WQ0007569_Monitoring - 11-2016_20161219 (2)

SUBMIT FORM ON YELLOW PAPER ONLY
NDWATER QUALITY MONITORING:
LIANCE REPORT FORM
Name: Brandywine Bay WWtP
Name (if different):
Address: 5058 Hwy. 70 West Ridge CenterN2A
:ad City (6fircet) IVC 28557 County Carteret
act Person: James Jenkins Telephone#: [phone]
Location/Site. Name WWTP No. of wells to be sampled: 6
(from Permit)
.L ID'NUMBER ffrorn Permit)t MW -2 Date sample collected: 11/15/2016
Depth: 20 ft. Well Diameter: 2 in.
h to Water Level 82546:6.4 ft. below measuring ,point Screened Interval: 5 ft. to 20 ft.
wring Point is 1.5 fL above land surface Relative M.P. Elevation: ft.
of water pumped/bailed before sampling: 6 gallons
WATER QUALITY414FORMATION PROCESSING UNIT
eRVICE CENTER, RALEIGH; NC 276994617 Phone
Number: Expiratioi
.harge. W00007569 UIC
'DES Other
PE OF PERMITTED OPERATION BEING MONITORED
13 Lagoon ❑ Remediation; Infiltration Gallery
N Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
FIELD ANALYSES
pH 00400: 7.1.6 units Temp. 000io: 19.3 °C
Spec. Cond. 00094: µMhos
Odor 000as: none
Appearance
ite sample analyzed: 11/15 to 12/02/2016 Laboratory' Name: Environmental Chemist
\RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N oosls 0 mg/L Pb Lead o1o51
Coliform: MF Fecal 31616 1 /100mL Nitrate (NO3) as N 00620 0 mg/L Zn -Zinc 01092
Coliform: MF Total 31s04 /100mL Phosphorus: Total as P oo665 0.13 mg/L
(Note: Use MPN method for highly turbid samples)
mg/L
Solved SolidsTotal 703oo 414
mg/L
pH (Lab) 00403
units
TOC oosao 19.8
mg/L
Chloride 0094o 23
mg/L
Arsenic 01002
ug/L
Grease and Oils 00552
mg/L
Phenol 32730
ug/L
Sulfate 00945
mg/L
:cifc Conductance 00095
µMhos
Total Ammonia omio
mg/L
(Amrnonla'Nitrogen; NH3as N; Ammonia Nitrogen, Total)
ug/L
TKN as N 00625 0 mg/L
Orthophosphate 70507
mg/L
Al -Aluminum o11o5
mg/L
Ba - Barium 01007
uglL
Ca- Calcium oo916
mg/L
Cd -Cadmium 01027
ug/L
Chromium: Total 01034
ug/L
Cu - Copper 01042 F r 9 f 7 n i
mg/L
Fe - Iron 01045
ug/L
Hg - Mercury 71900
ug/L
K- Potassium 00937
mg/L
Mg - Magnesium 00927
mg/L
Mn - Manganese o1o5s -
ug/L
Ni - Nickel 010$7
ug/L
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs;
Lassiter, Regional Manager I
,,e (or Authorized Anent) Name and Danny Lassiter
GW -59 Rev. 2/2010 Regional Manager
[e-mail]
800-525-7990
Certification No. 94
ug1L
mg/L
Other (Specify CorTpounds%and Concentration Units):
r
let g
ORGA I (by GG, GC/MS,, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? 0' Yes (1) ❑ No (0)
VOC 76732: method #
method #
method #
method' #
mg/L Effluent Total VOCs:
VOC Removal%
at
of

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION 1'mease Pnnt cleanyorType
Facility Name: Brandywine Bay WWtP
Permit Name (if different):
Facility Address: 5058 Hwy. 70 West Ridge CenterN2A
Morehead City - (Streel." NC 28557 County Carteret
act Person: James Jenkins Telephone#: [phone]
Location/Site Name: VVWTP No. of wells to be sampled: 6
L ID NUMBER (from Permit): MW -4
Depth:, 20 ft.
Depth to Water Level 82546:6 ft. below measuring point
Measuring Point is 1.5 ft. above land surface
Volume of water pumped/bailed before sampling: 5
Samples for metals were collected unfiltered: ❑ YES, (!!
;ION OF WATER QUALimmFORMA nom
MAIL SERVICE CENTER, RALEIGH, NC X
ERMIT Number: Expiration Date: 1-31-2017
on -Discharge WQ0007569 UIC
PDES Other
YPE OF PERMITTED OPERATION BEING MONITORED
El Lagoon ❑ Remediation: Infiltration Gallery
H Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
El Water Source Heat Pump ❑ Other:
Date sample collected: 11/15/2016_ _ FIELD ANALYSES:
Well Diameter: 2 in. pH 0040o: 6:79 units Temp. 000lo: 23.1 °C
Screened Interval: 5 ft. to 20 ft. Spec. Cond. 00094: µMhos
Relative M.P. Elevation: ft. Odor000s5:
is Appearance
and field acidified: ❑ YES © NO
Date sample analyzed: 11/15 to 12/0212016 Laboratory Name: Environmental Chemist
PARAMETERS NOTE:, Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L,
Nitrite (NO2) as N 00615 0
mg/L
Coliform: MF Fecal 316161
/100mL
Nitrate (NO3) as N oo62o 0
mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 0.33
mg/L
(Note: Use,MPN inethod for highly turbid samples)
µMhos
Orthophosphate 70507
mg/L
)issolved Solids:Total :703oo 758
mg/L
Al - Aluminum oil o5' _ _
mg/L
PH (Lab) 00403 -
units
Ba - Barium 01007
_ ug/L
TOC oo68o 32.4
mg/L
Chloride 00940 187
mg/L
Arsenic o1oo2 -
ug/L
Grease and Oils 00552
mg/L
Phenol 32730
ug/L
Sulfate oo945
mg/L
fic Conductance 00095
µMhos
Total Ammonia ooslo
mg/L
(Ammonia Nitrogen; NH�as N; Ammonia Nitrogen; Total)
ug/L
TION as N 00625 0
mg/L
For Remediation
Danny Lassiter
Regional Manager
nye(PrAuter, Regional [e-mail]
Mee (or Authorized Agentj
GW -59 Rev. 2/201' 800-525-7990
Ca - Calcium 00916
mg/L.
Cd - Cadmium o1o27
_ ug/L
Chromium: Total 01034
ug/L
Cu - Copper 01042
mg/L
Fe - iron 01045
ug/L
Hg - Mercury 71900
ug/L
K - Potassium 00937
mg/L
Mg - Magnesium 00927
mg/L.
Mn - Manganese 91085
ug/L
Ni - Nickel o1o67
ug/L
Certification No. 94
Pb - Lead 01o51 ug/L
Zn - Zine 01092_ mg/L
Other (Specify Compodsrand Concentration Units)
D lb
ORGANICS-., (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? 9 Yes (1) ❑ No (0)
VOC 73732: _ _ method #
method #
method #
method #/
Total VOCs: mg/L Effluent. Total VOCs:
mg/L VOC Removal%
If WELL
DRY at
time of
check
here: ❑

SUBMIT FORM ON YELLOW PAPER ONLY
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
Danny Lassiter, Regional Manager Danny LassiterRegional Ma
Permittee (or Authorized Agent) Name and Titld Hager
GW -59 Rev. 2/2010 [e-mail]
800-525-7990
mg/L Effluent Total VOCs:
mg/L VOC Removal%
11111Fa
fflMIDEPARTMENTOFENVIRONMENT
& NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:'
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
�6117
®
MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Cleady or Type
PERMIT Number: , Expiration Date: 1-31-2017
Facility Name: Brandywine Bay WWtP
Non -Discharge WQ0007569 UIC
Permit Name (if different):
NPDES Other
Facility Address: 5058 Hwy. 70 West Ridge Center
N2A
TYPE OF PERMITTED OPERATION BEING MONITORED
Morehead City (St`e") NC
28557 County Carteret
❑Lagoon El Remediation: Infiltration Gallery
(CiLY; (State)
(Zig).
Spray Field ❑'Remediation:
Contact Person: James Jenins
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: WWTP
- No. of wells to be sampled: 6
❑ Water Source Heat Pump ❑ Other:
_ from Permit..
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW -5
Date sample collected` 11/15/2016
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400: 6.69 units Temp. 000lo: 22.3 oC
DRY at
Depth to `Water Level 82546: 4.2 ft. below measuring ,point Screened Interval: 5 ft.
to 20 ft.
—
Spec. Cond. 0oo94: µMhos
time of
sampling;
Measuring Point is 1.5 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085: none
check
Volume of water pumped/bailed before sampling:
5
gallons
Appearance
here:
Samples for metals were collected unfiltered: ❑ YES
® NO and field acidified: ❑ YES I) NO
- _
LABORATORY INFORMATION
- -
Date sample analyzed: 11115 to 12/0212016
Laboratory Name: Environmental' Chemist
Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 0
mg/L
Pb - Lead o1o51 ug/L
Coliform; MF Fecal 31,616
/100mL
Nitrate (NO3) as N omm o
mg/L
Zn - Zinc 0.1092 mg/L
Coliform: MF Total 31504
/1OOmL
Phosphorus: Total as P 00665 0.33
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Como s and Concentration Units):
issolved' Solids:Total 70300 578
mg/L
Al -Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
Ur 91 2n ig
TOC oo6so 13.8
mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 133
mg/L
Cd - Cadmium.01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034 -
ug/L
Grease and Oils 00552
mg/L
Cu - Copper o1042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron o1o45
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 000m
µMhos
K - Potassium 00937
mg/L
VOC 78732: method #
Total Ammonia oomo
mg/L
Mg - Magnesium 00827
mg/L
method #
(Ammonia Nitrogen; NH3as,N; Ammonia Nitrogen,. Total)
Mn - Manganese olo55
ug/L
method #
TKN as N 00625 0
mg/L
Ni - Nicker 01067
ugfL
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
Danny Lassiter, Regional Manager Danny LassiterRegional Ma
Permittee (or Authorized Agent) Name and Titld Hager
GW -59 Rev. 2/2010 [e-mail]
800-525-7990
mg/L Effluent Total VOCs:
mg/L VOC Removal%

SUt3Ml 1 FORM ON YELLOW PAPER ONLY
ite sample analyzed: 11(15 to 12/02/2016
e e
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
1RAMETERS NOTE: Values should reflect dissolved and' colloidal concentrations.
DIVISION"OF WATER QUALITY4NFORMATION PROCESSING UNIT
COMPLIANCE REPORT .FORM
e e e e
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 1919► 733-3221
FACILITY INFORMATION Please Print Clearly or
PERMIT Number: Expiration Date: 1=31-2017
Facility Name: Brandywine Ba WVMP
Coliform: MF Fecal 31616 1
Non -Discharge WQ0007569 UiC
Permit Name (if different):
mg/L
NPDES Other -
Facility Address: 5058 Hwy, 70 West Ridge Center N2A
/100mL
TYPE OF PERMITTED OPERATION BEING MONITORED
Morehead Ci (s'ree`) 28557
City NC
--
County Carteret
❑ Lagoon ❑Remediation: Infiltration Gallery
rCi y).-sface; (Zip)
- - - -- - - - -
IN Spray Field. El Remediation:
Contact Person: James Jenkins
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: WNLrP
No. of wells to be sampled- 6
❑ Water Source Heat Pump ❑ Other:
- - _
from Permit)
-
SAMPLING INFORMATION
-
If WELL
WELL 10 NUMBER (from Permit): MW -8
Date sample collected: 11/15/2016
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 In.
pH 00400: 6.69 units Temp. 000lo, 21.9 °G
DRY
f
Depth to Water Level 82546: 5.8 ft. below measuring point
Screened Interval: 5 ft. to 20
ft. Spec. Cond. 00094: µMhos
time
li
sampling,
Measuring Point is 1.5 ft, above land surface
Relative M.P. Elevation: ft.
Odorooass:. srong
check
Volume of water um ed/balled before sam lin 5
p p p 9
gallons
Appearances
here:❑
Samples for metals were collected unfiltered: El YES ®
NO and field acidified: ❑ YES K NO
ite sample analyzed: 11(15 to 12/02/2016
mg/L
Laboratory Name: Environmentat Chemist
Certification No. 94
1RAMETERS NOTE: Values should reflect dissolved and' colloidal concentrations.
ug/L
Grease and Oils 0os52
COD 00335
mg/L
Nitrite (NOZ) as N 00615 0
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 1
/100mL
Nitrate (NO3) as N ooa2o 0
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF' Total 315o4 - -
/100mL
Phosphorus: Total as P 00665 0.16
mg/L
(Note: Use MPN method for highly,turbid samples)'
Orthophosphate 70607
mg/L
Other (Specify Comp o t n. nd Concentration Units);
solved Solids:Total 70300 604
mg/L
Al - Aluminum oil o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug1L
TOC oo6so 28.2
mg/L
Chloride 00940 158
mg/L
Arsenic 01002
ug/L
Grease and Oils 0os52
mg/L
Phenol 32730,
ug/L
Sulfate 00945
mg/L
fic Conductance 000s5
µMhos
Total Ammonia oosio
mg/L
(Ammonia; Nitrogen; N1­13as N;, Ammonia Nttrogan, Total)
ug/L
TKN as N ooe25 0 mg/L
For Remediation Systems Only (Attach Lab
Lassiter,
GW -59 Rev. 2/2010
Ca - Calcium 00916 - -
mg/L
Cd - Cadmium 01027
ug/L
Chromium:' Total 01034
- , ug/L
Cu - Copper 01042
mg/L
Fe- Iron 01045
ug/L
Hg - Mercury 71900
ug/L
K - Potassium 00937
mg/L
Mg - Magnesium oo927
mg/L
Mn - Manganese 01055
ug/L
Ni - Nickel 01067
ug/L
ttU
ORGANICS: (by GC, GC/MS, HPLC)'
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑■ Yes (1) ❑ No (0)
VOC 78732: , method #
Influent Total VOCs mg/L Effluent Total
Danny Lassiter
Regional Manager
[e-mail]
800-525-7990
method #
method #
method #
mg/L
VOC Removal%

SUBMIT FORM ON YELLOW PAPER ONLY
Mrr-IFM 0
1 certify that, to the best of my knowledge and belief._, the information submitted in this report is true, arc
DWQ-certifded laboratory:l am aware that the "- ;^^ h 'TMr falc nformat or
nny Lassiter
l,anny Lassiter, RegionalD.
ittee (or Authorized Agent) Name and T Regional Manager
GW -59 Rev, 2/2010 [e-mail]
800-525-7990
mg/L Effluent Total VOCs: ng/L VOC
s e
DEPARTMENT OF ENVIRONMENT& NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY-INFORMA-nON PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1.617 Phone: [phone]',
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 1-31-2017
Facility Name: Brandywine Bay WWtP
Non -Discharge W00007569 UIC_
Permit Name (if different):
NPDES Other
Facility Address: 5058 Hwy. 70 West Ridge Center
N2A
-
TYPE OF PERMITTED OPERATION BEING MONITORED
Morehead City tS1e``I NC
County Carteret
28557 Coup C
❑ Lagoon ❑Remediation: Infiltration Gallery
_
iat; s d e)
tz,Pl
9 Spray Field El Remediation:
Contact Person: James Jenkins
Telephone#: _252-659-0513
❑ Rotary Distributor (] Land Application of Sludge
Well Location/Site Name:'V WTP
_
No. of wells to be sampled: 6
❑ Water Source Heat Pump Other: _
fromPemtit-
_ _
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW -9
Date sample collected: 11/15/2016
FIELD ANALYSES:
WAS
Well Depth; 21.18 ft.
Well Diameter: 2 'in.
pH 00400: 5.45 units Temp. 0oolo: 21.2 °C
DRY at
Depth to Water Leve( 82546: 6.7 ft. below, measuring point Screened Interval: 5 ft.
to 21.18 ft. Spec. Cond, 00094: )iMhos
time of
—
sampling,
Measuring Point is 1.5 fit. above land surface
Relative M.P. Elevation
ft. Odor 000$5: slight
Volume of water pumped/bailed before sampling::
5
gallons
Appearance -
here:
Samples for metals were collected_ unfiltered: ❑ YES
® NO and field acidified: ❑ YES ® NO
LABORATORY INFORMATION
Date sample analyzed: 11/15 to 12/02/2016
Laboratory Name, Environmental Chemist Certification No. 84
PARAMETERS NOTE: Values should reflect
dissolvedand colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N oc61s 0
mg/L Pb - Lead 01os1 ug/L
Coliform: MF Fecal miiii 1
/100mL
Nitrate (NO3) as N 00620 0
mg/L Zn - Zinc 01092 mg /L
Coliform: MF Total 01504
1100mL
Phosphorus: Total as P oos65 0
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate'70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 87
mg/L
Al -Aluminum o11o5
mg/L gm a
pH (Lab) oo4m
units
Ba - Barium 01007
ug/L Uj
TOC 0o68o 7.3
mg/L
Ca - Calcium oogls
mg/L.
Chloride 00940 19
mg/L
Cd - Cadmium 01027
ug/L DEG
Arsenic 01002
ug/L
Chromium: Total o1oa4 _
ug/L
Grease and Oils 00552
mg/L
Cu -Copper oloa2
mg/L ORGANICS. (by GC, GC/MS, HPLC)
Phenol $2130 _
ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 001945
mg/L
Hg - Mercury 71960
ug/L Lab Report Attached? X Yes (1) ❑ No (0)
Specific Conductance 000gs
µMhos
K- Potassium 00937
mg/L VOC 78732: _ „ method '#
Total Ammonia o0610
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen Totaq
Mn -Manganese 61055
UgIL method #
TKN as N 00625 0
mg/L
Ni - Nickel 01067
ug/L method #
Mrr-IFM 0
1 certify that, to the best of my knowledge and belief._, the information submitted in this report is true, arc
DWQ-certifded laboratory:l am aware that the "- ;^^ h 'TMr falc nformat or
nny Lassiter
l,anny Lassiter, RegionalD.
ittee (or Authorized Agent) Name and T Regional Manager
GW -59 Rev, 2/2010 [e-mail]
800-525-7990
mg/L Effluent Total VOCs: ng/L VOC

SUBMIT FORM ON YELLOW PAPER ONLY
UNDWATER QUALITY MONITORING:
PLIANCE REPORT FORM
TY INFORMATION "ease rRnt ciea_rtycr Type
Name: Brandywine Bay VVMP
Name (if different):
=acility Address: 5058
Morehead City
/, 70 West Ridge. Center N2A
NC 28557 County
ict Person: james Jenkins Telephone#: [phone]
Location/Site Name: WWTP _ _ _ No. of wells to be sampled: 6
WELL ID NUMBER (from Permit): MW -10 Date sample collected: 11/15/2016
Well Depth: 26.81 ft. Well Diameter. 2 in.
Depth to Water Level 82546:6.2 ft. below measuring point Screened Interval; 5 fL to 26.81 ft.
Measuring Point is 1.5 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/balled before sampling: 5 gallons
SERVICE CENTER, RALEIGH, NC 27699.1617
Number: Expiration Date:
on -Discharge W00007569 UIC
PDES Other
YPE OF PERMITTED OPERATION BEING MONITORED
Lagoon ❑ Remediation: Infiltration Gallery
Spray Field ❑ Rem- ediation;
Rotary Distributor ❑ Land Application of Sludge
Water Source Heat Pump ❑ Other:
FIELD ANALYSES:
WAS
pH ooaoos 6.58 units Temp. 000lo: 20.7 °C
DRY at
Spec. Cond. 00094: µMhos
time of
Sulfate oos45
samplir
Odor00085: none
check
Appearance
here -.,F
ate sample analyzed': 11/15 to 12/02/2016
ug/L
Laboratory Name: Environmental Chemist
Certification No. 94
4RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
ug/L
Sulfate oos45
COD 00335
mg/L
Nitrite (NO2) as N 90615 0
mg/L
Pb - Lead 01 o51 _ _ _ ug/L
Coliform: MF Fecal 31616 1
/1'OOmL
Nitrate (NO3) as N 00620 0
mg/L
Zn - Zinc o1o92 mg/L
Coliform: MF Total 315o4
/100mL
Phosphorus: Total as P oows 0.11
mgLL
(mote: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
solved Solids;Total 70300 150
mg/L
AI -Aluminum 01105
mg/L
pH (Lab) oo403
units
Ba - Barium olow
ug/L
TOC oo680 0.6
mg/L
Ca - Calcium 00918
mg/L
Chloride 00940 12
mg/L
Cd - Cadmium 01027
ug/L
u
Arsenic 01002
ug/L
Grease and Oils 00552
mgLL
Phenol 32730
ug/L
Sulfate oos45
mg/L
fic Conductance 000g5
µMhos
Total Ammonia ooslo
mg/L
(Amnionia Nitrogen; NH as N Arimonia Nitrogen, Total)
ug/L
TKN as N oo62s 0 mg/L
Chromium: Total 01034
ug/L
Cu -Copper 01042
mg/L
,Fe - Iron o1o45
ug/L
Hg - Mercury 71900
ug/L.
K - Potassium 00937
mg/L
Mg - Magnesium 00927
mg/L
Mn - Manganese 01055
ug/L
Ni - Nickel 01067
ug/L
ror memealauon systems only (Attach Lab Reports): Influent Total VOCs:
1 • _
Danny Lassiter
Danny Lassiter,Regional Manager Regional Manager
Permittee (or Authorized Agent) Name an
GW -59 Rev. 212010 [e-mail]
800-525-7990
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? X■ Yes (1) El No (0).
VOC 78732: method #
method #
method #
method #
mg/L Effluent Total VOCs:
mg/L VOC Remova!%

GW -59A COMPLIANCE REPORT FORM Permit # WQ0007569
(Submit one each monitoring period with GIY-59 forms.)
I
Enter date monitoring results were due. (NoverrLbe Will this monitoring report (GW -59 and GW -59A)
YES
NO
be submitted after the established due date?
X
2
Was any required information missing on the GW -59 report forms?
YES
NO
X
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 'Fes", contact the Regional Office for guidance.
X
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 B.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentrations)
exceeding standards in the space provided below:
See Attachment
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?
X
If the answer to question 5 is "NO", skip to section S.
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).
See Attachment
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
y
x
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?
X
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 malt subject the permittee to a Notice of Violation,
fines, andlor 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 GiN-59 form.
1 hereby acknowledge that the above information was evaluated and the information submitted in this
report (Compliance Report GW -59A) is true and complete to the best of my knowledge.
12 12
Signature ofPer or Authorized Agent) Date
Danny Lassiter
GW -59A 12/8/2003 Regional Manager
[e-mail]
800-525-7990