WQ0018708_GW Monitoring_20081218

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANC8 REPORT FORM
FACILIIY INFORMATI N Please Print Clearly or Type
Facility Name: ^
Permit Name (if differen -
F C' ity Addre W _ .mac / -
rn (SVee G /
;County
�-} {state
(City) si eae- ll t9 AJIS' < <O) .'� t
Contact Person: Telephone #: -9w � SgB= /YdL
Well Location/ Site Name: we No� of Wells to be Sampled:
Well Identification Number (from Permit): `4,, For Groundwater Treatment Systems
Well Depth: 2 TF, 5—ft. Well Diameter: in. Check One; ❑ Influent (98)
Screened Interval: ft. to ft. A ❑ Effluent -(99)
Depth to Water Level: '7. eft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation '
Gallons of water pumped/bailed before sampling: /v. Date sample collect /A —Ty
8
Field analysis: pH y G Specific Conductance uMhos
Temp. , % 3 °C, Odor Appearance J`
1n0
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge W 69 00 / T ioTd UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludoe__. _ - --.-_--
Other:
NOTE: Values should reflect dissolved and, �� ����
colloidal concentrations. py
Date sample analyzed:
Laboratory Name: - P .4 N �-
Certification No. 2 of d' 9 Sr
PARAMETERS (Samples for metals were collected unfiltered YES
NO' and field acidified
YES NO)
COD
Coliform: MF Fecal l'
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
-- �� mg/I
L• 2- mg/I
Ni - Nickel rn I
Pb -Lead mg/I
Coliform: MF Total
/100ml
Phosphorus: Total
as Pmg/I
Zn - Zinc mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Ammonia Nitrogen mg/I
Dissolved Solids: Total -H, yo mg/I
Al - Aluminum
mg/I
Other (Specify Compounds and, Concentration Units)
pH (when analyzed)
units
Ba - Barium
mg/ITOC
- -
2 v Z
mg/I
Ca - Calcium
mg/I
Chloride !�K, o
mg/1
Cd - Cadmium
mg/I
ni= r 9 L+��
Arsenic
mg/I
Chromium: Total
mg/I
V
Grease and Oils
mg/I
Cu - Copper
mg/1
Phenol
mg/I
Fe - Iron
mg/I
ORGANICS: (GC,GC/MS,HPLC)
Sulfate
Specific Conductance
mg/I
uMhos
Hg - Mercury
K - Potassium
mg/I
mg/I
(Specify test and method #. Attach lab report.)
Report Attached?
Total Ammonia e- 2
mg/l
Mg - Magnesium
mg/I
Yes —(I) No (0)
VOC method # =
TKN as N
mg/I
Mn - Manganese
mg/l
method # =.
method # =
ct
e .•• • -• •• • • • e
R s 1 rM in -• .•e • • •' •- -• • • e
•
* A3 S � r `�/ •
GW-59
Permittee
AuthorizgddAAgent) !NRe and Title -print or type
T 'fj/ �-. I �- - ( �-- V
Rev. ()3/2000
Signature of Permittee (or Aulhonzed Agent)
(Date)

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: I A CA-C
Permit Name (if different
Facility Address:- 3 &-2-
ke // (street) A., c
(City) S 1�C ✓ � A '
Contact Person: iJ
Well Location/ Site Name: —6er
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County A d `
Telephone S44-rr
No. of Wells to be Sampled:..__
Well Identification Number (from Permit): A.-r// Z For Groundwater Treatment Systems
Well Depth: 2 FE. S I' ft. Well Diameter; _� in. Check 0ne: ❑ Influent (98)
Screened Interval: ft. to ft. ❑Effluent (99)
Depth to Water Level:9.0 ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surf ce. Relative M.P. Elevation in It.:
Gallons of water pumped/palled before sampling:1 Date sample collected: !/
Field analysis: pH. Specific Conductance uMhos
Temp. - 2.9 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT#: EXPIRATION DATE. '- o 1--e
Non-DischargeLWQ 0vj8"%vr UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
lSpray Field Remediation:
Rotary Distributor Land Application of Sludge
Other: - -
NOTE: Values should reflect dissolved and .
colloidal concentrations. I, .BAN 5 2009
Date sample analyzed: / �%� $err .:•,.- �� .,
Laboratory Name:
.4
Certification No. 2 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 e / /100ml Nitrate (NO3) as N •®2 mg/I
Coliform: MF Total /100ml PhosDhorus: Total as P S mo/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total L V42
mg/1
pH (when analyzed)
units
TOC 3. i/
mg/I
Chloride • 7
mg/l
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/l
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia Z,
mg/l
TKN as N
mg/I
v,
Orthophosphate
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I,
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/l
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/l
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
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 # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM.
FACILITY INFORMATION Please Print Clearly or Type
FacilityName: IA�er
Permit Name (if different/:
/ County �o
Contact Person: S V e �� ti� I o) Telephone #:Q/v - SeC$ - 51 X L
Welt Location/ Site Name: No, of Wells to be Sampled: _
• (from srmlt)
Well Identification Number (from Permit): e—e For Groundwater Treatment Systems
Well Depth: ? T, 7 2 ft. Well Diameter. _�L_ in. Check One: ❑ Influent (98)
Screened Interval: ft. to ft. ❑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:/o. 0 Date sample collected: y�
Field analysis: pH `l.r . , Specific Conductance * uMhos
Temp. / �- 7 °C, Odor Appearance
PARAMETERS (Samples for metals were collected unfiltered
COD mg/I Nitri
Coliform: MF Fecal /100ml Nitr
Coliform: MF Total /100ml Pho
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total I o mg/I
pH (when analyzed)
units
TOC 3, 3 ,}
mg/I
Chloride 2� !r
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
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: XPIRATION DATE:
Non-Discharge-WS2 OUP �'� UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations. .FAIN 0 5 203
+d Date sample analyzed:
Laboratory Name:y a titi 7i 1 __i _ r „
_ Certification No. 2 2—
YES NO and field acidified
to (NO2) as N mg/I
ate (NO3) as N /• 7 mg/I
sphorus: Total as P s- mg/I
Orthophosphate mg/I
Al - Aluminum mg/I
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 mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
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 #

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:____
Permit Name (if di
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
P
Contact Person: d3 "-0- "-�Pf " Telephone #: 9/0-
Well Location/ Site Name: No. of Wells to be Sampled:
Well Identification Number (from Permit): G-* For Groundwater Treatment Systems
Well Depth: ft. Well Diameter; —2— in. Check One: ❑ Influent (98)
Screened Interval: ft. to ft. 0 Effluent (99)
Depth to Water Level: _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: /0. L Date sample collected:
Field analysis: pH S, 4 , Specific Conductance uMhos
Temp. l V L °C, Odor Appearance
PARAMETERS (Samples for metals were collected unfiltered
COD mg/I Nitri
Coliform: MF Fecal G / /100ml Nitr
Coliform: MF Total /100ml Pho
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total 12 7 mg/I
pH (when analyzed)
units
TOC
, L S., mg/I
Chloride /y
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammoniac
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge W(2 Gam/ 20S' 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 . JAN 0 5 20"39
colloidal concentrations.
Date sample analyzed: PC,-
Laboratory Name:_ -
Certification No. 2
YES NO and field acidified
to (NO2) as N mg/I
ate (NO3) as N . s2p mg/I
sphorus: Total as P 4 o S mg/I
Orthophosphate mg/I
Al - Aluminum mg/I
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
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 # =

C:W-59A COMPLIANCE REPORT FORM Permit # w pD
' (,5uhniit one each nxiniforhr q perinil frith G tt -;9 f win.)
1
Enter date monitoring results were due. (%" - ) Will this monitoring report (GW-59 and GW-59A)
YES
O
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
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
identification plate, area overgrown, etc.)? !f the answer is "i es", contact the Regional Office for guiclance.
4
Are any monitored constituents equal to or above the established standards?
YES
O
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 constituents) exceeding
standards, concentrations) 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 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 dbsposal system is having at the review and comDliance
boundaries surrounding this facility. Failure to do so may subject 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 GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
Thereby acknowledge that.the above information was evaluated and.the information submitted in this:' '
report (Compliance Re -ortGW-59A is true and com lete to the;best_of my -knowledge._ _�
Signature of Permittee (or Authorized Agent) Date
CNV-59A 1218i2003

SUBMIT FORM ON.
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM SEp
FACILITY INEORMAT-1_O..N Please Britt Clearly oC Type_
Facility Name "%�%�/�-� _
Permit Name (if dlffq, a t):
N
Well Location/ Site Name:
County {✓'
Telephone M. 9AL 572
No. of Wells to be Sampled:
PAPER ONLY Kb
Well Identification Number (from Permit): I„ /cri A' For Groundwater Treatment Systems
Well Depth: 2%g ;-O , ft. Well Diameter: in. Check One; ❑ Influent (98)'
Screened Interval: it. to It. i] Effluent (99)
Depth to Water Level 9. Z0 ft. below measuring point.
Measuring Point (M.P.) Is: ft. above land surface. Relative M.P. Elevation In ft.:
Gallons of water pumped/baited before sampling: %= Gs' Date sample collected: 7 2/-'VV
Field analysis: pH , Specific Conductance uMhos
Temp. 1-9-11 °C, Odor - Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION,DATE:
Non -Discharge 0 UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
pray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NM- Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed. 7 Z / _4, 9-
Laboratory Name' 6-44I-A-
Certification No. 2T
PARAMETERS (Samples for metals were collected unfiltered -YES
NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/i
Collform: MF Fecal ^._ _!_
/100ml
Nitrate (NO3) as N
�'-�� �' mg/I
Coliform. MF Total
/100ml
Phosphorus: Total as P c .O mg/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total L Xe
mg/i
Orthophosphate
Al - Aluminum
mg/I
mg/I
pH (when analyzed)
units
Ba - Barium
mg/i,
mg/I
TOO > >
Chloride +L.b
mg/I
mg/I
Ca - Calcium
Cd - Cadmium
mg/i
Arsenic
mg/I
Chromium: Total
mg/l
Grease and Oils
mg/i
Cu -- Copper
mg/l
mg/I
Phenol
Sulfate
mg/l
rng/I
Fe - iron
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia cc
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/l
Mn - Manganese
mg/i
0V
Y}
- YES NO)
Ni : Nickel mg/I
Pb - Lear] mg/l
Zn - Zinc mg/I
Ammonia Nitrogen r r mg/I
Other (Specify Compoa`nds and Concentration Units)
r6 t G
ORGANICS: (GC,GC/MS,HPLC) .
(Specify test and method #. Attach lab report.)
Report Attached? Yes —(I) No (0)
VOC method # =
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMA�QN_ Please Print Clearly or Type
Facility Name: ` DA f/��
ree 14
Permit Name (if diff):
Fa ' it ddr �^ 1 � 7
yl r e %� g Xa tis��eeu .N 2
cCi T6 �4) c Ciro CioUnty `
Contacticily) Person: '� ti Telephone #: �f�r �� 8 ` �y
Well Location/ Site Name: Gv.e e No. of Wells to be Sampled: _
Well Identification Number (from Permit): &,cf/ .ol For Groundwater Treatment Systems
Well Depth: 'Z "Ya ft. Well Diameter:.-2_ in. Check One: ❑ Influent (98)'
Screened interval: ft. to ft. Gl Effluent (99)
Depth to Water Level: We'? Lft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation In ft.:
Gallons of water pumpped�/bailed before sampling: 0 Date sample collected: 7-21-V
Field analysis: pH._1a.�,._._ , Specific Conductance ' uMhos
Temp. L `.L I 11C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge %N 0 j6 0 /g 7® $' UIC '
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: infiltration Gallery
pray Field Remediation;
Rotary Distributor Land Application of Sludge
Other
N(= Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 2
Laboratory Name:
Certification No. 2r
pARAMETERS (Samples for metals were collected unfiltered -YES
NO and field acidified
YES NO)
COD
mg/I -
Nitrite (NO2) as N
mg/I
Ni - Nickel
mg/I
Coliform: MF Fecal /
/100ml
Nitrate (NO3) as N
.vim mg/I
Pb - Lead
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as
P -® ..._ mg/I
Zn - Zinc
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Ammonia Nitrogen
mg/I
Dissolved Solids: Total 4 yo
mg/I
Al - Aluminum
mg/I
Other (Specify Compounds and Concentration Units)
pH (when analyzed)
units
Ba - Barium
mg/l.
TOC -7. q�
mg/I
Ca - Calcium
mg/1
Chloride "7r r
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
A 6
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/l
Fe - Iron
mg/I
ORGAN:I.C,S-:. (GC,GC/MSHPLC) .
Sulfate
mg/l
Hg - Mercury
mg/I
(Specify test an'd'nietld'd #. Attach lab report.)
Specific Conductance
uMhos
K - Potassium
mg/I
Report Attached? Yes (1) No
(0)
Total Ammonia el 2°
mg/I
Mg - Magnesium
mg/I
VOC : method # _
TKN as N
mg/I
Mn - Manganese
mg/I
: method #
method # _

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: ��'J���-�
Permit Name (if diff%i t
Well Location/ Site Name:
SUBMIT FORM ON YELL-= PAPER ONLY
Please Print Clearly or Type
County
Telephone #, 9/0- 5"-
No. of Wells to be Sampled:
2
Well Identification Number (from Permit); For Groundwater Treatment Systems
Well Depth: 2�� �S' ft, Well Diameter; in. Check One: ❑ Influent (98)'
Screened interval: it. 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: lK_ Date sample collected: 7-21--4142-
Field analysis: pH d , Specific Conductance' uMhos
Temp. d _"DC, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAiL SERVICE CENTER
PERMIT #: EXPIRATION DATE: 6 -3 a -Z_y�
Non -Discharge Ltl [ C9 Ig 70 a- UIC
NPDES
TYPE -OF 2 EMITTED OPERATION BEING MONITORED
Lagoon _,._._,Remediation: Infiltration Gallery
.___ fsSpray Field Remediation:
Rotary Distributor Land Application of Sludge
Other.
NOTt;; Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: 7 i
Laboratory Name: TA
Certification No. _ ) ? 7r—
PARAMETERS (Samples for metals were collected unflltered YES
COD
NO and field acidified
Coliform: MF Fecal . /
mg/I
/100ml
- Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
/,s3 mg/I
Coliform: MFTotal
/100ml
Phosphorus: Total as
P —1,E mg/I "
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total L Y0
mg/I
Orthophosphate
Al - Aluminum
mg/I
pH analyzed)
units
Ba - Barium
mg/I
mg/!•
TOCwhen
o��
Chloride 1�•
mg/I
mg/I
Ca - Calcium
Cd - Cadmium
mg/I
mg/I
Arsenic
Grease and Oils
mg/i
mg/1
Chromium: Total
Cu - Copper
mg/I
mg/i
Phenol
Sulfate
mg/I
Fe - Iron
mg/I
Specific Conductance
mg/I
uMhos
Hg - Mercury
K - Potassium
m /I
mg/I
Total Ammonia
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
YES NO)
N! - Nickel mg/I
Pb - Leap mg/I
Zn - Zinc mg/i
Ammonia Nitrogen mg/l
Other (Specify Compounds and Concentration Units)
5
,.•.,_.rr..r :, • .. �•,.. -='.. _t' 4; ids;.
ORGANICS: (G(Cdc dAS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes - (1) No - (0)
VOC method #
method # =
nlAl CA

r
IPA
SUBMIT FORM ON XL,LQ-W PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FAGALI I Y Ii t UHMArI IUN % Please Print Clearly or Type
Facility Name. r e 141<
Permit Name (if diffe,(e t):. T,a � , I
'u . - if z Count ��,,,,`�
1c�ry) (stare) Iz P) y .—
Contact Person: s eve J'oz,.� s �. Telephone #: ` 6; 5 8 T
Well Location/ Site Name: 1� / No, of Wells to be Sampled:,
Well identification Number (from Permit), -L- ! For Groundwater Treatment systems
Well Depth: o it. Well Diameter•: in. Check One: ❑ influent (98)•
Screened Interval: It. to ft. E1 Effluent (99).
Depth to Water Level: /1.05- 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: `?'=[8' Date sample collected:
Field analysis: pti- -- $,!;; `- , Specific Conductance uMhos
Temp.l_°C, Odor — Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #; EXPIRATION DATE:
Non -Discharge -IV 6 6 0 /5 ?o r UIC
NPDES
TYPE OF RERMITTEp OPERATION BEING MONITORED
Lagoon - Remediation: infiltration Gallery
pray Field Remedlation:
Notary Distributor Land Application of Sludge
Other:
r'`i= Values should reflect dissolved and.
colloidal concentrations.
Date sample analyzed: % ;? o
Laboratory Name: -_&/Z A -
Certification No. 2 2 ';;P y-
PARAMETERS (Samples for metals were collected unfiltered YES
NO and field acidified
COD mg/l
Coliform: MF Fecal - _ 1 /100ml
- Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
mg/I
Coliform: MF Total
/100ml
Phosphorus: Totai as
P_ mg/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total 50
mg/I
Orthophosphate
Al - Aluminum
mg/I
mg/ITOC
when analyzed)9
units
Ba - Barium
mg/l.
t 0
Chloride ^�, �/
mg/I
mg/I
Ca - Calcium
Cd - Cadmium
mg/I
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
mg/I
Specific Conductance
uMhos
K -Potassium
mg/I
Total Ammonia _ - h ua
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)
f
--- „�1;--2
ORGANICS:'°(GC,GC/MS HPI.'C) .
(Specify test and method'#. Attach lab report.)
Report Attached? Yes_(I) No (0)
VOC method # =
method # =
mathnN #
r•{Ai Mn

a
(Submit one, each rnonitoring.period with G1i=59 f-mins.)
1
P
3
4
5
Enter date monitoring results were due. ( ) Will this monitoring re
be submitted after the established due date?
Was any required information missing on the GW-59 report forms?
IF the answer to question 1 or 2 is "YES", list in tiie space provided below the well
explain the problems encountered in obtaining the required information.
and
YES
YES
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap,.mis4s,n
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Office for guiddnce.
Are any monitored constituents equal to or above the established standards? 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 constituents) and concentra
exceeding standards in the space provided below.
For the constituents identified in question 4 above, have standards been exceeded
same constituent(s) in .the same well(s) in the last two years?
If the answer to question 5 is "NO ; skip to section B.
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
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.
tifff
he permittee implementing previously approved actions required by the Division involving this
undwater quality problem?
e 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
' - - ' - •:__ .s at.........e.. �nrl rmm�lram
fines and/or Penalties.
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.
11
YES I NO
NO
d-.x! coA 1171annn1

0
Well Samples
Client: lAw]hj"�- k•czk'S
Date Sampled: 2%l' 116 if
Sampled By: -
Vann Laboratories
P.O. Box 668
Wallace NC, 28466
Phone: [phone]
Fax: [phone]
pH Meter
Model: 50
Serial #: C0008222
Calibrated:, Date: 7 Zt Time: -Ic-014
Buffer 4.00 4,00
Buffer 10.00 jazD
Bu er 7. 0 %c� j
Analyst:
Location
-A$
Well I. D.�
Depth of Well (ft)
_-D
Ma
; #0
Depth to Water Level (ft)
i
Water Depth (ft)
I Z# 7
Well Vol. * 3 (Gals)
Time Sampled
�l
d' 20
pH
Temperature, °C
t.
Color
Sampler's Signature: z Date:
'}}}Y : j{}l Y.�: 1.'.} f=:.��'}:1"l��•�� }.f :'{:'.ti rtil'.•fl�': • } . J}: •' {'frl h}.lrf�.::' {ll.}•:::. �: - -

r'r Vann Laboratories
P. O. Box 668
Wallace, NC 28466,
WASTEWATER ANALYSIS REPORT
For: Bay Tree Lakes
Phone: [phone]
Wastewater ID #: 22
Date Samples Collected:
July 21,2008
PARAMETER
UNITS
DATE.
ANALYZED
well 4# I
well #2
Well #3
Well #5
PH -
BOD5
mg1L
COD
mg1L
Fecal Coliform
col.1100 ml
7-21-08
< 1
< I
< I
< l
Total Kjeldahl Nitrogen
mg1L
Total Residue (Dissolved)
»ig1L
7-21-08
<40
<40
62
80
Total Suspended Residue
mg1L
Detergents MBAS
mg1L
Oil & Crease
mg1L
Total Phosphorous
mglL
7-24,-0g
<0,, 02
<0 , 02
0.16
0.03
Sulfides
mg1L
Phenols
uglL
Total Chromium
u91L
Total Copper
ug1L
Total Magnesium
mg1L
Total Zinc
uglL
Ammonia Nitrogen
mg1L
7-21-08
<0.20
<0. 20
<0. 20
1.40
Nitrate*
mg/L
7-23-08
<0.05
<0.05
1.53/
<0.05
Chloride
mg/L
7-31--08
10.0
7.5
11.2
9.4
TOC
mg/L
8-2-08
2.15
7.92
10.8
9.03
*Analysis performed by Oxford Laboratory
Signed:
Date: gust 20 , 2008

r_ Tritest Inc.
6624 Gordon Road
Suite G Page 1 of 2
Telephone: [phone] Wilmington, NC 28411 NC/WW Cert. #: 075
Fax: [phone] NC/DW Cert. #/ _ 37721
www.tritestinc.com
La b o r a t o-r y Report,
--- Prepared for ---
Wayne Vann Report Date: 8/6/2008
Vann Laboratories Date Received: 7/22/2608
PO Box 668
Wallace, NC.28466 Work Order #: 0807-63350
Project No.:
Cust. Code:
VANN79
Project ID: VL072108101-5
Nox/NO3ITPhos
Cust. P.O.#:
No. Sample ID
Date Sampled
Time Sampled Matrix
Sample Type Condition
001 VL072108101
7/21/20.08
16:25 WW
Grab 4 +/- 2 deg C
Analyzed
Test Performed
Method:
Results
Date Time Qualifier
Nitrate+Nitrite
SM 4500E .
5.08 mg/L as N
7/30/08 13:00
No Sample ID ' Date Sampled Time Sampled Matrix Sample Type Condition
002 VL072108102 7/21/2008 15:40 WW Grab
4 +/- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Nitrate SM 4500 E <0:05 mg/L 7/23/08 9:00
Phosphorus, Total SM 4500 B/E . <0.02 mg/L 7/24/08 10:00
No. Sarrple.lb
Date Sampled
Time Sampled : Matrix
Sample Type
Condition
003 VL072108103
7/21/2008
16:00 WW
Grab
4 +/- 2 deg C
Analyzed
Test Performed
Method
Results
Date • Time
Qualifier
Nitrate
SM 4500 E
<0.05 mg/L
7/23/08 9:00
Phosphorus, Total
SM 4500 B/E
<0.02 mg/L
7/24/08 %:00
No. Sample ID
Date Sampled
'Time Sampled Matrix
Sample Type
Condition
004 VL072108104
.
7/21/2008
16:20 WW
Grab
4+/-2deg C
Analyzed
Test Performed'
Method
Results
Date -Time
Qualifier
Nitrate
SM 4500 E
1.53 mg/L
7/23/08 9:00
Phosphorus, Total
SM 4500 B/E
0.16 mg/L
7/24/08 10:00

y z
Tritest, t nc.
6624 Gordon Road
Page 2 of 2
Telephone: [phone] "
Suite G
"Fax: [phone]
-.Wilmington, NC -28411
NC/VIIW Cert. #: 075
NC/DW cert.#: 37721
www.tritestinc.com
Lab`.oratory� Re'po.rt,' ,
Work Order #: 0807-53350
' No. Sample ID .
Date Sampled Time Sampled Matrix
Sample Type Condition'
005 VL072108105
7/21/2008 16:40 WW
-Grab 4 +/- 2 deg C '
----Analyzed-
Test Performed
Method Results
Date Time Qualifier
Nitrate
SMA500 E <0.05 mg/L
7/23/08' . 9:00
Phosphorus, Total
SM4500 B/E 0.03 mg/L
7/24/08 10:00
Reviewe
'for Tritest, Inc.

r ,'r'�
GROUNDWATER- OUALITY MC�NITORIN - MAY 0.6 -20
COMPLIANCE REPORT FORM
w r�i rry urrrr�u wT.ru'. - - .. ..._-_ - "'_•__. r..-__•_,: __. �-._-
Facility Name77/'-p Q 14 /S'e-
PAPER ONLY
• DEPARTMENT OF ENVIRONMENT & NATURAL -RESOURCES
• WATER QUALITY. DIVISION, GROUNDWATER SECTION
1616 MAIL SERVICE CENTER
Permit Name (if d_ ifterentl: - -
Fac37
il' y Addres , / ., r e
!a (Street
(City). a �ti a� .GS (ZiO YYYCounty �
Contact Person:-� 75 Telephone #: 9YO
Well Location/Site Name: .�,�1./ _, No. of, Wells to be Sampled:
Well, ldentification Nutnber(from Permit):Lv For Groundwater Treatment Systems
Well.Depth. ft. , Well Diameter: _ in. Check One:. O 'Influent (98),
Screened Interval: ft to ft. D ' 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 samplingaO.S Date sample collected.. =2 F d �S
Field analysis: pH_„e , Specific Conductance " uMhos 12
Temp.0°C, Odor Appearance
PERMIT #: z ,'EXPIRATION DATE: S!'�4
Non -Discharge lo-q 6, VK70 r- UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
n Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary- Distributor Land Application of Sludge
Other: ---
-NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: . S�CP
Laboratory' Name:
Certification' No. - 2 % S
PARAMETERS-(Samples,for i metals were -collected unfiltered YES NO - andfield-acidified
YES - -NO}
.COD
%mg/I
Nitrite (NO2) as,N-.
m9/1'
Ni - Nickel
mg/I
Coiiform:. MF Fecal 1
/100ml
Nitrate (NO3) as N s
mg/1
Pb. - Lead-
mg/1
Coliform: MF Total
/100ml
Phosphorus:. Total as P —I,.: 0
mg/I
Zn - Zinc
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
_mg/I
Ammonia Nitrogen
mg/1-
Dissolved Solids:.Total . `/�
mg/I
Al --Aluminum,
mg/L
Other.(Specify compounds and Concentration Units)
pH (when :analyzed)
units'.-
Ba =Barium -
m /I : -
g
TOC ,05
mg/1
Ca --Calcium
mg/I
Chloride 7. 5--
-mg/I
-Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/f
Cu -Copper :. .'-.
mg/l
Phenol.
mg/I :
Fe --.Iron
mg/I
ORGANICS: (Gc,GC/MS,HPLC)
Sulfate
mg/I
Hg _ Mercury
mg/I
(specify test and method #. Attach lab report.)
-Specific Conductance
uMhos
K -Potassium
mg/I,
Report Attached? Yes ' (1) No
(0)
Total Ammonia s
mg/I
Mg - Magnesium
mg/1
VOC method # =
TKN as N.
mg/I
Mn.- Manganese -
mg/I
method #
method #
7�4•IITl1I-Ill\t•li:ilNYd111[�\4Nlt=lQ•lll-'tom r v tf s wl r.(.� i C.� 6,eU
Permits (or Authorized agent) Name and itle - Please print or type �/
,. GW-59-
Rev. 03/2000

SUBMIT FORM ON"YELLOW. PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM -
FACILITY INFORMATION Please'Print Clearly or Type
Facility: Name: �F p •e2 �.4 ez S
N f
Permit Name"(if different
(Sueeq
(cart y ycoun `
tY -.
Contact Person. '� Z�,,. (s�.� �-? •, izio) .Telephone
:Well Location/ Site. Name: °' 1 No of Wells to be Sampled:
t - (from PerrnN)
Well Identification Numb! (from. Permit): w For Groundwater Treatment Systems
Well Depth: �� �% ft:.WeiP,Diameter: in. Check One: ❑' Influent (98)-
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, -GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH: NC 27699-1636 Phone: [phone]
PERMIT #:, - EXPIRATION DATE:
Non-DischargeUIC-
NPDES
TYPE OF PERMITTED -OPERATION -BEING MONITORED
on Remediation: Infiltration Gallery
Spray Field Remediation:
4Rotarypistributor Land Application of Sludge
Other:
Screened Interval: ft.•,to !t.
Depth to Water Level; � � `3.� � -Effluent (99)
p ft. below measuring point:,
- 'Measuring Point (M.P.) is:" tt. above Land surface. r Relative-M.R. Elevation m ft
Gallons.of water pumped/bailed before sampling;' '/`�, c;) ' Date sample,collected 3..2 5�
Field analysis:' pH �f - `% ; Specific Conductance ,uMhos ! 2 1 /0' ,•
Temp."L�-°C, Odor Appearance
Values should reflect dissolved n . .
��: Va ved and
colloidal concentrations:,.
- -,
Date sample analyzed: .2 3;
Laboratory Name: t1 .vn. /.4 • 13.
certification No.
PARAMETERS` (Samples for metals were collected, unfiltered' YES -NO
and field acidified:
YES - NO)-.
COD
mg/i.
Nitrite :(NO2) "as:N . '
mg/1"
Ni --Nickel.
mg/I
Coliform: MF'Fecal
/100ml _-
Nitrate.(NOg)'as.N •'off m'g/I'
'Pb - Lead
mg/I
Coliform: MF Total
/1 OOml
Phosphorus: Total as-P mg&.
Zn =-Zinc '
mg/I
- (Note: use MPN method for highly turbid Samples)
--Orthophosphate'.
mg/I
Ammonia:. ro,gen r _,-' F�
,mg/l
Dissolved Solids: Total--- $ mg/I
Al - Alulnin•um =
rng/I'.
Other (Specify -Compounds and Concentration Units)
pH (when analyzed) -
units.--
Ba•- Barium
mg/I.
TOC 0 S'
mg/I
'Ca - Calcium
mg/l
Chloride ?. s^
mg/(_,
Cd -Cadmium
mg/I
- -
Arsenic
mg/I
Chromium:_Total-
mg/I
Grease and Oils
mg/l
Cu -Copper
mg/I
Phenol
mg/I •
Fe - Iron`
'' mg/I
ORGANICS: (GC,GC/MS,HPLC)
Sulfate
trig/I
Hg = Mercury
mg/I ..
(Specify test -and method #. Attach lab report.)
Specific Conductance
uMhos
K - Potassium-'
mg/I
Report Attached? "Yes . (1). No
(0)
Total Ammonia Z • 20
mg/I :
Mg - Magnesium
trig/l.
VOC " :. - method # _
TKN as N
: ' °mg/I.,
Mr!:'_ Manganese
rcg/f
method #
method #
Permitt (or Authorized AgenA Name -and Title -Please print or type
`-(-z l_0
Y
,...
rt: GW-5J
(`
signature of Permittee (or Authorized Agent)
-
(Dale)
-Rev. 03/2006

SUBMIT FORM ON YELLOW W PAPER ONLY
GROUNDWATER 'QUALITY.MONITORING-
COMPLIANCE REPORT -FORM
FACILITY INFORMATION- Please Print Clearly or Type
t
Facility Name: �e 44�-s
Permit -Name (if different) `
!C)Un(01Y)' (Siaie)
Contact Person:a ey
/ r- YTephone #
Well Location/ Site'Name:z -No. of Wells'to be Sampled:
.•. .
Well'Identification Number (from Permit): A_W 3
For Groundwater Treatment Systems
Well':Depth: '2 5f • .2 (it. Well Diameter, in. -Check One• El Influent (98)
DEPARTMENT oP ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION -
1636 MAIL SERVICE CENTER'
RALEIGH N627699-1636 Phone: [phone]
PERMIT #: EXPIRATION DATE: /'•i
Non-DischargeW_Q Q,>l 8'74 g:, U10
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
moon Remedialion, Infiltration Gallery,
` Spray.Field ' ; Remediation
Rotary Distributor " Land Application of Sludge
Other: _
Screened' Interval: - ft. to .. ft. .
Depth to Water Levu - - - 1 0 Effluent .(99,) NOTE:.Values should.reflect dissolved and .
p �_ft. below -measuring point. colloidal concentrations.
Measuring -Point (M,P.} is:' tt: above land surface. Relative. M P: Elevation in ft.:
Gallons of water pumrd/bailed before sampling: %�. ��' Date. sa_ mple collected.. Z) _ Date sample analyzed: -, 2 5 =a
Field analysis:' pH is G Specific Conductance uMhos rl� LaboratoryName:-- ,4. LA. _ot to
:Terhp..L - -C; Odor ' Appearance Certification No.
PARAMETERS (Samples for metals were.collected, unfiltered YES -' NO `and=field'acid)f)ed
--
'YES ` - NO) ` -
COD
mg/I
Nitrite.,(NO2) as N
mgll'
Ni -`Nickel mg/I
Coliform:- MF Fecal i
/100m1
Nitrate '(NO3). as.N `L•• L L
mg/I .
Pb`- Lead mg/I -
,Coliform: MF-Total,
/100m1
Phosphorus: Total as P �.�
mg/I
Zn -Zinc mg/I ,
(Note: Use MPN,method for highly turbid samples)
;Orth"OphOsphate.
mg/I
-Ar onia Nitrogen
im
Dissolved'.SOlids,: Total L/- 2 .
mg/l'
AI"= Aluminum
= mg/I
-Othet -(Specify Cornpounds`and Concentatidn Units) _
PH (when, analyzed)
units
-- Ba - Barium
m /I
a �
TOC' 3 s
mg/I,
Ca.- Calcium
mg/I
Chloride,mg/I
Cd -Cadmium- _ _ -
mg/I
Arsenic ".
mg/I..
Chromium:'Total
trig/I
;,,��„ ��ar;,, ^
Grease- r d Oils :.
mg/I :., ,
.Cu - Copper
mg/I,
_ :n.
Phenol
M /I
g
FeIron' - �
, rng/I .
_
(dC Gclnns'HPLe). r
Sulfate"
mg/I.
Hg - Mercury'.
t1'lg/I ,
_.ORGANICS
(Specify test and, method #. Attach lab report.)
Specific Conductance
uMhos
K -Potassium
mg/I
Report Attached? Yes ,(1) No JO)
Total Ammonia - : L • z
mg/1'
Mg - Magnesium
mg/l, _ .
VOC . method. #
TKN as;N - ,
mg/I
Mn -"Manganese
mg/I
_
:method
- method, #'
MM... . ... -.
..- .
Ct
Per o i mittee (o�juth Hied Age ame and Title lease print or type
-59 Signature of Perrrt)ttee (or Authorized Agent) (Date)
Rev., 03/2000

SUBMIT FORM ON YELLOW PAPER- ONLY
GROUNDWATER- QUALITY MONITORING:
COMPLIANCE. REPORT FORM
FACILITY INFORMATION / Please Print Clearly or Type
Facility Name: `- , e
Permit Name .(if different
Fac' ity AdIrpss: �— 154 / -" {
(SIre el Rai
(City)COUnty _ -
Contact Person: ��' 'rf Telephone #: �'�� ig
Well Location/'Site Na e: wt No. of Wells to be Sampled:, -
Well Identification Number (from -Permit): le // 57- For -Groundwater Treatment Systems
Well Depth: 2Ir. 1-3 ft. Well -biameter ' in.
Check one: ❑ .Influent (98)
Screened Interval: ft. to ft. ❑Effluent (9.9)
Depth to Water Level: , n. below measuring point. _
Measuring Point (M.P.) is: .ft. above.land surface. Relative M.P.' Elevation in ft.:
Gallons of water pumped/bled befoie sampling: Date sample collected.;..3
Field analysis: pH. , Specific. Conductance uMhos i
Temp. i,_°C, Odor Appearance
mail • . DEPARTMENT OF ' ENVIRONMENT & NATURAL RESOURCES`
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT C.EXPIRATION DATE: 22 G
Non -Discharge ( Lz_ l>f a 7) � UIC "
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
lagoon " Aemediation: Infiltration Gallery
Spray Field Remediation:
-Rotary Distributor Land Application of Sludge
Other:
NOTE:. Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 3. 2 S
Laboratory Name: L/evri
Certification, No. n- 7 S'
PARAMETERS (Samples for metals were collected unfiltered ­ • YES NO
and field acidified
YES NO)
COD
Tng/I
Nitrite (NO2) as N
mg/I'
Ni - Nickel - mg/1
Coliform: MF Fecal /
/100ml
Nitrate (NO3) as N L
, ©S mg/1
Pb - Lead rrtg/I
Coliform; MF Total
1100rril
Phosphorus: Total -as P '
Z s mg/I
Zn - Zinc mg/I
(Note: Use MPN method for highly turbi s mpies)
-
Orthophosphate,
mg/I, : -
Ammonia Nitrogen
Dissolved -Solids: Total
mg/I
Al =Aluminum
mg/I '.
Other•(Specify Compounds grid"ConcentrAtion•Units)
pH.(when analyzed,)
units
Ba - Barium
mg/I.(
TOC 7
mg/I
Ca - Calcium
mg/1
MT
Chloride / `��
•mg/I
Cd - Cadmium
mg/l
Arsenic
mg/I
Chromium: Total -
_
mg/I
Grease and Oils
mg/l
Cu" Copper,
mg/I
_
Phenol
mg/1-
Fe--- Iron
:mg/I
ORGANICS: (GC,GC/MS,HPLC)
Sulfate
mg/I
Hg - Mercury_
mg/I
(Specify test and method - lab report.)
Specific Conductance
uMhos .
K-- Potassium
mg/I
Report Attached? Yes (1), No (0)
Total _Ammonia 2, 03-
mg/I
Mg -.Magnesium
mg/I
VOC method # =
TKN.as N
mg/I
Mn:-Manganese
mg/I
method-#=
method # —
Hev. oslzuUU

(Submit one each manitaringperiod with Gfi=59 forfns.)
1
Enter date monitoring results were due. - Will this monitoring report (GW-59 and GW-59A)
YES
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
N
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
N
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Office for guidance.
4
Are any monitored constituents equal to or above the established standards?
YES
O
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 constituents) 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).
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES', a groundwaterquality 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
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 maysubiect the permittee to a Notice of Violation,
fines, and/or penalties.
g
The person completing this portion (G W-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 fiereby acknowledge that the above information was evaluated and the mformation submitted m this
repOrt.(Complianc'6 Report GW;59complete to the best of my.-m qw,
Signature of Permittee'(or Authorized Agent) Date
r1XV-40a IIIS2i7i)(1I