WQ0023310_Monitoring - 11-2016_20161222

GW -59A COMPLIANCE REPORT FORM Permit i# C3 I'
(Submit one each monitoring period with GW -59 forma)
1
Enter date monitoring results were due. Will this monitoring report (GW -59 and GW39A)
YES
O
be submitted after the established due date?
2
Was any required information missing on the GW -59 report forms?
YES
NO
toquestion 1 or 2 is 'YES' list in the space provided below the well identification numbers) and
T1hnswer
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
O
identification plate, area overgrown, etc.)? ffthe answer is "Yes", contact the Regional Office for guidance.
4
Are any monitored constituents equal to or above the established standards?
S
NO
If the answer to question 4 is 'NO" skip to section 8.
H the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding ' standards in the space provided Pelow: �{3
�p� s. owl unt
`
an;iss 1 Ago co) lloa
L
5
For the constituents Identified in question 4 a is, have standards been a ceeded previously for the
YES
NO
same constltuerd(s) in the same well(s) in the last two years?
ff the answer to question 5 is 'NO" skip to section B.
lithe answer to question 5 I "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentiation(s) reported, and sample collection date for each occu nce (for the last two years).
rnW-1R. � 3-�-/� 6.`Pa. ►�-to—it/- Y,�*� mW-�T2. P
16.65 I1 -13 -Is alta I1 -'1-/s 5.09
Are the monitoring wells listed in section 5 located at or beyond the revlei r boundary?
YES
O
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?
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
,
ul determine Im t e wasta disposal system Is haul at the review and compliance
boundaries surrounding this facility. Failure to do so may sublets the Violation.
lines, and/or penalties. Mqprf
OEC 22 2016
WcORWTION PROCESSING UNIT
g
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.
apdt�3abormafion submitted In this
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Signature of ermhtse (or Authorized Agent) Date
GW -59A 12W2003
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TER QUALITY MONITORING:
EREPORTFORM
Name:
Name (If
act Person: k%,ku
Location/Site Name
SUBMIT FORM ON YELLOW PAPER ONLY
County
Telephone#:
No. of wells to be sampled:
n -Discharge
UIC
'DES
Other
PE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation: Infiltration Gallery
Iti- pray Field
❑ Remedlatlon:
❑ Rotary Distributor
❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other
SAMPLING INFORMATION Date sample collected: ��- � —16
�
FIELD ANALYSES:
FnJ ruche
WAS
WELL ID NUMBER (from Permit):
��t�
Well Diameter:, In.
pH 00000:�unite Temp. 66010: I B 3 °C
eiti
DRY at
Well Depth: ft.
Depth to water Level 02546:�ft.
below measuring point Screened Interval: _ft. to _ft.
Spec. Cond. o0aea: µMhos
Coliform: MF Total 316134
time of
sampling,
ft.
above land surface Relative M.P. Elevation: ft.
Odor 0oosa: 'T\ O L.
check
Measuring Point is
`turbid
solved Sollds:Total 70300 ` k Q,
Appearance
At - Aluminum o11oia
here:❑
Volume of water pumpedlballed before
sampling: _gallons
Be - Barlum 01007
-r IL
TOC 00680mg/L
4BORATORYI FOR TIO
- -
- I G - I6 Laboratory Name:
FnJ ruche
ate sample analyzed:-
1RAMETERS NOTE: Values shoo d reflec d ssoivad andolloidal concentrations.
COD 00336
mg/L
eiti
mglL
Collform: MF Fecal 31x16 1 Cp ,
/100ml-
Nitrate (NO3) as N 0aa2o Q , L(3 mg/L
Coliform: MF Total 316134
/100mL
Phosphorus: Total as P 00tas
mg/L
(Note: Use MPNmethod for highly sample-)
Orthophosphate70ao7
mg/L
`turbid
solved Sollds:Total 70300 ` k Q,
mg/L
At - Aluminum o11oia
_- mg/L
pH (Lab) 00403
units
Be - Barlum 01007
-r IL
TOC 00680mg/L
Ce - Calcium 00016
-BOIL
�—
Cd - Cadmium 01027
nglL
Chloride 00940 L 1
mg/L
uglL
-----
Chromium: Total 01034
Arsenic 01002
Arsenic
mg/L
Cu - Copper 131042
L P- � mg/L
Grease and 011s 00882
uglL
Fe - Iron o1o4a=T
L
Phenol 32730
m IL
g
Hg - Mercury 71000
" --—
uVoL
z
Sulfate 00648
µMhos
K - Potassium 00067
m0/L
scific Conductance atto08
Total Ammonla oaatc .G O .
m g IL
Ng -Magnesium 00ez7
- mglL
-
(Ammonia Nitrogen; NHe96 N; Ammonia N11mllen, Tolal)
Mn - Manganese 01055
ug/L
mg/L
NI - Nickel 01067
ug/L
TKN as N 00626
For Remediation Systems Only (Attach Lab Reports):
Rev. 812013
Influent Total VOCs:
�I (U IIaACa-
0P�a6
Certification No. ILt—
Pb - Lead o1oa1 ug/L
Zn - Zinc 01092 mg/L
Other (Specilaipounds and Concentration Units):
ORGANICS: (by GC, GCIMS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7073 method #
method #
method #
method #
Effluent Total VOCs:
VOC

ER QUALITY MONITORING:
REPORTFORM
Name:
Name (if
act Person: W
Locatlon/Site Name
I
County
Telephone#:"11U "d 10 -
No. of wells to be sampled:
:RMIT Number: VKUQ �(J,3 )QExpiratlon Date: t1 - 3 1 - 1
n-Dlecharge
UIC
IDES
Other
PE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation: Infiltration Gallery
M -spray Field
❑ Remediation:
❑ Rotary Distributor
❑ Land Application of Sludge
❑ Water Source Hest Pump ❑ Other
SAMPLING INFORMATION r�{J
d `�
Date sample collected: ��- t ' I iii
FIELD ANALYSES:
^�1
MMETERS NOTE: Valu s shou reflect dfssotvec and colloidal
`foed(NO
WAS
WELL ID NUMBER (from Permit):
Well Diameter: �In.
pH 00400;�0i units Temp. aa0ta: o(�. 1 aC
q
mg/L
DRY at
Well Depth: �5 ft.
Depth to Water Level 62848:below measuring point
Screened Interval: S ft. to �I S ft.
_
Spec. Cond. ooa9a: µMhos
Coliform: MF Total 31504
time of
sampling,
_ft.
Measuring Point le ft. above land surface
Relative M.P. Elevation: 5 O. 8 ft.
Odor aoaes: O
check
Volume of water pumped/balled before sampling: �S
gallonsJ J ` J
_ __ _ rlvcc nntn
Appearance r
Al - Aluminum 01105
mg/L
here:❑
90VR/irVRi uvra�r�m�••...•-
atsample anaI Zed:1>w- r\ 1 \\- \\' \�
��- I6__
6 Laboratory Name:
MMETERS NOTE: Valu s shou reflect dfssotvec and colloidal
`foed(NO
COD 00336
mg/L
)nee Ntcost sn®
mg/L
Coliform: MF Fecal 31616 G C p/100ml-
Nitrate (NO3) as N 00620 G Q e Q
mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total ee P ooee6
mglL
(Note: Use MPN method for highly turbid.MPI--)Orthophosphate
70607
mg/L
Solids:Total 70300 O
mglL
Al - Aluminum 01105
mg/L
,solved
pH (Lab) 00403
unite
Be - Barlum 01007
u91L
TOC a0eea
mglL
Ce - Calcium 00919
mg/L
—
Chloride 06046
mg/L
Cd - Cadmium 01027
ug/L
uglL
Chromium: Total 01a34
uglL
Arsenic 01002
mg/L
Cu - Copper 01042
mg/L
Grease and 011e 00562
uglL
Fe - Iron 01046
uglL
Phenol 32730
mg/L
Hg - Mercury 71900
uglL
Sulfate 00945
µMhos
K - Potaselum 00937
Mg lL
eclflc Conductance 000a5
G_ O�_mg/L
Magnesium 00az7
Mg g
Ing/L
Total Ammonia 00510
uglL
(Ammonia Nitrogen; NK, as N; Ammonia Nitrogen, Totap
Mn - Manganese 01066
mg/L
NI - Nickel 01067
ug/L
TKN as N 00625
_
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
� \I RUI rnl\ 4� 14 �OM�IraneuJ
ed Apentl Name and Ti Is - Pleses print flr type I
Rev. 612013 Ctrl
mg/L
Certification No. -I
Pb - Lead a10s1 uglL
Zn - Zinc 01092 mg1L
Other (Specify CcKtyrcls and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify teat and method #. ATTACH LAB REPORT.)
Lab ReportAttached? ❑ Yes (1) ❑ No (0)
VOC 7973 , method #
method #
method #
method #
Effluent Total VOCs:
mg/L VOC Removal%

....
----- -
Coliform: MF Fecal 31616
/100ml-
Coliform: MF Total 31504
SUBMIT FORM ON YELLOW PAPER ONLY
(Nota: Uee MPN method for highly turbld samples)
Be - Barium 01007
3UNDWATER QUALITY MONITORING:
mg/L
/
s ()/
VIPLIANCE REPORT FORM
mglL
a !
�, ' I 1,H�l+ pAN9IIN
Rint Clearly or Type 11
LITY INFORMATION 1)
PERMIT Number: Q()
33( Ffxpiratlon Date: —
II'' II C_Please
IyName: IAIQ�(SRW
r A
Non -Discharge
UIC
It Name (If different
'pacific Conductance axons
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
y ddress:
(sheen NC
County
❑��La�goon
❑ Remedletlon: Infiltration Gallery
Mot S0.
(slelel (Lpl
mg/L
� spray Field
❑ Remediation:
,�„yl
�COA �ee-�
p q q
Telephone#: l`O'- o� 1�1-5330
❑ Rotary Distributor
❑ Land Application of Sludge
act Person: q �J�"\�L
`
No. of wells to be sampled:—
❑ Water Source Heat Pump ❑ Other:
Locatlon/Site Name 4
Ilmm PaIm111
NI - Nickel 91087
—_
�NW -3
Depth: it.
h to Water Level 02846: S ft. below measuring point
curing Point Is ft, above land surface
me of water pumped/balled before sampling:
sample analyzed: \1—r� , Ik7 n ) \— 11) t 1.
COD 00336
mg/L
Coliform: MF Fecal 31616
/100ml-
Coliform: MF Total 31504
/100mi-
(Nota: Uee MPN method for highly turbld samples)
Be - Barium 01007
Nssolved Sollds:Total 7(13110 3 G _
mg/L
pH (Lab) 004x3
units
TOC 0oeso
mglL
Chloride 00040 `oZ �o
mg/L
Arsenic 01002
ugll-
Grease and Oils 00552
mg/L
Phenol 32730
uglL
Sulfate 00945
mg/L
'pacific Conductance axons
µMhos
Total Ammonia 00610
mg/L
(Ammonle Nitrogen; NH3es N; Ammonte Nltmaen, Tale I
ugll-
TKN as N 00526
mg/L
For Remediation Systems Only (Attach Lab Reports):
GW -59 Rev. 8120113
Date sample collected: k l—
Well Diameter: In.
Screened Interval: fL to ft.
Relative M.P. Elevetlon: 490 ft.
gallons
NO
FIELD ANALYSES:
pH 00400&0 units Temp. oaol0: , 5 eC
Spec. Cond. 00004: µMhos
Odor aooss: O
Appearance QC'E.H (\
r 1
6— /� LaboratoryName: Ez"�� Q,`/t co NPX( Certification No.—T
end colloldal concentrations.
Nitrite (NOJ as N a9eib mg/L Pb - Lead oteal ugli-
Nitrate (NO,) as N 00020 n , 5 r) mg/L Zn - Zinc 01002 mg/L
Phosphorus: Total as P 00685 mg/L
Orthophosphate 7oao7
M91L
Other (Specify Cc and Concentration Units):
AI - Aluminum olloti
mg/L
•fILJ
Be - Barium 01007
ug/L
Ce - Calcium 09916
mg/L
C 2 8 20IG
Cd - Cadmium 01027
ug/L
Chromium: Total 01034
uglL
Cu - Copper 91042
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
ug/L
(Specify teat and method #. ATTACH LAB REPORT.)
Fe - Iron 01045
ugll-
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Hg - Mercury 71900
mg/L
VOC 71173 method #
K - Potassium 00937
method #
Mg - Magnesium 0(1827
mglL
method #
Mn - Manganese 01056
ug/L
method #
NI - Nickel 91087
ug/L
Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC
at
of