mg/I
Chloride • v
mg/I
Cd - Cadmium
mg/1
Arsenic
mg/1
Chromium: Total -- __
_- mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/l
Fe - Iron
mg/I
Sulfate __-_
__ mg/l
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia /V 14 3 .21
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
_ mg/I
YES NO)
Ni - Nickel
mg/I
Pb - Lead
mg/l
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/1
Other (Specify Compounds and Concentration
Units)
ORGANICS (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes —(I) No (0)
VOC : method # =
�. method # = - -
: method 4 =

'r*
FACILITY INFQ173 CATION
Facility Name: —
Permit Name (if
Facility Address
Contact Person:?
Well Location/ Site
SUBMiT FORM ON YELLQW PAPER ONLY
Please Print Clearly or Type
-3 )3A,�i- —lT—ed--�ve_ /�cs. -
County
tSta ) (2ip) '
..eL...-Y."JE` % w 'telephone #. !2/0".,e,
2 No. of Wells to be Sampled: 'L/
.—__—_— (from permit!
Well Identification Number (from Permit): �4,,,,jj For Groundwater Treatment Systems
Well Depth; ?a. 6 sr- ft. Well Diameter: 2" in. Check One: 0 Influent (98)
Screened Interval ft. to ft. (] Effluent (99)
Depth to Water Level; i- 3 It. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumpedll ailed before sampling: /-0- / i Date sample collected: 7.1
Field analysis: pH 12- Specific Conductance • uMhos
Temp. i g. 9 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE: eL
Non-Discharge-_W!? c>Ls t T- UIC
NPDES
TYPE QF PERMITTED OPERATiON BEING MONITORED
_ Lagoon ._-_a._.-Remedialion: Infiltration Gallery
§pray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other: �J _--
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 7. 3/
Laboratory Name:
Certification No. A-/ Z 2
PARAMET 13 (Samples for metals were collected unfiltered YES No and field acidified
COD
mg/I
Nitrite (NO2) as N __
mg/i
Coliform: MF Fecal /
/100m1
Nitrate (NO3) as N z
mg/I
Coliform: MF Total
M 00ml
Phosphorus: Total as P • 2
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total 4 Yo
mg/I
Al - Aluminum
mg/I
pH (when analyzed)
units
Ba - Barium
mg/I
TOC �' . Z s'"
mg/I
Ca _ Calcium
mg/i
Chloride 6 - 7
mg/i
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/i
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
rng/l
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia e�u-/ 0,11
rng/I
Mg - Magnesium
mg/I
TKN as N _ �_ ___�
mg/l
Mn - Manganese _ _-_
_ _ mg/I
YES NO)
Ni - Nickel mg/l
Pb - Lead mg/l
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS- (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Deport Attached? Yes (1) No (0)
voc method #
method # µ
— method 9

_'. f
SUBMIT FORM ON YELLOW PAPER ONLY
� • � ~' �� Nam.
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: -rc_-
Permit Name (if differs t
Facility Address:— -- �' • A �/ c-�
,�i &'Cr' 1P� rsi�ueq / a� Count -^ __4
Contact Person: She°�` ��+"S''- t��pt y � y ` 3
Telephone #: �/a . �� %
Well Location/ Site Name: c— lI No, of Wells to be Sampled: nroro nem,u,
Well Identification Number (from Permit): _ !rrfl03 For Groundwater Treatment Systems
Well Depth: ft. Well Diameter: Z in. Check One:13 influent (98)
Screened Interval: ft. to _ ft. ® Effluent (99)
Depth to Water Level: _. f ft. below measuring point.
Measuring Point (M.P.) is: It.. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: j/._/a Date sample collected: 2. 2 v
Field analysis: pH `y 9 , Specific Conductance uMhos
Temp. / F.. °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE: c'
Non•Discharge. W 47 001 UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
— Lagoon Remediation: Infiltration Gallery
Spray Field - Remediation:
Rotary Distributor Land Application of Sludge
Other
NOT-: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: %Z-�>2! 7� a t 7 3�
Laboratory Name: �✓,r� �r
Certification No. Y 2- �-
P_ARAME -9 (Samples for metals were collected unfiltered —YES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal ®
/100ml
Nitrate (NO3) as N 30
mg/I
Coliform: MF Total — _
/100ml
Phosphorus: Total as P
mg/i
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total 7 2.
mg/I
Al - Aluminum
mg/I
pH(when analyzed)_
units
Pa - Barium
mgll
O �
mg/I
Ca - Calcium
mg/I
Chloride "7. 0
mg/i
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total __.__
- mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
—YES NO)
N! - Nickel
mg/l
Pb - Lead
mg/t
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
Phenol
mg/I
Fe - Iron.
mg/I
ORGANICS: (GC,GC/MS,HPLC)
Sulfate
mg/I
Hg - Mercury
mg/I
(Specify test and method #f. Attach lob report.)
Specific Conductance
uMhos
K - Potassium
mg/I
Deport Attached? Yes____...,(1) Na (0)
Total Ammonia • as,
mg/I
Mg - Magnesium
mg/I
VOC method # =
TKN as N
mg/l.
Mn - Manganese_ _
mg/I
T�� method # = -
method 11

AM& 12111111
F-11 0 1301 CaMll■ ( . M
FACILITY INFORMATIQju
Facility Name:_
ra�.Y. c# Fd'__ rs
SUBMIT FORM ON YELL PAPER ONLY
Please Print Clearly or Type
No. of Wells to be Sampled:
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: , a 26c,_Y s� -it. Well Diameter: _ `2 In. Check One: [] influent (98)
Screened Interval: ft. to ft. ® Effluent (99)
Depth to Water Level: _ __.- 2- _ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: Date sample collected: �p L°'•�°'
Field analysis: pH • 0 , Specific Conductance uMhos
Temp. °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE: 4!r-l'
Non-Discharge_W!? 0S- UIC
NPDES
TYPE OEPERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field . Remedlation:
Rotary Distributor Land Application of Sludge
Other:
-NQ1,P,; Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: % 2 2 -2 7-3
LaboratoryName: -- k'✓���-°8�'
Certification No. �7- 2- _
PARAMETERS (Samples for metals were collected unfiltered YES
NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal C 1
/100m1
Nitrate (NO3) as N mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
• ®�` mg/I
(Note: Use MPN method for highly turbid sampler)
{Dissolved Solids: Total A. mg/I
Orthophosphate
AI - Aluminum
mg/I
mg/I
pH (when analyzed)
units
Ba - Barium
mg/l
TOG - _
Mg/I
Ca - Calcium
mg/I
Chloride 7
mg/I
Cd - Cadmium
mg/I
Arsenic,
mg/I
Chromium: Total
mg/I
Grease and ails �.._
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
_ mg/I
Hg -Mercury
mg/I
Specific Conductance
uMhos
K - Potassium._..._.._
mg/I
Total Ammonia
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
YES NO)
Ni - Nickel
mg/i
Pb - Lead
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method #
method #
method 11

t'Ml}'(.!.{._V.1. RF.11'i)RT V0101 1,Ci-,11111 h
'.1:r+rlelrur•rrr,l:rttuul;,rrjri�ptrrn;(.rjlh{,li_itlra'/nt.f --
1 Enter date monitoring results were due: ( )Will this monitoring report (GW-59 and GW-59A} VETS s\'O
be submitted after the established due date?
S
'2 Was any required information missing on the GW-59 report forms? YES s�ti;Q
1F the answer to question t or 2 is "YES , list in the space provided be ow the v✓ell identification numbers) 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
I identification plate, area overgrown, etc.)? /J'the an. wer is "Yes ". contact the Jte;jwra/ Offrce jor guidatrce.
4 Are any monitored constituents equal to or above the established standards?
YES i
if the answer to question 4 is 'NO", skip to section 8.
If the answer to question 4 is "YES"list the affected tells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below.
For the constituents identified in question 4 above; have standards been exceeded previously for the YES 1 NO
j same constituent(s) in the same wells) in the last two years?
If the ansv✓er 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 constituents) exceeding
standards, concentrafion(s) repotted, and sample collection date for each occurrence (for the last two years).
Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES I NO
If the answer is "YES" a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE 1MMED/ATELY FOR GUIDANCE. If the answer is "NO", monitoring wells may be improperly
located; contact the Regional Office.
'] Is the permittee implementing previously approved actions required by the Division involving this YES NO7
quality problem?
if the answer to' uestion 7 '
4 rs YES ; describe those action's in the space provided below.
If the answer to question 7 is "NO" contact the Regional Office within 90 days• an evaluation maybe
reouired to determine the impact the waste — -
fines. and/or penalties
$ 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>>nfocmation was evaluated and:the informatlon submitted I thfs report (Compharice Report G1p{59A) is rue and:compfe% tofthe-be§t'of my Knowledge.
11
r
Signature of Permittee (or Authorized Agent) Date
4
is \i -59A 12/ 1r200?