WQ0004972_Monitoring - 11-2016_20161222

SUBMIT FORM ON YELLOW PAPER ONLY
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
I certify that, to the best of my knowledge and belief, the information submitted in this report is true, accurate, and com plate, and
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility
James M. Cheshire
Permittee (or Authorized Agent) Name and Title - Please obnt or type
GW -59 Rev. 2/2010
mg/L Effluent Total VOCs: mg/L VOC Removal°
r laboratory analys ' d was produced using approved methods of analysis by a
/fines nit imprisonment/ n violations.
(Date)
Mall original
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
and i COpy t0:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
L'OMPLIANCEREPORTFORM
1917 MAIL SERVICE CENTER, RALEIGH, NC 27699-1917 Phone:[phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: W00004972 Expiration Date:
Facility Name: Forest Lake ELS
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 192 Thousand Trails Drive
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Advance """" NC 27006 County Davie
© Spray Field ❑ Remediation:
Contact Person: Barbara Stanza
Telephone#:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
M1,n, Paenll
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW -1
Date sample collected:
11/22/2016 FIELD ANALYSES:
WAS
Well Depth: 90.00 ft.
Well Diameter:
2 in. pH 00400: 6_29 units Temp. 000lo: 16.1 nC
DRY at
Dept to Water Level 74.27 ft. below measurin
P g point
Screened Interval:
ft. to ft. Spec. Cord. o00sa: p Mhos
time of
Measuring Point is ft. above land surface
Relative M.P. Elevation:
ft. Odor 00095:
sampling,check
Volume of water pumped/bailed before sampling:
4.50 -Dry
gallons
Appearance
here:
❑
Samples for metals were collected unfiltered: ❑ YES El
NO and field acidified: [I YES El NO
LABORATORY INFORMATION
Date sample analyzed: 11/22, 11/29 & 11/30/16
Laboratory Name: Research & Analytical Laboratories Inc Certification No. 34
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (1,102) as N 00615
mg/L Pb - Lead 01051 u 91L
Coliform: MF Fecal 31616 5
/100ml-
Nitrate (NO3) as N 00620
<0.05 mg/L Zn - Zinc 01092 Q Pr Iii � rl
Coliform: MF Total 31504
/100mL Phosphorus: Total as P 00665
mg/L - r��T. r
(Note. Use MPN method for highly turod samples)
Orthophosphate 70507
mg/L Other ($PeCIty Compounds GAdb6brip@q6n Units):
Dissolved Solids:Total 70300
mg/L
Al - Aluminum of los
mg/L
pH (Lab) o04o3
units
Be - Barium 01007
ug/LDWR dECTION
TOC 00600 53.2
mg/L
Ca - Calcium 00916
mg/L ORM IT
Chloride oes4o 3.15
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total alom.,, �'t
ug/L
Grease and Oils 00552
mg/L
Cu - Copper oifui n
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron oras VME
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? 0 Yes (1) ❑ No (0)
Specific Conductance oo09s
µMhos
K - Potassium 00937
mg/L VOC 78732: , method # 8260
Total Ammonia ocaf o
mg/L
Mg - Magnesium 00927
mg/L , method #
(Ammonle Nihogen', NHs as N: Ammons Nitrogen, Tatar
Mn -Manganese 01055
ug/L ,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L , method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
I certify that, to the best of my knowledge and belief, the information submitted in this report is true, accurate, and com plate, and
DWO-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility
James M. Cheshire
Permittee (or Authorized Agent) Name and Title - Please obnt or type
GW -59 Rev. 2/2010
mg/L Effluent Total VOCs: mg/L VOC Removal°
r laboratory analys ' d was produced using approved methods of analysis by a
/fines nit imprisonment/ n violations.
(Date)

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER
RQUALITY MONITORING:
Mail original
DEPARTMENT OF ENVIRONMENT 8 NATURAL RESOURCES
and cot0:
copy
DNISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPPNDLIANNCECE REPORT FORM
1917 MAIL SERVICE CENTER, RALEIGH, NC 279994917 Phone:[phone]
FACILITY INFORMATION
Please Pdnt C/aady or Type
PERMIT Number: W00004972 Expiration Date:
Facility Name: Forest Lake ELS
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 192 Thousand Trails Drive
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Advance NC 27006 County Davie
© Spray Field ❑ Remediation:
Contact Person: Barbara Stanze
Telephonelf:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No, of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
Noon Permd
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW -2
Date sample collected:
FIELD ANALYSES:
WAS
Well Depth: 39.00 ft.
Well Diameter:
2 in. pH oofoa:_ units Temp. 00010: °C
DRY at
Dept to Water Level 38_48 ft. below measuring
P g point
Screened Interval:
ft. to ft. Spec. Cord. 00064: P Mhos
time of
Measuring Point is ft. above land surface
Relative M.P. Elevation:
ft. Odor 000s5:
sampling,
check
Volume of water pumped/bailed before sampling:
Well Dry
gallons
Appearance
here:
Samples for metals were collected unfiltered:
❑ YES ❑
NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:
Laboratory Name: Research & Analytical Laboratories, Inc Certification No. 34
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrile (NO2) as N 00915
mg/L Pb - Lead o1a51 ug/L
Coliform: MF Fecal 31919
/1 OOmL
Nitrate (NO3) as N 00920
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL Phosphorus: Total as P 00665
mg/L
(Nate: Use MPN method far highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units),
Dissolved Solids:Total 70300
mg/L
Al - Aluminum o1105
mg/L DEC IS 2016
pH (Lab) 00403
units
Be - Barium 01007
ug/L
TOC ooaso
mg/L
Ca - Calcium 00916
mg/L VUE-
Chloride oos4o
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total aio34
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
ni 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? EllYes (1) 0 No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L VOC 78732. , method # 8260
Total Ammonia oo610
mg/L
Mg - Magnesium 00927
ni , method #
(Ammonia Nitrogen, NH3 as N: Ammons Nitrogen, Total)
Mn - Manganese ato55
ug/L , method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
I certify that, to the best of my knoWledge and belief, the information submitted in this report is true, accurate, and complete, and
DWl}cenlAed Laboratory. I am aware that there are significant penalties for submitting false information, inducing the possibility
James M. Cheshire
Permittee for Authorized Apart) Name and Title - Please pont or type
GW -59 Rev. 2/2010
Effluent Total VOCs: mg/L VOC Removal%
story analytical data wqt oduosd using approved methods of analysis by a
12- l5- I b

SUBMIT FORM ON YELLOW PAPER ONLY
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs:
I cartdy that, to the best of my knowledge and belief, the information submitted in this report is true, accurate, and complete, and that the Iabc
OWO-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of 4m and
James M. Cheshire
Permittee (or Authorized Agent) Name and Tdle - Please print or type
GW -59 Rev. 212010
mg/L VOC Removals/,
produced using approved methods of analysis by a
Mall original
DEPARTMENT OF ENVIRONMENT& NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
and 1 Copy to:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1917 MAIL SERVICE CENTER, RALEIGH, NC 27999-1917 Phone: [phone]
FACILITY INFORMATION
Plasm Print Clearly or Type
PERMIT Number: W00004972 Expiration Date:
Facility Name: Forest Lake ELS
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 192 Thousand Trails Drive
TYPE OF PERMITTED OPERATION BEING MONITORED
❑Lagoon ❑ Remediation: Infiltration Gallery
Advance"""" NC 27006 County Davie
© Spray Field ❑ Remediation:
Contact Person: Barbara Stanza
Telephone#:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other
ham P.mN
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW -3
Date sample collected:
11/22/2016 FIELD ANALYSES:
WAS
Well Depth: 19.10 ft.
Well Diameter:
2 in. pH oo400: 6_34 units Temp. 000lo: 16.8 sC
DRY at
Dept to Water Level 11_20 ft. below measuring point
Screened Interval:
ft. to ft. Spec. Cond. 0oo94: µMhos
time of
sampling,
Measuring Point is ft. above land surface
Relative M.P. Elevation:
ft. Odor 000es:
check
Volume of water pumped/bailed before sampling:
1.25 -Dry
gallons
Appearance
here:❑
Samples for metals were collected unfiltered: []YES ❑
NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11/22,11/29 & 11/30/16
Laboratory Name: Research & Analytical Laboratories, Inc Certification No. 34
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NOS) as N 00615
mg/L Pb - Lead alos1 ug/L
Coliform: MF Fecal 31616 25
/100mL
Nitrate (NO3) as N 00620
3.70 mg/L Zn -Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL Phosphorus: Total as P 00665
mg/L
(Nola Use MPN meMad forhlgNywrbid simples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300
mg/L
AI -Aluminum ollo5
mg/L DEC 2 Q 9016
pH (Lab) 00003
units
Be -Barium 01007
��
ug/L
TOC aosao <1.0
mg/L
Ca - Calcium aosla
mg/L
Chloride aosao 32.5
mg/L
Cd - Cadmium o1o27
ug/L
Arsenic 01002
ug/L
Chromium: Total olo34
ug/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 #. ,TACH LAB REPORT.)
Sulfate oosss
mglL
Hg - Mercury 71900
ug/L Lab Report Attached? � Yes (1) =No (0)
Specific Conductance 000gs
µMhos
K - Potassium 00937
mg/L VOC 78732: , method # 8260
Total Ammonia oo610
mg/L
Mg - Magnesium 00927
nr lL , method #
(Ammonia Nitrogen. NHsas N; Ammonia Nitrogen, Tim)
Mn - Manganese 01055
ug/L method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs:
I cartdy that, to the best of my knowledge and belief, the information submitted in this report is true, accurate, and complete, and that the Iabc
OWO-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of 4m and
James M. Cheshire
Permittee (or Authorized Agent) Name and Tdle - Please print or type
GW -59 Rev. 212010
mg/L VOC Removals/,
produced using approved methods of analysis by a

SUBMIT FORM ON YELLOW PAPER ONLY
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
I certify that, to the best of my knowledge and belief, the Information submitted in this report is true, accurate, and Cort
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information, including the
James M. Cheshire
Permittee (or Authorized Agent) Name and Title- Please print or type
GW -59 Rev. 212010
I Effluent Total VOCs:
I th he laboratory analyb a vin
r offi ae and impdtwam for
mg/L VOC Removal%
produced using approved methods of analysis by a
Violations.
Mall original
DEPARTMENTOF ENVIRONMENT& NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING'
and 'l copy to:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: W00004972 Expiration Date:
Facility Name: Forest Lake ELS
Non -Discharge UIC
NPDES Other
Permit Name (if different):
Facility Address: 192 Thousand Trails Drive
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
Advance " NC 27006 County Davie
'1 "''
"'
© Spray Field ❑ Remediation:
Contact Person: Barbara Stanza
Telephone#:
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled:
4
❑ Water Source Heat Pump ❑ Other:
eom Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MWA
Date sample collected:
11/22/2016 FIELD ANALYSES:
WAS
Well Depth: 46.00 ft.
Well Diameter:
2 in. pH 00400: 6_31 units Temp. 00010: 16.7 IC
DRY at
Dept to Water Level 41_03 ft. below measuring point
Screened Intemal:_ft.
to ft. Spec. Cond. 00094: µMhos
time li
sampling,
Measuring Point is ft. above land surface
Relative M.P. Elevation:
ft. Odor 00065:
check
Volume of water pumped/bailed before sampling:
1.50 -Dry
gallons
Appearance
here: ❑
Samples for metals were collected unfiltered: ❑ YES ❑
NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11122,11/29 & 11/30/16
Laboratory Name: Research & Analytical Laboratories, Inc Certification No. 34
PARAMETERS NOTE: Values should reflect dissolved and
colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L Pb - Lead om51 ug/l_
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (1,103) as N 00620
<0.05 mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mi- Phosphorus: Total as P othI
mg/L
(Nate: Use MPNmeModbrhighlytuMdeamplee)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300
mg/L
AI - Aluminum 01106
mg/L
pH (Lab) 00403
units
Be - Barium 01007
ug/L
TOC oo6ao <1.0
mg/L
Ca - Calcium gog16
mg/L DEC 2 8 289
Chloride oag4o 3.15
mg/L
Cd - Cadmium 01027
ug/L
WE
Arsenic o1oo2
ug/L
Chromium: Total 01034
ug/L
Grease and Oils oo5s2
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 N. ATTACH LAB REPORT.)
Sulfate oo945
mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? 0' Yes (1) ❑ No (0)
Specific Conductance oaog5
µMhos
K - Potassium 00937
mg/L VOC 78732 , method # 8260
Total Ammonia oasio
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen: Nn, as NI Ammonia Nitrogen, Total)
Mn - Manganese 01os5
ug/L method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
I certify that, to the best of my knowledge and belief, the Information submitted in this report is true, accurate, and Cort
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information, including the
James M. Cheshire
Permittee (or Authorized Agent) Name and Title- Please print or type
GW -59 Rev. 212010
I Effluent Total VOCs:
I th he laboratory analyb a vin
r offi ae and impdtwam for
mg/L VOC Removal%
produced using approved methods of analysis by a
Violations.