WQ0011360_Monitoring - 11-2022_20221222

GW-59A COMPLIANCE REPORT FORM � Permit # & V Q
(Submit one each monitoring period with GW-59 forms.)
j
Enter date monitoring results were due. Will this monitoring report (GW-59 and GW-59A)
YES
be submitted after the established due date?
n
2
Was any required information missing on the GW-59 report forms?
YES
NO
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
O
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
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 individ ally with constituent(s) and concentrations
exceeding stan ards in the sp a provided below: '- }A % au
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
k,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
l
standards, c centration(s) reported, and sample co ection da e for Pa h occurrence (for the last two years).
�-� (A ° -� -ai �� t �� a-a�, s, o��, �_ rl
sks ���t-a� �,� R��-aa. �.0 3-,A-ax 6,3
EA �_ -a0 Sit 3�1-aa. ��a �k-4-ao E,
Are the monitoring wells listed in section 5 located at or beyorhe review boundary?
YES
NO
If the answer is "YES", a groundwater quality problem maybe o6ciWAn CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer � "NO,,' Wells ,wells may be improperly
'�'
located; contact the Regional Office. C >' •' ;,
2<2
Is the permittee implementing previously approved actions req y 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 subject the permittee to a Notice of Violation,
Fines, and/or penalties. I
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 G W-59 form.
1 hereby acknowledge that the above informat on was evakuAed and the irdonnation submitted in this
report (Complimi ;e Report GW 9A) is true a complete to the best of my knowlecige.
Signature of Pe ittee (or Authorized Agent) JA Date
4
1h
GW-59A 12/8/2003

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Al IRMIT POPM ON VPi i ntA, DADCD nku v
GROUNDWATER QUALITY MONITORING:
DEPARTMENT OF ENVIRONMENTAL Qualm - DIV. of WAiE jt REsqu C_ es -
COMPLIANCE REPORT FORM
INFORMATION ►ROCESSINo UNIT
III MAIL SERVICE CENTER. RALEIGH, NET
PERMIT Number: x iration Date:
a A: �.J�X p
FACILITY INFORMATION T� Please Print Clea yorT pe
0l
Facility Name: ii GA
OX 0` ,
Non -Discharge UIC
Permit Name (if diff rent :
NPDES Other
Facility Address:
TYPE OF PERMITTED OPERATION BEING MONITORED
County
9;on ❑ Remediation: Infiltration Gallery
cir� at iai n,,,
pray Field ❑ Remediation:
Contact Person: j ' -�
�y
Telephone#:�' Q` c�`�3 '3 T�-
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name.
No. of wells to be sampled:
j
❑ Water Source Heat Pump ❑ Other
from Per,nil
SAMPLING INFORMATION
WELL ID NUMBER (from Permit):
Date sample collected::
FIELD ANALYSES:
If WELL
Well Depth: V--Lft.
Well Diameter: sip
in.
pH 00400 � units Temp. 000to: 0(01, °C
WAS
DRY at
Depth to Water Level 82546: 10 , E ft. below measuring point Screened Interval:
ft. to
ft. Spec. Cond. 00094 µMhos
time of
Measuring Point is at S ft. above land surface
Relative M.P. Elevation:
ft.
Odor 000es �
Volume of water pumped/bailed before sampling: / Q
gallons
Appearance '
check
Samples for metals were collected unfiltered: 0 YES
❑ NO and field acidified: 0 YES
El NO
-
LABORATORY INFORMATION
Date sample analyzed: - ` -3 -` �' Laboratory Name:
\ (Q 2 (1f\
PARAMETERS NOTE: Val es s ould feflect dissolved and colloidal concentrations.
Certification No.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead olo51 ug/L
Coliform: MF Fecal 31616 ,g �—/100mL
Nitrate (NO3) as N 00620 t mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665
(Note Use MPN method for highly turbid samples)
Orthophosphate 70507
_mg/L
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids Total7o3o0� mg/L
AI - Aluminum oilo5
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC oo68o mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
Total Ammonia ooslo mg/L
K - Potassium 00937
Mg - Magnesium
mg/L
VOC 7873 method #
(Ammonia Nitrogen, NH3asN, Ammonia Nitrogen, Total)
00927
mg/L
method #
Mn -Manganese 01055
ug/L
,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
k+
and Title - Please
GW-59 — Rev. 06-07-2018
nmucnt iutai vvw mg/L Ettluent total VOCs mg/L VOC Removal%
Agent)
1 7 '—

CI IMAIT CnD11• nkl VCI 1 ­1 n
GROUNDWATER QUALITY MONITORING:
QUALITY • DIV.O WATER RESOURCES
COMPLIANCE REPORT FORM
10ORMATtON RROC"SIN© UNIT
47 MAIL esRviC@ al' -LATER• RALEIGH, NC 2769e-1617
FACILITY INFORMATION Please Print Cl an! or Type
PERMIT Nu�mberk-jU )1, Sr; gxpiration Date. rJ "'31
Facility Name: I r hQ\t\� \4
L1
O±�
Non -Discharge UIC
Permit Name (if different):
NPDES Other
Facilit Address: 3 { 1
TYPE OF PERMITTED OPERATION BEING MONITORED
County
kTagoon ❑ Remediation: Infiltration Gallery
caul sl la; :
4 DEl Field Remediation
Contact Person:
Telephone#:1-10 -�13'-313�
❑ Rotary Distributor ❑ Land Application of Sludge '
Well Location/Site Name: 4 o'o
No. of wells to be sampled:
ElWater Source Heat Pump ❑ Other:
from Perrrel
SAMPLING INFORMATION M',\
WELL ID NUMBER (from Permit): a�\W "` �*
`t
Date sample collected: 1\ "'
FIELD ANALYSES:
if WELL
WAS
Well Depth: ft.
Well Diameter: in.
pH 00400 rj units Temp. 000io t - °C
DRY at
Depth to Water Level 82546: � ft. below measuring point
Screened Interval: ft. to
ft. Spec. Cond, 00094 µMhos
time
Measuring Point is a ,
g �.�, ' ft. above land surface
Relative M.P. Elevation: ft.
Odor 000e5
li
sampling,
check
Volume of water pumped/bailed before sampling: 10
gallons
Appearance c ; t
here:❑
Samples for metals were collected unfiltered: ® YES ❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:\— 111—� —ISM
as Laboratory Name �V NCO G��,tY� Certification
I IM
PARAMETERS NOTE: Valdes sh uld r flect dissolved and colloidal concentrations.
No.
COD 00335 mg/L
Nitrite (NO2) as N oo615 rng/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616— C Dl /100mL
Nitrate (NO3) as N 00620 mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 mg/L
(Note Use MPN method for MgNy turbid samples)
Orthophosphate 70507 mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 \,J mg/L
All - Aluminum o1 io5 mg/L
pH (Lab) 00403 units
Ba - Barium 01007 ugiL
TOC 00680 mg/L
Ca - Calcium 00916 mg/L
Chloride oo940mg/L
Cd - Cadmium 01027 ug/L
Arsenic 01002 ug/L
Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042 mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045 ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900 ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937 mg/L
VOC 7873 method #
Total Ammonia 00610 _ mg/L
Mg - Magnesium 00927 mg/L
method #
(Ammonia Nitrogen, NH3asN, Ammonibi Nitrogen, Total)
Mn - Manganese o1o55 ug/L g
,method #
TKN as N 00625 mg/L
Ni - Nickel 01067 ug/L
method #
, V-1 .1. IIIIIuC11l luldl vuub mg/L Lttluent total VOGs mg/L VOC Removal%
Rev. 06-07-2018-W
v
N

SUBMIT FORM ON YF1 I nVV PAPER nlul v
GROUNDWATER QUALITY MONITORING:Ill FTI 13EPAR.TMENT OF ENVIRONMENTAL QUALITY - Dill. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM •X14• • •311111 11617 MAIL SERVICE CENTER, RALEIGH. NI. t7666-1617
FACILITY INFORMATION Plea P f Cie y or Type
'A, t PERMIT Number( t31- expiration Date
Facility Name: \RC\��.\(�(�� c,� (�� Non -Discharge ��6 UIC
Permit Name (if different): NPDES Other
Facilit d ess: ' (Xk p0. (. TYPE OF PERMITTED OPERATION BEING MONITORED
C" aaro n Count �, �
Y_ r Lt'ragoon ❑Remediation: Infiltration Gallery
v ,SlNle �, ��
(-Way Field ❑ Remediation:
Contact Person: Q` �' Telephone#:� R13 - 3lk31- ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:. A IN ck, rjNo. of wells to be sampled: _ ❑ Water Source Heat Pump ❑ Other:
aAMrLlrvy INr•VKMA1JUN �,`
WELL ID NUMBER (from Permit): _ft, 4_
Date sample collected:
11 -
FIELD ANALYSES:
If WELL
WAS
Well Depth:
Well Diameter:
in.
pH ooaoo units Temp. 000lo: ► °C
DRY at
Depth to Water Level 82546: �, ft. below measuring
point Screened Interval:
ft. to ft.
Spec. Cond. 00094 µMhos
time of
MeasuringPoint is Is ft. above land surface
Relative M.P. Elevation:
ft.
Odor 000m O`Y
sampling,
Volume of water pumped/bailed before sampling: to _gallons
Appearance COV,i
check
here:❑
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: ON YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: - - �^' '
c-
-` J ee� Laboratory Name:
\
Qw
Certification No.
PARAMETERS NOTE: Valubs sholuld refibct dis olved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NOZ) as N 00615
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 C /100mL Nitrate (NO,) as N 00620
14 mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00e65 01 `a mg/L
(Note Use MPN method for highly turbid samples)
issolvedSolids:Total70300_
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
mg/L
AI- Aluminum o11o5
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC owao mg/L
Ca - Calcium 00916
mg/L
Chloride oosao� mg/L
Cd - Cadmium o1o27
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
uglL
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 _ ItMhos
Total Ammonia 00610 0 ��-mg/L
K - Potassium 00937
Mg Magnesium
mg/L
VOC 7e73 method #
- 00927
mg/L
method #
(Ammonia Nitrogen, NH. as N. Ammonia Nitrogen, Total)
Mn -Manganese o1055
ug/L
,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
- _..._—.—.. ..Y t ..... teaaNvmwl. 11"lUCllt I oral vul.s ma/L Ettluent Total VnCc ,,,wit vnr

i
OU[Sm1 I rvnM UN TtLLUVV PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: Q
Permit Name (if different): _
Facilit Address:
0.0 ee_
,l:11J1
Contact Person: q� I
Well Location/Site Name:
or
County �h
Telephone#:'1y of l 3
5 qfi No. of wells to be sampled:
DEPARTMENT OF E AL QUALITY- DIY. OF wATER virr ouRe
INFC11MAMN PROCE981NO UNIT
1017 MAIL SERVICE CENTER. RALEIGH, NC 2T699.1
PERMIT Number: to t J J / expiration Date 0
Non -Discharge ID vV UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
goon ❑ Remediation: Infiltration Gallery
'Spray Field ❑ Remediation.
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
_...... _..._ .....,... �W e9 ���� '} r'�
WELL ID NUMBER (from Permit): Date sample collected: /� ` �( cX
FIELD ANALYSES:
If WELL
WAS
Well Depth: 3 ft. Well Diameter: �in.
pH ooaoo .S , 9 units Temp. 000io:/ /q Q r J °C
DRY at
Depth to Water Level 82546: , ft. below measuring point Screened Interval: ft. to ft.
Spec. Cond. 000sa µMhos
time of
MeasuringPoint is �- ft. above land surface Relative M.P. Elevation: ft.
Odor 000m 413
sampling,
Volume of water pumped/bailed before sampling: gallons
Appearance A7(Z(\
check
here:
Samples for metals were collected unfiltered: BE YES ❑ NO and field acidified: ® YES ❑ NO
LABORATORY INFORMATION ,� t
Date sample analyzed: I I - - 11- �� aa. Laboratory Name tf1 Ur rG 1 Y
PARAMETERS NOTE: Val es sh uld r flect dissolved and colloidal concentrations.
Certification No.
COD 00335 mg/L Nitrite (NOZ) as N 00615 mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 ,C C /100mL Nitrate (NO3) as N 00620 L7L, 0 mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 (:) Q mg/L
(Note Use MPN method for tugMy tuQrrAd samples) Orthophosphate 70507 mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 (J mg/L All -Aluminum 01105 mg/L
pH (Lab) 00403 units Ba - Barium 01007 ug/L
TOC 00680 _77 mg/L Ca - Calcium 00916 mg/L
Chloride 00940
mg/L Cd - Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium: Total 01034 ug/L
Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe - Iron 01045 ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg - Mercury 71900 ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos K - Potassium 00937 mg/L
Total Ammonia oosio
VOC 7873 method #
, mg/L Mg -Magnesium 00927 mg/L
(Ammonia Nitrogen, NH3asN, Ammonia Nitrogen, Total)
method #
Mn -Manganese o1055 ug/L
method #
TKN as N 00625 mg/L Ni - Nickel 01067 ug/L
method #
Fnr Rmm�iii�►t.,., c..�s.,...� n.. r.. iw..__�
nuiu 1 Mal vljl.lb MOIL I-rflllpnt Intal\/O('c- --It vnn

4
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION P104
Facility Name:
Permit Name (if different):
Facility Address: /1 q
a`.Iraun
II:IIVI ISlylc .
Fw0e
act Person: CA,� C'E
Location/Site Name:
o aiom, I rvr%m UPI TtLLVW VAVtK UNLY
or
County
�. Telephone#:
No. of wells to be sampled: .SS -
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSINQ UNIT
1e17 MAI I ENTER. RALIwIGH, NC 27490-1617
PERMIT Nuinber: ,13C,�xpiration Date % Lj -
Non -Discharge UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
,.�,kt8goon ❑ Remediation: Infiltration Gallery
k-95-ray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
WELL ID NUMBER (from `` (�(�,. r
Permit): 1 ` ��j
ry
Date sample collected: �' �° �� OC�
FIELD ANALYSES:
If WELL
WAS
Well Depth: ka--ft.
Well Diameter: Q_in.
pH 00400(4, units Temp. 000lo Q 0 °C
DRY at
Depth to Water level 82546: C , a ft. below measuring point
Screened Interval: ft. to
Spec. Cond. 00094 µMhos
time
Measuring Point is ft. above land surface
_ft,
Relative M.P. Elevation: ft.
Odor 000s5 O
sampling,
Volume of water pumped/bailed before sampling: /40_ gallons
Appearance
check
here:
Samples for metals were collected unfiltered: N YES ❑ NO
and field acidified: ® YES ❑ NO
-
,., Vr .-I VI\
Date sample analyzed: = j-3 — -
\
- S-�Laboratory Name. ��y S �Q��e11��
Certification No.
PARAMETERS NOTE: Values should refl ct dissofvod and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N oosls
mg/L
Pb - Lead oio51 ug/L
Coliform: MF Fecal 31616 C,� + /100mL
Nitrate (NO3) as N 00620_ iq,
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665j
mg/L
(Note Use MPN method for tsgNy turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300p �_ mg/L
Al - Aluminum oil o5
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC 00680 mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 a mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095 ItMhos
Total Ammonia 00610 tj y �� mg/L
K - Potassium 00937
Mg Magnesium
mg/L
VOC 7873 method #
(Ammonia Nitrogen, NH3 as N. Anvnorsa Nitrogen, Total)
- 00927
mg/L
method #
Mn - Manganese 01055
ug/L 9
,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
Fnr Ramariint•inn n—h, rAu-._,- , _
mgiL tmuent I otal VOCs. mg/L VOC Removal%
rrnmrn>tr�r