WQ0003361_Monitoring - 08-2016_20160830

GW -59A COMPLIANCE REPORT FORM Permit 33�
(Submit one each monitoring period with GW -59 forms.)
1
Enter date monitoring results were due. ( ) Will this monitorin report (GW -59 and GW -59A)
YES
NO
be submitted after the established due date? tp�
A
_ 1V
2
Was any required information missing on the GW -59 report forms?
YES
O
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 Officefor 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. g� �
�
If the answer to question 4 is "YES" list the affected wells individually wi Cnn�sr�irniQ( ,,hh �oncentration(s)
exceeding standards in the space provided below:
ip,�'G 3 0 2016
DVdR SEO110N
5
For the constituents identified in question 4 above, have standards�I��i<iCi' rets busty 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) reported, and sample collection date for each occurrence (for the last two years).
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
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.
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 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.
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 GW -59 form.
I hereby acknowledge that the above information was evaluated and the information submitted in this
report, Compliance Report GW9A) is._true and _ mplete to the besteof my knowledge,
Si na a of Permittee (or Authorized Agent) Date
S tt e r g (t Evwtrok1�qe44
GW -59A 12/8/2003

`.,
SUBMIT FORM ON YELLOW PAPER ONLY
NDWATER QUALITY MONITORING:
LIANCE REPORT FORM
lity Name: Oak -Bark Corporation
nit Name (if different):
IityAddress Riegelwood, NC 2845.6_
elwood, NC 28456 (Street)
County Columbus
tact Person: W E Lewis, Plant Manager Telephone#: cjj D `(v S j- &q80
I Location/Site Name: Kelly Pond No. of wells to be sampled: 4
Number: Expiration Date
;harge WQ0003361 UIC
'DES Other
PE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump Other: Closed Loop Recycle
SAMPLING INFORMATIONM u `
2-1
obo/4 !
Arsenic 01002
ug/L
It WtLL
WAS
WELL ID NUMBER (from Permit): ! 1 �1
Date sample collected:
FIELD ANALYSES:
Sulfate 00945 _ , 5
mg/L
Well Depth: 30J5 5 ft.
Well Diameter: . in.
pH 00400: e units Temp. 00010: F -e °C
DRY at
Depth to Water Level 82546: j I h ft. below measuring point Screened Interval ft. to ft.
—
Spec. Cond. 00094: -'3 µMhos
time of
sampling,
Measuring Point is ft. above land surface
Relative M.P. Elevation_: ft.
Odor 00085: Q O K - e
check
Volume of water pumped/bailed before sampling: CI _
gallons
Appearance CA ep v-
here:
El
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES ❑ NO
tBORATORY INFORMATION
ite sample analyzed-yj ®�� / E 6� Laboratory Name: ENCO
1RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N oo615 mg/L Pb Lead 01051
Coliform: MF Fecal 31616 /100mL Nitrate (NO3) as N 09620 < Os � mg/L Zn- Zinc 01092
Coliform: MF Total 31504 /100ml- Phosphorus: Total as P oo665 mg/L
(Note: Use MPN method for highly turbid samples)
// - Orthophosphate 70507 mg/L
Ived Solids:Total 70300 (1!D mg/L
pH (Lab) 00403 units
TOC 0068o mg/L
Chloride 00940
mg/L
Arsenic 01002
ug/L
Grease and Oils 00552
mg/L
Phenol 3273o
ug/L
Sulfate 00945 _ , 5
mg/L
fic Conductance 00095
µMhos
Total Ammonia oo610 < 0 e ( _mg/L
(Ammonia Nitrogen; NH3 as, N; Ammonia Nitrogen, Total)
TKN as N 00625 mg/L
For Remediation Systems Only (Attach Lab Reports):
Al - Aluminum o1105 1 mg/L
Ba- Barium 01007 1c1 ug/L
Ca - Calcium oo916 ,mg/L
Cd - Cadmium 01027 n p L 9 I g1L
Chromium: Total 01034
Cu -Copper oio42
Fe - Iron ob45
Hg = Mercury 71900
K - Potassium 00937
ug/L
mg/L
ug/L
ug/L
mg/L
Mg - Magnesium 00927
mg/L
Mn - Manganese 01055
ug/L
Ni - Nickel 01067
ug/L
Influent Total VOCs:
Certification No. LJ I
ug/L
mg/L.
Other (Specify Compounds and Conce��p1 tration Units):
Formaldehyde w ©u(' R erg v trf
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method C, ATTACH LAB REPORT.).
Lab Report, Attached? ❑ Yes (1) ❑ No (0).
VOC 7873 , method #
62006 method # None Detected
mg/L Effluent Total VOCs:
, method #
method #
mg/L VOC Removal%
John Sherrill, LG, Sherrill Environmental, Inc., President /y5 / 16
Permittee (or Authorized Agent) Name and Title - Please print or type 5 natur of Permittee (or Authorized Agent) (Date)
GW -59 Rev. 3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
NDWATER QUALITY MONITORING:.
LIANCE REPORT FORM
OF
FACILITY INFORMATION Please Pant Clearly or Type
PERMIT Number: Expiration Date: j
Facility Name: Oak -Bark -Corporation
L) 'g/L
Non -Discharge WQ0003361 UIC
Permit Name (if different):
_
NPDES _ Other
Facility Address: Riegelwood, NC 28456
M91L
TYPE OF PERMITTED OPERATION BEING MONITORED
Riegelwood, NG 28456 Sstreet)
County Columbus
❑ Lagoon ❑ Remediation: Infiltration Gallery
Guy) (s,atz) (zip)
mg/L
❑ Spray Field ❑ Remediation:
Contact Person: W E Lewis, Plant Manager
Telephone#: [phone] _
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Kelly Pond
No. of wells to be sampled'; 4
❑ Water Source Heat Pump ■ Other: Closed Loop Recycle
mg/L
from Permit)
SAMPLING INFORMATION'y (�
\0 _1
g
/i t
ANALYSES:
If WELL
WAS
WELL ID NUMBER from'Permit): 1
Date sample collected: 1
FIELD
Well Depth: �,,� ` 'a ft.
Well Diameter; in,
�s
pH oo400: iunits Temp. woio; J�:0 -C
DRY at
" };�
Depth to Water Level 82546: �a�CJ6f ft. below measuring point
Screened Interval: ft. to
! a
ft.. Spec. Cond. 00094: F pMhos
time of
sampling,
Measuring Point is ft. above land surface
b
Relative M.P. Elevation: ft_
Odor 00085: !} p P
check
Volume of water pumped/bailed before sampling: S gallons
Appearance C\yki-
here: 11Samples
for metals were collected unfiltered: El YES El NO
and field acidified: El YES El NO
LABORATORY INFORMATION /�' r ] e
Date sample analyzed: P, / � I'& / I & Laboratory Name: ENCO Certification No. ct
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead 01051 ug/L
Coliform' MF Fecal 31646 /100mL Nitrate (NO3) as N 00620 L, mg/L Zn - Zine olo92 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P oo6m mg/L
(Note; 'Use MPN method for highly turbidsamples)
fm m(1 g/L
(
2
L) 'g/L
)issolved Solids:Total 70300 !
mg/L
pH (Lab) 00403
units
TOC ooeso _ (0eD
M91L
Chloride oo94o
mg/L
Arsenic 01002
ug/L
Grease and Oils 00552
mg/L
Phenol 32730
ug/L
Sulfate oo945 1 Z
mg/L
Specific Conductance 00095
µMhos
Total Ammonia 00610 < % c
mg/L
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
TKN as N 00625
mg/L
For Remediation Systems Only (Attach Lab Reports):
Orthophosphate 70507
fm m(1 g/L
Al -Aluminum 01109
L) 'g/L
Ba - Barium 01007/rL
Ca - Calcium 00916 t i mg7L1S
Cd - Cadmium 0102
ug/L
Chromium: Total 01034
ug/L
Cu - Copper oio42
mg/L
Fe - Iron 01045
ug/L.
Hg - Mercury 71900
ug/L
K- Potassium 00937
mg/L
Mg - Magnesium 00927
mg/L
Mn - Manganese 01055
ug/L
Ni - Nickel o1067
_ ug/L
Influent Total VOCs
Other (Specify Compounds and Concentration Units):
Formaldehyde _� o 0 S y1V% !a
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7873 method #
6200B method # None Detected
mg/L Effluent Total VOCs:
John Sherrill, LG; Sherrill Environmental, Inc., President
Permittee (or Authorized Agent) Name and Title - Please,print or type Sign ure of Permittee (or
GW -59 Rev. 3-1-2016
method #
method #
_mg/L VOC Removal%
approved methods of analysis by a
-_7

SUBMIT FORM ON YELLOW PAPER ONLY
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L, VOC Removal%
John Sherrill, LG, Sherrill Environmental, Inc., President 4 5
Permittee (or Authorized Agent) Name and Title—Please print or type Si�t a of PermitteaTor Authorized Agent)
GW -59 Rev. 3-1-2016
DEPARTMENT'OF ENVIRONMENTAL QUALITY - DIV. €JF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INi=ORMATtON PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27689.1617 'Phone: [phone]
FACILITY_INFORIVIATION Please PrintCearlyorType
PERMIT'Number: Expiration Date:
Facility Name: Oak -Bark Corporation
Non -Discharge 'WQ0003361 UIC
Permit Name (if different):
NPDES Other
Facility Address: Riegelwood, NC 28.456
TYPE
OF PERMITTED OPERATION BEING MONITORED
El Lagoon El Remediation: Infiltration Gallery
Riegelwood, NC 28456 {stre5t)
9 County Columbus
State) (Zip)
_ -
❑ Spray Field; ❑ Remediation:
Contact Person: W E Lewis, Plant Manager
Telephone#: ,910655-6980
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Kelly Pond
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other: Closed Loop Recycle
- -
from Permit
SAMPLING INFORMATION ; \
' w 2–S
r 1
t Q
If WELL
WAS
WELL ID NUMBER (from Permit); 1
Date sample collected: C7 l
FIELD ANALYSES:
Well Depth: ft.
Well Diameter: in.
11
pH 00400: 5i4l units Temp. 000lo: oC
DRY at
Depth to Water Level 82546:4,2.0 ft. below measuring point
Screened Interval: ft. to
ft.
Spec. Cond. 00094:. c7t 'I,µMhos
time of
Measuring Point is ft. above land surface
Relative M.P. Elevation: ft.
—
-
Odor 00085: �i .4✓�
sampling,- check
Volume of water pumped/bailed before sampling: JR i0
gallons
Appearance CleC,+r
here:,❑
Samples for metals were collected unfiltered: 11 YES ❑
NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
I
- -
Date sample analyzed: eyi t-1(/
Laboratory Name: ENCO
_ _ Certification No. 591
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620 G (1 d e C�
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P00665
mg/L
(Note. Use MPN method for highly turbid,samples) -
Orthophosphate 7o5D7
mg/L
Other (Specify Compounds and Concentr ton Units):
issolved Solids:Total 70300 4- mgiL
AI - Aluminum 011o5
mg/L
Formaldehyde mA RFej (f f -
pH (Lab) oo4m units
Ba - Barium 01007 i { _ug/L
TOC 00680 5 mgiL
Ca - Calcium oo916
mg/L
Chloride 00940 mgiL
Cd - Cadmium 01027 S F p 9 A gn ie
ug/L
Arsenic 01002' ug/L
Chromium: Total o1o34
ug/L
Grease and Oils 00552 mg/L
r
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GCiMS„HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 r mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? El Yes (1) ❑ No (0)
pecificConductance 00095 µMhos
K -Potassium oo937
mgiL
VOC 7873 method #
Total Ammonia 00610 ` o mgiL
Mg - Magnesium 00927
mg/L
62006 method # None Detected
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total)
Mn =Manganese 01055
ug/L
,method # ,
TKN as N 00625mg/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%
John Sherrill, LG, Sherrill Environmental, Inc., President 4 5
Permittee (or Authorized Agent) Name and Title—Please print or type Si�t a of PermitteaTor Authorized Agent)
GW -59 Rev. 3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
For Remediation Systems Only (AttachLab Reports): Influent Total VOCs:
John Sherrill; LG, Sherrill Environmental, Inc., President
Permittee (or'Authorized Agent) Name and Title - Please print or type
GW -59 Rev. 3-1-2016
mg/L Effluent Total VOCs:
(or
mg/L VOC Removal%
•
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIU `OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SEF11jCE CENTER, RALEIGH, NC 27699-1617< ;Phone: 919-$D7-630fi•,
_.
FACILITY INFORMATION
Please PrintCleanyorType
PERMIT Number: Expiration Date: Z-1Z6114f
Facility Name- Oak -Bark Corporation,
Non -Discharge WQ0003361 UIC
Permit Name (if different):
_
NPDES Other
Facility Address: Riegelwood, NC 28456
TYPE OF PERMITTED OPERATION BEING' MONITORED
Riegelwood, NC 28456 (Street)
County Columbus
❑, Lagoon ❑ Remediation: Infiltration Gallery
tatE)
(Zip)
-
❑ Spray Field ❑ Remediation:
Contact Person: W ELewis, Plant Manager
Telephone#: [phone]
❑ Rotary Distributor El Land Application of Sludge
Well Location/Site Name: Kelly Pond
No. of wells to be sampled: 4
❑ Water Source Heat Pump D Other: Closed Loop Recycle
ftm.Permit
SAMPLING INFORMATION
WELL ID NUMBER MW
2
If WELL
WAS
from Permit):
-Co
Date sample collected:
FIELD ANALYSES:
r�
Well the ft.
Well Diameter: in.
�
pH o040o:j,t units Temp: 00010: ?_bS °C
DRY at
Depth to Water Level 82546: 5cO ft. below measuring
point Screened Interval: ft. to
ft. Spec. Cond. o0094: 6 y µMhos
time li
Measuring Point is ft. above land surface
—
Relative M.P. Elevation; ft.
Odor 00085: IQ 0
sampling,
check
Volume of water pumped/bailed before sampling:
60
gallons
Appearance pct
here:❑
Samples for metals were collected' unfiltered: El
YES
El NO and field acidified: E3 YES El NO
LABORATORY INFORMATION _
It.
'Certification
Date sample analyzed:/(2
Laboratory Name: ENCO
No. 591
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 mg/L Pb - Lead 01051 ug[,
Coliform: MF Fecal 31616'
/100mL
Nitrate (NO3) as N. 00620 (j mg/L Zn - Zinc 010921 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P00665 mg/L.
(Note: use MPN method for highly turbid samples)
Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 ^
mg/L
Al - Aluminum 01105 mg/L Formaldehyde mg,
pH (Lab) oo403_
units
Ba - Barium 01007 ug/L
TOC 00680
mg/L
Ca - Calcium oo916 _ ,; mg/L
Chloride 00940
mg/L
Cd - Cadmium 01027 ug/L
Arsenic 01002
ug/L
Chromium: Total o1o34 q F p�� lrug/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
µMhos
K - Potassium 00937 mg/L VOC 7873 Method #
s
Total Ammonia 00610 0-�' �
mg/L
Mg -Magnesium 00027 mg/L 62006 „method. # None Detected
(Ammonia Nitrogen; NH3 as M Ammonia Nitrogen, Total)
Mn - Manganese 01055 _ ug/L _ _ , method "#
TKN as N 00625
mg/L
Ni - Nickel olos7 ug/L method #
For Remediation Systems Only (AttachLab Reports): Influent Total VOCs:
John Sherrill; LG, Sherrill Environmental, Inc., President
Permittee (or'Authorized Agent) Name and Title - Please print or type
GW -59 Rev. 3-1-2016
mg/L Effluent Total VOCs:
(or
mg/L VOC Removal%