WQ0018992_Monitoring - 08-2016_20161007 (4)

GROUNDWATER QUALITY MONITORING`:
COMPLIANCE REPORT FORM
Facility Name:—
Permit Name .(if
Contact Person:
Wel Location/ Site P
Please Print Clearly or Type
County_
Telephone #:1
No. of Wells to be Sampled:
Well Identification Number (from Permit): d
Well Depth: For Groundwater Treatment Systems
ftWell Diameter: tn. .
Check One. Influent (98)
Screened Interval: ft. to ft. El Effluent (99)
Depth to Water Level: ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. 'Relativ_e M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling t t Date sample collected: R 6Aj;,,.
Field analysis: pH fit, , Specific Conductance uMhos
Temp. °C, Odor. Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #:
EXPIRATION DATE:
Non-Discharge`%�)�! W
S �i 1 UFC_
NPD'ES
Coliform: MF Fecal I
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon
Remediation: Infiltration Gallery
Spray Field
Remediation:
Rotary Distributor
- Land Application of Sludge
Other. �3) V'.%
J-1.0
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name,��
Certification NO.' l
PARAMETERS (Samples for metals were collected unfiltered -:YES NO and field acidified
COD
mg/l
Nitrite (NO2) as N
mg/1
Coliform: MF Fecal I
11 00m
Nitrate (NO3) as N n. I
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Totals mg/I
Al -Aluminum
mg/I
pH (when analyzed) b_
units
Ba - Barium
mg/I
TOC
mg/I
Ca - Calcium
mg/l.
Chloride ei
mg/I
Cd - Cadmium
rng/l
Arsenic
mg/I
Chromium: Total; �' ;�d `
mIIC
Grease and Oils ._
mg/I
... . r, 1fi
Cu -Copper � .��Y �°
m g/I
Phenol _-
mg/I
Fe - Iron
mg/,l
Sulfate
mg/I
Hg - Mercury
Specific Conductance
uMhos
K - Potassiummg/I
G'Af1S' �i1 `mg/I
Total Ammonia
mg/I'
Mg - Magnuti"��
esiu
TKN as N
mg/I
Mn - Manganese
mg/l
V_
GW -50
Rev. 0312000
YES NO)
Ni - Nickel mg/I
Pb Lead mg/l
Zn'- Zinc mg/I
Ammonia Nitrogen. mg/I
Other (Specify Compounds and Concentration Units)
r, HI1l'a
ORGANICS: (G&,&-0 rY07,VPm,1-,ot' UN
(Specify test and method #. Attach lab repo )
Report Attached? Yes (1) No, (0)
VOC method# =
method # =
method #=

ORO'UNDWATER QUALITY MONITORING
COMPLIANCE REPORT FORM
Facility Name:_
Permit Name (if
Contact Person \-aLr\
Well Location/ Site Name:
Print Clearly or Type,
County
Telephone #.
No. of Wells to be Sampled:
Wel Identification Number (from Permit): For Groundwater Treatment Systems
Wel Depth: Ir ft. Well Diameter:`
--� � ln. Cheek One:.I] Influent (98)
Screened Interval ft. to ft, ❑ Effluent (99)
Depth to Water Level:-4aDft. below measuring point. -
Measuring Point (M.P.) is; ft. above land surface. Relative M.P. Elevation in ft.:
ed/ —�---
Gallons of water pumped/bailed before sampling: f ' Date sample collected: l
Field analysis: pH_ ice— , Specific Conductance - uMhos
Temp- OC, Odor - Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICECENTER
PERMIT #: EXPIRATION DATE:
Non -Discharge W_w tin si 2 UIQ
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other � .'C,,J-1- P
.NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: -
Laboratory Name:. -
Certification No. 1>
PARAMETER (Samples4 for metals were collected unfiltered YES': NO and field acidified
COD - mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal p /100ml -- Nitrate (NO3) as N —(o- ` mg/I
Coliform: MF Total /100ml Phosphorus: Total as P mq/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total�te,
_ mg/I
pH (when analyzed)
units
TOC
mg/I
Chloride
mgAl
Arsenic
mg/l
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific ConductanceUMh.
oS
Total Ammonia
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
Urtnopnosphate
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium --_
mg/I
Cd - Cadmium
mg/I
Chromium: Total =
mg/I
Cu - Copper
- mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
- YES NO)
Ni -Nickel - mg/I
Pb - Lean rng/I
Zn: Zinc mg/I
Ammonia Nitrogen. M7 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 _moo (0)
VOC method # =
:.method #
method # =
Rev. 03/2000

GROUNDWATER QUALITY MONITORING:
COMPLIANCE, REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name:
Permit Name .(if different):-
Well Location/ Site Name:
County !, (`s
Telephone #; .
No. of Wells to be Sampled:
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: ft. Well Diameter:. in. Check One: 0 influent (98)
Screened Interval ft. to ft. ❑ Effluent (99)
Depth to Water Level: ft. below measuring point:
Measuring Point,(M.P.) is: ft. above fand surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: A, Date sample collected: `
Field analysis: pH ` t% , Specific Conductance a uMhos
Temp. —°C, Odor Appearance
DEPARTMENT of ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT ##: EXPIRATION DATE:
Nan -Discharges t UFG
NPDES
TYPE OF'PERMITTED OPERATION BEING MONITORED
Lagoon _ Remediation; Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other. ) T- .. 1-1 +
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name:•�h.�'t-
Certification No.
PARAMETERS (Samples for metals were collected unfiltered . YES � NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
rng/I
Coliform: MF Fecal _
/100ml
Nitrate (NO3) as N ( mg/1
Coliform: MF Total
/100ml
Phosphorus: Total as P.
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
Ing/I
Dissolved Solids: Total 116
mg/I
Al - Aluminum
mg/i
pH (when analyzed) n
-units
Ba - Barium
mg/I
TOC -
mg/I
Ca = Calcium
mg/I'
Chloride 61
mg/I "
Cd - Cadmium
mg/I
Arsenic
mgll
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper,
mg/1
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/1
-
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/1
Mg - Magnesium _ _
rng/I
TKN as N
mg/I
Mn - Manganese
mg/I
F
YES NO)
Ni - Nicker mg/I
Pb. - Lead rng/I
Zn.'- Zinc mg/I
Ammonia Nitrogen •0 -CIA mg/1
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 #
GW -59
Rev. 03/2000