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WQ0007569_Monitoring - 07-2024_20240908
Monitoring Report Submittal Permit Number#* Name of Facility:* Month:* July Report Information Type * GW-59 WQ0007569 Brandywine Bay Year:* 2024 Upload Document* Brandywine Bay GW-59 July 2024 (3).pdf PDF Only 2.02 M B Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). Confirmation Email Address: * anthony.futrell@nexuswg.com Name of Submitter: * Anthony Futrell Signature: �.rMarj lvewl Date of submittal: 9/8/2024 This will be filled in automatically Initial Review Reviewer: Wanda.Gerald Is the project number correct?* W00007569 Is the monitoring report accepted?* Yes NO Regional Office* Wilmington Reviewer: _anonymous Review Date: 10/3/2024 GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION PleasePrin[ClearlyorToe Facility Name: Brandywine Bay Permit Name (if different): Facility Address: 104 Sleepy Courl act Person: Sari, Cox Locationf5ite Name:UVWTP SUBMIT FORM ON YELLOW PAPER ONLY NC 28557 County Carteret Telephone#; 252-808-7676 No. of yells to be sampled; B DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES INFORMATION PROCEss1NG uw 1617 MAIL SERVICE CENTER, RALEIGH, INC 27699.1617 PERMIT Number: Expiration pate: jj $az� Nan -Discharge WQ0007669 UIC NPDES Other TYPE OF PERMITTE OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ® Spray Field ❑ RemediaWn: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat pump ❑ Other: SAMPLING INFORMATION 'from permit WELL ID NUMBER (from Permit]: IVIW-2 Date sample collected; 7/8/2024 Weil Depth: ZQ fit. Well Diameter 2 in. Depth to Water Level 82546:7•9 ft. below measuring point Screened Intervaf: 5 ft. to ft Measuring Point is 1.5 ft. above land surface Relative M.P. Elevation: ft, Volume of water pumpedlbailed before sampling: 5.0 gallons Samples for metals were collected unfiltered: I] YES NO and field acidified: ❑ YES NO LABORATORY iNFORIhMATION Date sample analyzed;7)8)2024 Laboratory Name: Environmental Chemist PARAMETERS NOTE: Values should reffect dissolved and colloidal concentrations. COD {I0335 mg/L —1100mL Nilrite (NO,,.) as N 00615 e0,02 mgJL Coliform: MF Fecal 21676 a j Nitrate (NO3) as N 00620 0.20 mglL Coliform: MF Total 31so4 1100mL Phosphorus: Total as P wsa5 0.50 mg1L tNox: use S4Pt MOMOd OF highly -Whid saripiesl Orthophosphate raso7 Ip9 IL Iissolved Salids;Toial 7o30o 427 mg[L Al - Aluminum ot,a5 mg/L pH (Lab) omm units Ba - Barium 01007 uglL TOC Gawp 26.0 mg1L Ca - Calcium W916 mg1L Chloride nosao 31 mg/L Cd - Cadmium o,a27 uglL Arsenic ciioo2 uglL Chromium; Total a-=4 uglL Grease and Oils oe552 mg/L Cu - Capper 01G42 mglL Phenol 32730 uglL Fe - Iron nt045 uglL Sulfate oo946 mg1L Hg - Mercury 71goo uglL pecific Conductance mo95 pMhos K - Potassium 00937 mglL Total Ammonia oomo 0.4 mglL Mg - Magnesium U0927 mg& ;Anvnpngl hil?open: Nh. as N; Rmeropnia Ndmgen, TOthlj Mn - Manganese o,o55 uglL TKN as N nce2s rng1L Ni - Nickel O1067 uglL FIELD ANALYSES: PH 00400: 8.8 units Spec. Cand. 00094' Odor 00085: none Appearance If WELL Ten,p. 0oo10: 21.5 :�C DRY at omhos time of Certification No. 94 Pb -Lead o1o6, ug]L Zn - Zinc o1092 mg1L Other tSpecify Compounds and Concentration Units): ORGANICS: (by GC, GCIMS, HPLC) (Specify test and method #. ATTACH LAB REPORT.) Lab Report Attached? ❑ Yes (1) ❑ No (0) VOC 7873 method # method # method # method # For Remediatien Systems Only (Attach Lab Reports); Influent Total VOCs: _ mg1L Effluent Total VoCs: P I. ;!=_._s .. a �� _ Tom...KonsuI Pnrmittep (or Authorized Agent Name and Title - Please print or type Signature of Pprrnittee (or Auto ized GOI-59 Rev.06-07-2018 Agent} mg/L VOC Rernoval°!o check here:❑ SUBMIT FORM ON YE_ LL—= PAPER ONLY NDWATER QUALITY MONITORING: LIANCE REPORT FORM Please Awr# Clearly or Facility Name: Brandywine Bay Permit !Name (if different)- Facility Address: 104 Sleepy Court vlorehead City IVC 28557 County Carteret Contact Person; Sam Cox Well Location/Site Name:WWTP WELL ID NUMBER (from Permit). MW4 Well Depth: 2-0 ft. Depth to Water Level 82546:6.8 ft, below measuring point Measuring Point is 1.5 ft. above land surface dolume of water Pumped/bailed before sampling: 5-0 Samples for metals were collected unfiltered: ❑ YES -A RA DO irnpv Thi ul nRaa ^...� Telephone#: 2 52-808-7 E 16 No. of wells to be sampled: B DEPARTMENT OF ENVIRONMENTAL QUALITY • DIV. OF WATER RESOURCES INFORMATION PRocessmr. UNIT 1617 MAIL SERVICE CENTER, RALEIGH, NC 27599-1617 PERMIT Number: Expiration Date- Non -Discharge VVQ0007569 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation; Infiltration Gallery Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ other: Date sample collected: 7/8/2024 Well Diameter: 2 in. Screened Interval: 5 ft, to ft. Relative M.P. Elevation: ft. gallons NO and field acidified: ❑ YES If No Date sample analyzed:W812024 Laboratory Name: Environmental Chemist PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COt7 09335 mg/L Nitrite (NO,) as N 00515 c0-02 mg/L Coliform: MF Fecal 31616 ¢1 1100mL Nitrate (NO3) as N 00620 <0.02 m L Coliform: MF Total 31ae4 i�otc: iJ5t7 '100mL Phosphorus: Total as P Dcw5 0.15 mglL f1PN mcth[td rw �ipfly :�. hid _s-7mp;as� Orthophosphate 7o507 issolved Solids -.Total 70300 564 mg1L Al' - Aluminum c1105 mg/L. PH (Lab) cma3 units f3a - Barium mn(y7 mg/L uglL TOC omso 23.5 mglL Ca - Calcium onat6 mg1L Chloride ocs4o 66 mg/L Cd - Cadmium 01927 ugfL Arsenic o1oa2 uglL Chromium: Total 01034 uglL Grease and Oils 00562 mg/L Cu - Copper olm2 mg/L g Phenol 32730 uglt Fa - Iron 01645 ugfL Sulfate ❑oNf, mg/L Hg - Mercury ri9m uglL )ecific Conductance uao95 pMhos K - Potassium 00937 mg/L Total Ammonia nosh 1.6 iNrxronia Wrr,9en; mgfL Nlg - Magnesium 00927 mg/L NH, as N: ix: ANgxoger, -otMj Mn - Manganese o1 o55 ug/L TKN as N oo625 mglL Ni - Nickel ow67 ugfL For Remediation Systems Only (Attach Lab Reports): FIELD ANALYSES: pH e040e: 6.7 units Temp. coolo. 22.8 'C Spec. Cond. oocr,4: u#vmhos Odor ome none Appearance Certification No. 94 Pb -Lead c1o51 ug1L Zn - Zinc C1092 mg/L Other (Speclfy Compounds and Concentration Units): ORGANICS: (by GC, GC/MS, HPLC) (Specify test and method #. ATTACH LAB REPORT.) Lab Report Attached? ❑ Yes (1) ❑ No (0) VOC 7673 method # method # method # method # Influent Total VOCs: mg/L Effluent Total VOCs: w� Perml![ee [Of Auri Driced Ay�e:>?) Name ad Ton Ti1ie - i'fer�se p inf or type Signature of Fe-rnitrsP for Aulhorized Apantl GYV-59 Rev. 06-07-2018 mg/L VOC Removal% Mate) !If WELL WAS DRY at time of sampling, ;Q UNOUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION Please Print Clearly ar Facility Name: Brandywine Bay Permit Name {If different]: Facility Address: 104 Sleepy Court Morehead Ci NC 28557 Contact Person: Sam Cox Well Location/Site NameoWTP JSAIVIPL INQ INFDI4IVIATl0N. 'WELL ID NUMBER (from Permit): Well Depth: 7-0 ft Depth to Water Level 82546:6.8 ft. below measuring point Measuring Point is 1.5 ft. above land surface Volume of water pumpedlbailed before sampling: 5.0 Sam les fof metals were collected unfiltered: ❑ YES E SU13MIT FORM ON YE_ LLOW PAPER ONLY County Carteret Telephone* 262-806-76 76 No. of wells to be Sampled: 6 Date sample Collected: 71812024 Well Dlameter: 2 in. Screened Interval: 5 ft_ Relative M.P. Elevation: DEPARTMENT OF ENVIRONMENTAL QUALMY - Div. OF WATER RESOt1IRCE$ INFORMATION PROCESSING UNIT 1517 MAIL SERVICE CENTER, RALEIGH, NC 27099-1817 PERMIT Number.- Expiration Date- -11r Non -Discharge WQ0007569 LAC NPDES Other TYPE OF PERMITTED OPERATION BEfNG MONITORED ❑ Lagoon ❑ Remediation: infiltration Gallery N Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat frump © Other: to � ft. ft. gallons NO and Feld acidified: ❑ YES ® NO Pate sample analyzed:71812024 Laboratory Name: EnWronmental Chemist ARAMETERS NOTE: Values should reflect dissolved and colloidal COD 00,335 mglL concentrations, Nitrite (NO2) as N oosm r0.02 Coliform: MF Fecal 31616 ¢1 11GII Nitrate (NO3) as N 00620 r0_02 mg1L Colifoml: IIRI= Total 31604 1100ML ;Note! urIPN 7,,,Wq-rhw Phosphorus: Total as P oo655 O. �� mglL rttg1L se mound for Ssmpiest Orthophosphate zuso7 mg1L ,solved Solids:Total 70300_ Sip mglL Al - Aluminum otffl5 PH {Lap} ou4m units Sa - Barium 01007 mg1L ug1L TOC caea0- /& • (0 mg1L Ca - Cafcium 90916 mglL Chloride fl094e�� (,v rng1L Cd - Cadmium 01027 ug1L Arsenic o1o02 uglL Chromium: Total 01034 uglL Grease and Oils o0552 mglL Cu - Copper 01042 1L Phenol 32730 uglL Fe - Iran o7095 u�L uU Sulfate ODS45 rnWL Hg - Mercury 7uI u 1L 9 :cific Conductance D�o95 ttMhps K -Potassium 00937 Total Ammonia aosla Q mg1L Mg . Magnesium 00927 mg1L rnmam iAs Narogen: NH Ias ft� amlbrria Mitrogen, Total) mglL Mn - Manganese a1 o55 uglL TKN as N oo625 mg1L Ni - Nickel01067 � ug1L For Remediation Systems Only (Attach Lab Reports): FIELD ANALYSES: pHe0400:_120- units Spec. Cond, ooaa4- Odor omw8 none Appearance Temp. eoato: 7_1.I °C whos Certification No. 94 Pb - Lead olos1 ug1L Zn - Zinc U1092 mg1L Other (Specify Compounds and Concentration Units): ORGANICS: (by GC, GC1MS, HPLC) (Specify test and method #. ATTACH LAB REPORT.) Lab Report Attached? ❑ Yes ( 1) ❑ No {D} VOC 7873 method # method # method # method # Influent Total VOCa- mglL Effluent Total VQCs: To Konsuft PermrtiRe (or Authorized Agent) Name and Title - Please print of type � Signature of Permitte8 for AuIhorixed Apen!) GW-59 Rev. 06-07-2018 mglL VDC Removal°% (Date) lif WELL WAS DRY at time of sampling, check here; El SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM Facility Name: Brandywine Bay Permit Name {if different): Facility Address: 104 Sleepy Court Person: Sam Cox Location/Site Neme:WWTP Please Prud Clead oror IBC 2$557 County Carteret Taieph one#: 2 52-SOB-7676 No. of wells to be sampled: 6 DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WAtER RESOURCES INFORMATION PROCESSING UNIT 1617 MAIL SERVICE CENTER, RALEIGik, NC 2789E-9B17 PERMIT Number: Expiration Date- I f1611T Non -Discharge W00007569 UIC NPOES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: WELL ID NUMBER (from Permit): im W Date sample collected: 718f2024 if WELL Well Depth: 7-p FIELD ANALYSES: Depth to Water Level 8254s:6•t3 ft. below measuring point Vile!! lJlameter: 2 in, pH oeao0:� units Temp, cools: ZI °C Measuring Point is 1.5 ft. above land surface Screened Interval- 6 ft, to � ft. Spec. Cond. ooa94: µMhos Volume of water pumpedlbailed before sampling: 5•0 Relative M.P. Elevation: ft. Odor voos5: none $ Lhere- gallons Sam lee for metals were collected unfiltered: ❑ YE5 ®NO and field acidified: ❑YES ®NO Appearance El LABORATORY INFORMATiOIV Gate sample anal ed 7I812A24 � La6vratory Name: Env"tronmental Chemist PARAMETERS NOTE: Values should reflect dissolved and eoiioidaf concentrations. COD oas35 m IL Nitrk N Califarm: MF Fecal 31616 ¢1 9 1100mL Colifvrrrl: MFTatal 315C4 1100mL Moto: Vqo 1.1PM me;hatl (°r highly Surh samp!xsl issolved 5alidS-Total 70300� mg/L PH (Lab) C0403 Units TOC Mew Jill l mglL Chloride 00940 G mg1L Arsenic e10o2 uglL Grease and Oils 00552 mglL Phenol a2730 uglL Sulfate 6D945 mglL )ecifio Conductance =95 ),Mhos Total Ammonia naelo_ mglL (Ammon ra milroyen; Nh, as A; Wrsnorya Nil:Ogen, Totg1] TKN as N ao625 mg1L For Remediation Systems Only (Attach Lab Reports) e ( 02) as N o0615 �0,p2 mglL Nitrate (NO.) as N 00620, 0.03 mglL Phosphorus: Total as P Doses mg1L Orthophosphate ?05g7 mg1L Al - Aluminum 01105 mglL Ba - Barium 01007 ug7L Ca - Calcium oo916 mglL Cd - Cadmium 01027 ug/L Chromium: Total atDac uglL Cu • Copper 01042 mglL Fe - Iron 01045 uglL Hg - Mercury 71900 ugIL K - Potassium 00987 mglL Mg - Magnesium Doll mg1 Mn - Manganese o1055 uglL Ni - Nickel 01067 uglL Influent Total VOCs: ° 111 �� Yt.� re Permittee (or Aulhprized Agent) Name and Title - Please print pr type GW-59 Rev.06-07-2018 Certification No. 94 Pb -Lead elasl uglL Zn • Zinc c1092 mglL Other (Specify Compounds and Concentration Units): ORGANICS: (by GC, GC/MS, HPLC) (SPIll test and method #. ATTACH LAB REPORT.) Lab Report Attached? ❑ Yes (1) ❑ No (0) VOC 7873 method # method # method # method # r,^,fete, and tha-the laha-ato^y dnalyl,c:rl data ,vas p Au,_eei usinc app > pass:bitity of rineti and it G sonrnent ror {ri 7w r1g :in'a'icns rng/L VOC Removat°Io 'GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATfON Please Pro>r Cleady or Facility Name: Brandywine Bay Permit Name {if different}: Facility Address: 104 Sleepy Court dlarehead City NC 2 5557 Contact Person: Sam Cox Well Locationlsite Name: WMTP SUBMIT FORM ON YELLOW PAPER ONLY County Carteret Telephone#: 252-808-7676 No, of wells to be sampled: 6 I DEPARTMENT OF ENVIRONMENTAL QUALITY- DIV, OF WATER RESOURCES INFORMATION PROCESSING UNIT 1 S77 MAIL SERVICE CENTER. RALEIGH, NC 27699.1617 PERMIT Number: Expiration Date- q 38 IFF Non-Disdlarge W00007569 UtC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediabon: Infiltration Gallery Spray Field ❑ Remediation- ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Waler Source Heat Pump ❑ Other: WELL ID NUMBER from Permit).- MW-9 { ) Date sample collected: 71812024 FIELD ANALYSES: if WELL Well Depth, ft. Welt Diameter: 2 in_ PH aa.;oo: 5.7 units Tamp- coolo: 22.7 °C WAS DRY at Depth to Water Level 82546:6.4 ft- below measuring point Screened Interval: 5 ft, to ft Spec. Cond. vaa&n= µMhos time of Measuring Point is 1.5 €t. above land surface Relative M.P. Elevation: ft. � Odor ama5: none sampling, Volume of water pumped/bailed before sampling: 5.0 p 9 gallons check Samples far metals evere collected unfiltered: ©YES ®NO and field acidified; ❑ YE5 ®NQ Appearance here; LABORATORY INFORMATION Lia#t= sample analyzed:718l2a24 Laboratory Name: Environmental chernist PARAMF7EfZ5 NQTE: Values should reflect rlissnlved and avlioldal concentrations. Certification No, 94 CaD a3335 mgiL Caliform: MF Pecal alsls ¢ 1 Nitrite {fs1Oz} as f� 0v615 �0.02 mgiL Pb -Lead o1o6i uglL 11Q0mL Nitrate {Na3} as N 00620 <0,02 mg1L Zn -Zinc G1o82 mgiL Collform: MF Total 31504 1100mL :tom: Phosphorus; Total as P oo665 0.16 mgiL Unr. !41pN met!•alj 1Cr niFhEy 3a0: ri galTllOies} issolved SofidB:TGNI 70WO 188 Orthophosphate 70507 rngJL Other (specify Compounds and Concentration Units): mg1L Ai -Aluminum of 7o5 mg{L PH (Lab) oo4o3 : units Ba - Barium 01007 ug1L TOC eosso 9.9 mgiL Ca - Calcium a0916 mgiL Chloride oo?4o 51 mgiL Cd - Cadmium U1027 ugJL Arsenic 01002 ug/L Chromium; Total 01v34 ugJL Grease and ails o0552 mg1L Cu - CoppeF01D42 mgiL ORGANICS: (by GC, GCIN15, HPLC) Phenol 32730 ugJL Suifele mama Fe - Iron 01045 ug/L (Specify test and method #. ATTACK LAB REPORT.) mgiL pecific Conductance 000m Fig - Mercury 719co ugJL Lab Report Attached? ❑ Yes ( 1) ❑ No (0) i_iMhos Ammonia po61a 0.3 K - Potassium 90937 mgiL VOC 7873 , method #Total mgiL LAmmonia Nhtmpen; TRH=as N. Aminartia CdiErc7gun, -ntwr My - Magnesium 00927 m�- , method # Mn - Manganese o1055 ug1L method # TKN as N 00625 mglL Ni - Nickel 01067 ugJL method # For Remediatlon Systems Only (Attach Lab Reports): Influent Total VOCs: mgiL Effluent Taal VOCs: mgiL VOC Remaval°I° �► .., u s - � Ton Kon :.:. 5 u � ?-ermittee (a Authorizers APenQ Name and TIPe - Pie asc print or type Signature of Permittee (or Aulhwized Agenly - GVI+-59 Rev. U6-07-2018 lli3lPj GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM Of Type Facilily Name: Brandywine Bay Permit Name {if different}: FacilFty Address: 104 Sleepy Court Morehead Ci NC 28557 :ontact Person: Sam Cox Neil Locationlsite Name.WWTP WELL ID NUMBER (from Permit): MW-?a Well Depth: -0 ft. Depth to Water Level 82546:8.0 ft. below measuring Point Measuring Point is 1.5 ft. above land surface Volume of water pumpediballed before sampling: 5.0 gallon Sample-9 for metals were collected unfiltered: ❑ YES ® NO SUBMIT FORM ON Y OW PAPER ONLY County Carteret Telephone#: 252-808.7676 No. of wells to be sampled: 6 DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV, OF WATER RESOURCES INFQRMATION PROCESSING UNIT 1617 MAIL SERVICE CENTER, RALEIGH, NC 21699.16J7 PERMIT Number: Expiration Date Non -Discharge WQ0007569 UIC NPOES rather TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ® Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Wst8r Source Heat Pump ❑ Other: Date sample collected: 7/8/2024 FIELD ANALYSES: Weil Diameter: 2 in. pHpo4oa: 5.0 units Temp. ImpIa: i1.rJ °C Screened Interval: 5 ft- to ft. Spec. Cond. 000u4: IiMhos Relative M.P. Elevation: ft. Odpr po0e5: none and field acidified: ❑ YES ® NO Date sample analyzed:71812024 Laboratory {dame: Environmental Chemist PARAMETERS NOTE: Values should reflect dissolved COD 00335 and Colloidal concentrations_ Colifarm: MF Fecal 315I6 r1 mg/L Nitrite (NQ,) as N 00515 r0.02 mglL1100ML Nitrate (NO3) as N U0620 3.03 mg1L Colifarm: MF Total 31504 INota: 11sc NPN mr:firpf{ !or ieeghly 1�;r�c spmtriesj 11 OOmL Phosphorus: Total as P oass5 0.06 mg/L issolved Salids:Tatal 7o3ov 102 Orthophosphate 70507 _ _mg/L � PH (Lab) co4o3 mg/1-Al -Aluminum amps rng1L TOG ❑058o 1.2 units Ba - Barium olo07 uglL Chloride pna4o 9 mg/L Ca - Calcium "15 mg/L Arsenic 01002 mg/L Cd -Cadmium pto27 ag1L Grease and Oils oo552 ug/L Chromium: Total 01034 —.—u91L Phenol 3273o mg/L Cu - Copper 01042 mg/L Sulfate DOS46 ug1L Fe - Iron o1045 ugAL Specific Conductance o4om5 mg/L pMhos Hg -Mercury 719po ug1L Total Ammonia oaeta a0.2 K - Potassium 00937 —_�L IAmm nia Nitro , gerl; Nit ae N; gnYrlOnia Nitrogen, TvGal] mg/L g M9 - Magnesium 00927 mglL TKN as N 00625 Mn - Manganese oloss ug& mg/L Ni . Nickel 01067 ug1L For Remediation Systems Only (Attach Lab Reports); Influent Total VQCs: ARKWAILLUMMUM.. mg/L Appearance Certification No. 94 Pb -Lead oio51 u9111- Zn - Zinc olnez mg/L Other (Specify Compounds and Concentration Units): ORGANICS; jby GC, GCIM% ? PLC) (Specify test and method #. ATTACH LAB REPORT,) Lab Report Attached? ❑ Yes (1) ❑ No (0) VOC 7873 method # method # method # ` method # Effluent Total VOCs: Kat~)►.l,ee 4"RIPI. �« :�...� �Ton Kons��R Fermittor Authorized Agent} Name Ono Title - lease print or type _ •�' ^-r��i� �� GW-58 Rev. 06-07-2018 SigrlaturP o Permute. (ar AUlhorized Agent}ry mg/L VOC Removar% (Jatt:. !f I DRY at time of sampling, check here:❑