HomeMy WebLinkAboutWQ0024756_Monitoring - 02-2021_20210406 (2),
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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)