WQ0000185_Monitoring - 07-2024_20241027 (3)

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month:* July
Report Information
Type *
Revised - GW-59
Confirmation Email Address:
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
WQ0000185
Ocean Sands WWTP
Year:* 2024
Upload Document*
Ocean Sands GW59.pdf 5.71 MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Rod Holley
Reviewer: Wanda.Gerald
10/27/2024
This will be filled in automatically

Is the project number correct?* WQ0000185
Is the monitoring report accepted?* Yes No
Regional Office* Washington
Reviewer: _anonymous
Review Date: 11/19/2024

Cam'-59A COMPLIANCE REPORT FORM Permit # 1,10 0 l)D 0 i y S-
(Submit one each monitoring period with Gig'-59 fbrnz.c.)
1
Enter date monitoring results were due. 7 1 Will this monitoring report (GW-59 and GW-59A)
YES
NO 7
be submitted after the established due date?
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
NO
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 individually with constituent(s) and concentr ions)
exceeding standards in the space provided below: ►✓) W -7 M W '
mw -� mw mw -(,, 600
I�Sv�L4L-To I-S9,-i -rJD-S N0-3-7-3,� Ni}3I N)43-3.q
N D - 7 O. '7 C'110(4�At- - Z � ( /J 0-1 b. -(
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 constituent(s) exceeding
standards, concentration(s) repotted, and sample collection date for each occurrence (for the last two years).
ry►v3 � �1 rn w ..,s
/ /3c/Ly N�3 - 2X.5- (v13ah IVA3-11',Z 613el °7bS-
NO3 - zq,3 1,130 /zY ,?,y- 5/71
(o%
'�
44,3 ",42 y
y
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
O
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.
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 havinq 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. �y h14JL 9 1 i_ ry ._ to kf� ,l/ f (� 41V
Jn/
A,,,lS C,� -
�q 9 �vu jCj i 5S1-s
z.v
s;'n► �' 19-n V.;' o t 1 b� c,;(
rvrn
.`,x.,�-/
IDTTI C*— �ANC-*t• 5
g
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.
1 hereby acknowledge that the above information was evaluated and the information submitted in this
report(ComplianceReport GW-59A) is true and complete to the best of my knowledge.
/
b2- j { /3/ / 2
Signature of Permittee (or Aut rized Agent) Date
GW-59A 12/8/2003

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
�16117
MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2032
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Corolla NC 27927 County Currituck
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump ❑■ Other: Infiltration
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW4
Date sample collected: 7/9/24
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 7.0 units Temp, 000lo: 25.7 °C
DRY at
Depth to Water Level 82546:8 2 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 00094: µMhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: None
check
Volume of water pumped/bailed before sampling:
5.0
gallons
Appearance Tan
here:❑
Samples for metals were collected unfiltered: © YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:7/9/24
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 g
/100mL
Nitrate (NO3) as N 00620 0.36
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 1.07
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 840
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 7.0
units
Ba - Barium 01007
ug/L
TOC 0068o 4.4
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 160
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 VOC 78732: method #
Total Ammonia 00610 0.9
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L , method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
ON1617
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2032
Facility Name: Ocean Sands
Non -Discharge UIC
Permit Name (if different):
NPDES Other
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Corolla NC 27927 County Currituck
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump Other: Infiltration
(from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW5
Date sample collected: 7/9/24
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 6.2 units Temp. 000lo: 26.7 eC
DRY at
Depth to Water Level 82546:3.1 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 00094: µ
time ofMhos sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: None
check
Volume of water pumped/bailed before sampling:
5.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ©'YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:7/9/24
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 0.16
mg/L Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 5
/100mL
Nitrate (NO3) as N 00620 20.7
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P006650.83
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7030o 594
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 6.2
units
Ba - Barium 01007
ug/L
TOC 0068o 3.9
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 202
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 o0095
µMhos
K - Potassium 00937
mg/L VOC 78732: method #
Total Ammonia 00610 <0.2
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L , method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
• .
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2032
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Corolla NC 27927 County Currituck
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump K Other: Infiltration
(from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW6
Date sample collected: 7/9/24
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 6.6 units Temp. 000lo: 25.6 °C
DRY at
Depth to Water Level 82546:4 7 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 00094: µMhos
time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: None
check
Volume of water pumped/bailed before sampling:
2.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: EYES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:7/9/24
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 0.04
mg/L Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 1
/100mL
Nitrate (NO3) as N 00620 23.8
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 0.45
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 703oo 540
mg/L
Al - Aluminum oilo5
mg/L
pH (Lab) 00403 6.6
units
Ba - Barium 01007
ug/L
TOC 0068o 3.2
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 261
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 VOC 78732: method #
Total Ammonia 00610 <0.2
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L , method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only •VO(12
certify that, to the best of my knowledge and belief, the information submitted in this report is true, aci
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false informati(
Rod Holley Wastewater Superintendent
Permittee (or Authorized Agent) Name and Title - Please print or type
mg/L Effluent Total VOCs:
Signature of Permittee (or Authorizgd Agent)
mg/L VOC Removal%
8/31/24
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: Ocean Sands
Permit Name (if different):
Facility Address: 741 Ocean Trail
Corolla
Contact Person. Rod Holley
Well Location/Site Name: Ocean Sands
NC
..
rint Clearly or Type
27927 County Currituck
Te le phone#: [phone]
No. of wells to be sampled: 5
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION
PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
PERMIT Number: W00000185
Expiration Date: 6/30/2032
Non -Discharge
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 0 Other: Infiltration
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW7 Date sample collected: 7/9/24
Well Depth: 17.6 ft. Well Diameter: 3 in.
Depth to Water Level 82546:3.1 ft. below measuring point Screened Interval: 12 ft.
Measuring Point is 2 ft. above land surface Relative M.P. Elevation:
Volume of water pumped/bailed before sampling: 4.5 gallons
Samples for metals were collected unfiltered: © YES ❑ NO and field acidified: [I YES
to 17 ft.
ft.
El NO
FIELD ANALYSES:
pH 00400: 6.9 units Temp. 000lo: 27.9 °C
Spec. Cond. 00094: µMhos
Odor 00085: None
Appearance Clear
If WELL
WAS
DRY at
time ofsampling,
check
here:
❑
LABORATORY INFORMATION
Date sample analyzed:7/9/24
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 0.04
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 >600
/100mL
Nitrate (NO3) as N 00620 0.15
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 3.14
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 7030o 410
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 6.9
units
Ba - Barium 01007
ug/L
TOC 0068o 7.3
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 149
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
VOC 78732: method #
Total Ammonia oo6lo 9.1
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
, method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
Rod Holley Wastewater Superintendent Trainee C—i `Gf 8/31/24
Permittee (or Authorized Agent) Name and Title - Please print or type Signature of Permittee (or Authori d Agent) (Date)
GW-59 Rev. 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
. .
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: WQ0000185 Expiration Date: 6/30/2032
Facility Name: Ocean Sands
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 741 Ocean Trail
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
g El Remediation: Infiltration Gallery
Corolla NC 27927 County Currituck
❑ Spray Field ❑ Remediation:
Contact Person: Rod Holley
Telephone#: [phone]
ElRotary Distributor ElLand Application of Sludge
Well Location/Site Name: Ocean Sands
No. of wells to be sampled: 5
❑ Water Source Heat Pump 0 Other: Infiltration
(from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW9
Date sample collected: 7/9/24
FIELD ANALYSES:
WAS
Well Depth: 17.6 ft.
Well Diameter: 3 in.
pH 00400: 6.9 units Temp. 00010: 23.9 eC
DRY at
Depth to Water Level 82546:4.5 ft. below measuring point Screened Interval: 12 ft.
to 17 ft. Spec. Cond. 00094: µMhos
time of
sampling,check
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: None
Volume of water pumped/bailed before sampling:
5.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ❑✓ YES
❑ NO and field acidified: ❑ YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:7/9/24
Laboratory Name: Enviro Chem
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 0.02
mg/L Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 14
/100mL
Nitrate (NO3) as N 00620 16.0
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 2.66
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 7030o 540
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 6.9
units
Ba - Barium 01007
ug/L
TOC 0068o 6.0
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 176
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 VOC 78732: method #
Total Ammonia oo610 3.4
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L , method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
Rod Holley Wastewater Superintendent Trainee
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev. 2/2010
•Total•
iplete, and that the laboratory analytical data
possibility of fines and imprisopment for knc
mg/L VOC Removal%
8/31/24
(Date)