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HomeMy WebLinkAboutWQ0024756_Monitoring - 02-2021_20210406 (2), JuOlvll t r-UMM UN rtLLUVV 1`-PietK UNLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION x Please Print Clearly or Type Facility Name: c ��1r-Z� L��Q� LUL, Permit Name (if different): Farilihr Arir4r _'i .1 i .1 1l .. \ t. 1 .. c. 1 c,­_ c .- , Contact Person:Ma Well Location/ Site Name: County Q?j�- Telephone -7 No. of Wells to be Sampled: Well Identification Number (from Permit): a Well Depth: - 1 of For Groundwater Treatment Systems P ft. Well Diameter: in. Check One: ❑ Influent (98) Screened interval: ft. to ft. Depth to Water Level: _ft. below measuring point. Effluent (99) Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in It.: Gallons of water pumped/bailed before sampling: i , n Date sample collected: _xLaiJ'] Field analysis: pH `_)-Li , Specific Conductance uMhos Temp. -14 OC, Odor Appearance DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES WATER QUALITY DIVISION, GROUNDWATER SECTION 1636 MAIL SERVICE CENTER RALEIGH. NC 27R99-1 R3R oh, - rot ON �» ar PERMIT #: EXPIRATION DATE: Non-Discharge,y 1y7C(e UIC NPDES TYPE OF PERMITTED OPERATION BEING MONITORED Lagoon Remediation: Infiltration Gallery Spray Feld Remedialiort: Rotary Distributor Land Application of Sludne Other NOTE: Values should reflect dissolved and colloidal concentrations. Date sample analyzed: Laboratory Name: !j! v Ne- r C _ Certification No. ya PARAMETERS (Samples for metals were collected unfiltered YES COD NO and field acidified Coliform: MF Fecal Coliform: MF Total mg/I /100ml /100ml Nitrite (NO2) as N Nitrate (NO3) as N Phosphorus: mg /l tn_(� mg/I Total as P . 0. 1 mg/I (Note: Use MON method for highly turbid samples) Dissolved Solids: Total O mg/l Orthophosphate Al Aluminum m pH (when analyzed) `E units - Ba - Barium mg mg/I TOC 4 S mg/I Ca - Calcium mg/I ArseChlonic Arsenic c mg/1 Cd - Cadmium mg/I Grease and Oils mg/l mg/I Chromium: Total Cu - Copper - mg/I 2tmg/I Phenof Sulfate mg/I Fe - Iron__ t p mg/I Specific Conductance mg/I umhos Hg - Mercury K - Potassium - : _Mg/f V,'' ,,( [C��I Total Ammonia TKN as N mg/I M9 - Magnesium --�t >`'= " ``` mg/I mg/1 Mn - Manganese mg/I YES NO) Ni - Nickel mg/I Pb - Lean mg/l Zn - Zinc mg/I Ammonia Nitrogen- 0.05 mg/I Other (Specify Compounds and Concentration Units) ORGANICS: (GC,GC/MS,HPLC) (Specify test and method #. Attach lab report.) ReportAttached? Yes (1) No (0) VOC : method # = : method # = method # = r Prnrgee (or Authonzed Agent) Name and Title -Please print or type r Rev. 03/2000 Signature of Pemultee (or Authorized Agent) avomr i rumm U!V r tLLUVV Y/iYttt ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION Please Print Clearly or Type Facility Name: VtEfZ Cg-� 7: � �,-Q� LI' Permit Name (it different): GnnilR,. A.rA.,...,.. rN � i , A, I. . N k t l Corita6t Person:_2Cz),,,a. Well Location/ Site Name: County &.�e - Telephone #: IZ) -) No_ of Wells to be Sampled: Well Identification Number (from Permit): , For Groundwater Treatment Systems Well Depth: X1 ft. Well Diameter. in. Check One: ❑ Influent (98) Screened Interval: ft. to it. El Effluent (99) Depth to Water Level:Z 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: 1 : S Date sample collected: Field analysis: pH_ , Specific Conductance uMhos Temp. —'C, Odor Appearance DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES WATER QUALITY DIVISION, GROUNDWATER SECTION 1636 MAIL SERVICE CENTER RALEIGH, NC 27699-1636 Phone, r9191 711-19; PERMIT #: EXPIRATION DATE: Non-Discharge_%,� UIC NPDES TYPE OF PERMITTED OPERATION BEING MONITORED Lagoon Remediation: Infiltration Gallery Spray Field Rotary Distributor Other Remediation: Land Application of Sludge NOTE Values should reflect dissolved and colloidal concentrations. Date sample analyzed: Laboratory Name: Y�t.Y1r- . _ _ _ T�t"L Certification No. PARAMETERS (Samples for metals .were collected unfiltered YES NO and field acidified COD Coliform: MF Fecal mg/I /100ml Nitrite (NO2) as N Nitrate (NO3) as N mg/I mg/I Coliform: MF Total /100m1 Phosphorus: Total as P__ (0-L-)4 mg/l (Note: Use MPN method for highly turbid samples) Dissolved Solids: Total '}�OL7 Orthophosphate n ) gA _ pH (when analyzed)_ I.S mg/I units Al - Aluminum Ba - Barium m mg/I TOC 4 a, mg/I Ca - Calcium mg/I Chloride t Arsenic mg/I Cd - Cadmium mg/I Grease and Oils mg/I mg/I Chromium: Total Cu - Copper mg/I mg/l Phenol mg/I Fe - Iron mgA Sulfate Specific Conductance mg/I uMhos Hg - Mercury K - Potassium mg/I mg/I Total Ammonia TKN as N mg/I Mg - Magnesium mg/I mg/I Mn - Manganese mg/l —YES NO) Ni - Nickel mg/I Pb - Lead mg/I Zn - Zinc mg/I Ammonia Nitrogen-_ if-)Z)_y 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 # _ n•-• f= t­ rxmnq name ano i me - mease pnnt or Rev. 03/200o Signature of Permittee (or Authorized Agent)