WQ0023310_Monitoring - 10-2016_20161024

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DWATER QUALITY MONITORING:
IANCE REPORT FORM
Name:
Name (if i
Address:
Contact Person: \\
Well Location/Site Name
SUBMIT FORM ON ti
'dnt Cleady or T e
Qt,3 County !X> Lk
Telephone#: 'AM- ot'13'
No. of wells to be sampled:
PAPER ONLY
PERMIT Number:(nTJ W 3I0Expiretion Date: n_ d i" L i
_ Non -Discharge UIC
_ NPDES Other
_ TYPE OF PERMITTED OPERATION BEING MONITORED
_ ❑ Lagoon ❑ Remedlation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor - ❑ Land Application of Slpdge
❑ Water Source Heat Pump 8 O her: e
SAMPLING INFORMATION 1
S � U�,�1 Date sample collected: �4` S'- G
WELL ID NUMBER (from Permit):
Well Diameter: in.
Well Depth: ft.
Depth to Water Level 82546: ft. below measuring point Screened Interval: ft. to ft.
Measuring Point is ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: gallons
.- - -_. _ _ — _r_•_ ..._--. ..Irw_►ad—f114ararl• 1-1 VF_S ❑ NO and field acidified: _ El YES El NO
PARAMETERS
FIELD ANALYSES:
pH 00400: units Temp. 000lo: oC
Spec. Cond. 013094: µMhos
Odor ame5:
Appearance
1O� ro .4-) Q - 9 — I G Laboratory Name:-
_.____ __i1wwL AHa 110 ar{ and colloldal concentrations.
COD oo33e
mg/L
Coliform: MF Fecal 31616
/100mL
Coliform: MF Total 31504
/100mL
(Note; Use MPN method for highly turbid samples)
Zn - Zinc 01092 mg/L
isolved Solids:Total 70300 2 � C
mgd-
,
pH (Lab) D0403
units
TOC 00680
mg/L
Chloride 00940
mg/L
Arsenic 01002
ug1L
Grease and Oils 00552
mg/L
Phenol 32730
uglL
Sulfate 00945
mg/L
)ecific Conductance Doo95
µMhos
Total Ammonia 00610
mg/L
(Ammonia Nllrogen; NH3as N; Ammonia Nitrogen, Total)
�mg
TKN as N ooem mg/L
Certification No.
WAS
DRY at
time of
sampling,
check
Nitrite (NO2) as N ooe15
mg/L
Pb - Lead D1D51 uglL
Nitrate (NO3) as N 00620
mg/L
Zn - Zinc 01092 mg/L
Phosphorus: Total as P 00665
70507
mg/L
rrg/L
Other (Specify Compounds and Concentration Units):
Orthophosphate
Al - Aluminum 01105
va
m*
Be - Barium 01007
ugr'
Ca -Calcium 00916
�mg
Cd - Cadmium olo27
Chromium: Total 01030.%
mg/L- l
ORGANICS: (by GC, GC/MS, HPLC)
cn_
Cu -Copper D1aa2
c)
ug1L
(Specify test and method #. ATTACH LAB REPORT.)
Fe - Iron 01 003
uglL
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Hg - Mercury 71900
m /L
g
VOC 7373 , method #
K - Potassium 00937
mg/L
, method #
Mg - Magnesium 00927
method #
Mn - Manganese 01055
ug1L
method #
Mt _ Minkni x11037
uglL
, -
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
NOR 111411111HO
=t)
� � — Ulf Cts Permittee ( r A tllorized AgeNerne and Title -Please print or type
GW -59 Rev. 812013 % �%,Rwerjtne, C—
P 0
mg/L Effluent Total VOCs:
mg/L VOC Removal%