WQ0015052_Monitoring - 11-2016_20161228 (2)

SUBMIT FORM ON YELLOW PAPER ONLY
r
as
DEPARTMENT OF ENVIRONMENT a NAWML NE50URGE5
GROUNDWATER QUALITY MONITORING:
/100ml-
DIVISION OFWATER OUAUTY4NFORMATIONPROCESSING UNIT
COMPLIANCE REPORT FORM
/100mL
1617 MAIL SERVICE CENTER, RALEIGH, NC 27669.1617 Phone: [phone]
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: Expiration Date: 8/31/2018
Facility Name: Village at Ocean HIII
mg/L
Non -Discharge W00015052 UIC
Permit Name (if different):
units
NPDES Other
Facility Address: Rt. 12
mg/L
TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla '' NC 27927 County Currituck
mg/L
❑ Lagoon ❑ Remediation: Infiltration Gallery
°
uglL
K Spray Field ❑ Remediation:
Contact Person: William G Freed Telephone#: [phone]
iWell
mg/L
❑ Rotary Distributor ❑ Land Application of Sludge
Location/Site Name: LAT 36-22-954 LON 75-49-952 EAST of Field No. of wells to be sampled: 2
ug/L
❑ Water Source Heat Pump ❑ Other:
LID NUMBER (from Permit): MVV -9
Depth: 12.9 ft.
h to Water Level 82546: 6 ft. below measuring point
luring Point is 2.75 ft. above land surface
ne of water pumped/bailed before sampling: 5
Dies for metals were collected unfiltered: ❑ YES ❑
Date sample collected: 11-15.2016 FIELD ANALYSES:
Well Diameter: 2 in. pH 00400: 6.41 units Temp. 000lo: 18.6 °C
Screened Interval: 5 ft. to ft. Spec. Cond. 00094: µMhos
Relative M.P. Elevation: ft. Odor 000as: Faint
s Appearance Light
NO and field acidified: ❑ YES ❑ NO
ate sample analyzed: Laboratory Name: Universal Labs
\RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitnte (NO.) as N oo61s mg/L
Coliform: MF Fecal 31616 <1
/100ml-
Nitrate (NO3) as N 00620 <0.1 mg/L
Coliform: MF Total 315o4
/100mL
Phosphorus: Total as P oos6s mg/L
(Note: Use MPN"too for highly khoid sarross)
Orthophosphate 70507 mg/L
;solved SolidS:TOtal 70300 520
mg/L
AI - Aluminum 0116�a mg/L
pH (Lab) 00403
units
Be - Barium oto® ug/L
TOC oo6ao 514
mg/L
Ca - Calcium oogEmg/L
Chloride oog4o 163.9
mg/L
Cd - Cadmium o1oA cm -a •1 ugfL
Arsenic 01002
uglL
Chromium: Total o1o4l- ug1L
Grease and Oils 00552
mg/L
Cu - Copper o1 �c�'Docp _ oo — mg/L
Phenol 32730
ug/L
Fe - Iron woo; o ^' ug/L
Sulfate oog4s
mg/L
Hg - Mercury 719W P" uglL.
lecific Conductance 000gs
pMhos
K- Potassium oogS��~mg/L
Total Ammonia oos/o 1.07
mg/L
Mg - Magnesium oo9uimg/L
(Ammonia Mtrogen; NH,as N: )nmionia Nitrogen, Thiel)
Mn - Manganese 01055 ug/L
TKN as N 00625
mg/L
Ni - Nickel 01067 ug/L
For Remediation Systems Only (Attach Lab Reports):
Rev. 2/2010
Certification No. NCW W543
Pb - Lead o1o51 ug/L
Zn - Zinc 01092 mg/L
Other (Specify C rI L>11nds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) © No (0)
VOC 78732: method #
On file in office , method #
method #
method #
Influent Total VOCs: mg/L Effluent Total VOCs:
mg/L VOC
-_2�2
at
of

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Name. Village
Name (d different)
Address: Rt. 12
Corolla
at Ocean Hill
SUBMIT FORM ON YELLOW PAPER ONLY
NC 27927 County Currituck
act Person: William G Freed Telephone#: [phone]
Location/Site Name: LAT 36-22-955 LON 75-50-037 No. of wells to be sampled: 2
LID NUMBER (from Permit): MW -10 Date sample collected: 11-15-2016
Depth: 10.4 ft. Well Diameter. 2 in.
h to Water Level 82546:6 ft. below measuring point Screened Interval: 5 ft. to ft.
luring Point is 2.25 ft. above land surface Relative M.P. Elevation: ft.
ne of water pumped/bailed before sampling: 2 gallons
Dies for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
ite sample analyzed: Laboratory Name: Universal Labs
1RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (1402) as N oos15
mg/L
Coliform: MF Fecal 31616 <1
/100ml-
Nitrate (NO3) as N 00620 c0.1
mg/L
Coliform: MF Total 31504
/10omL
Phosphorus: Total as P 00565
mg/L
(Note; Use MPN rteMaE for highly turbl4 wring0w)
Orthophosphate 70507
mg/L
,solved Solids:Total 703oo 420
mg/L
AI -Aluminum o11os
mg/L
pH (Lab) 00403
units
Be - Barium 01007
uglL
TOC 001 21.1
mg/L
Ca - Calcium 00916
mg/L
Chloride Doi 131.1
mg/L
Cd - Cadmium 01027
ugfL
Arsenic 01002
ugir
Chromium: Total oloa4
ugfL
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
Phenol 32730
ui
Fe- Iron ot045
uglL
Sulfate oog45
mg/L
Hg - Mercury 71900
uglL
ecfc Conductance 000gs
NMhos
K - Potassium 00937
mg/L
Total Ammonia ooslo 0.71
mg/L
Mg - Magnesium 00927
mi
(Aemonia Nitrogen; N1-f3as N: Ammonia Nitrogen. Total)
Mn - Manganese 01oss
ugi
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
GW -59 Rev. 212010
ISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
7 MAIL SERVICE CENTER, RALEIGH, NC 27999-1917 Phone: (919) 773J221
RMIT Number: Expiration Date: 8/31/2018
n -Discharge W00015052 UIC
'DES Other
PE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
IN Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
FIELD ANALYSES:
WAS
pH oo400: 6.25 units Temp. 000lo: 16.2 °C
DRY at
Spec. Cord. 00094: µMhos
time of
samplin
Odor 000es: Faint
check
Appearance Light
here:r
Certification No. NCWW543
Pb - Lead o1o51 uglL
Zn - Zinc 01092 mg/L
Other (Specify Cc1nds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ® No (0)
VOC 78732: , method #
On file in office , method #
method #
method #
mg/L Effluent Total VOCs:
ni VOC Removal

GW -59A COMPLIANCE REPORT FORM Permit # OO 1 05
(Submit one each monitoring period with GN' -59 forms)
I
Enter date monitoring results were due. () 31--M&) Will this monitoring report (GW -59 and GW -59A)
YES
be submitted after the established due date?
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
identification plate, area overgrown, etc.)? If the answer is "Yes ". contact the Regional Offieefar guidance.
4
Are any monitored constituents equal to or above the established standards?
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 concentration(s)
exceeding standards in the space provided below.
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) 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 maybe 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 permiftee 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 GW -59A) is true and complete to the best of my knowledge.
2�% r:�?? 12 -�2 a -I�C
Signature of P m' (or Authorized Agent) Date
CW -59A 12/8/2003