HomeMy WebLinkAboutWQ0013181_Monitoring - 11-2016_20170106Please Print Clearly or
:Facility Narn'ar _`
'Permit Name (if I
Fat,agity Address:
-
-aaul--- (
'-County
21:tO)
Corrlact Person.. -_
Telephone 4,
WL511 Locationl Site Name, No. of Wells to be. Sampled:_--
;e1i 1c entificafilnnjqumberl (from For Groun0woter Treatment Systems
Well . Depth: OL, -ft. well Diameter Check One '13 Influent (98)
Screened , Interval; "'Effluent (99-)
Depth to Water Level-' ft. below measuring point. - _0
Measuring Point (M.P.) is -3— _' it. above land surfate. Relatlye M.P.Elevation in It.,
- . 1 1. - 17 4-1
G,allong of Water pumped/ atjed, before sarnplin --o� - Oetq sample c0lject,&/r4&SW'5
--sper-ific Ccmduc L�MhQS
Temp. /4_�-C . Odor 4qdlzxz_ Appearance
DEPARTNJENT QP ENVIRONMENT & NATURAL RE90URC-ES
WATER QUALITY DIVISION, GROUNDWATER SECTION
lr-,36 MAIL.SERVICE .CENTER - -- q 6.
UQTF- Val.ue$should reflect dissai'ved and.
colla one
��dgl c-� centrations:
Date sarnpla analyzed.: 11Z 71,1 a / L
Laboratory Name:,
Certification No.
PARAMELJTVI(Samples for metals were collected unfiltered _ YES '
_KQ and field acidified
c). / 7 M 9A
'GOD
rngil
/I 00ml
I Nitrite (NO2)as, N
Nitrate rate(NO3) as, N
�4-
M g/1
-
Coliform' MF F
Coliform: MFT01al _,..11
00ml
Phosphorus:- Total as P-_ - - 6,S3
mg/1
(Note., Use KIP 14 rneth9d for jilghly, tu%bicittmpit
Orthophosphatia
MQ/1
rng
Dissolved Solids: Total
m g/l
Al -Aluminum
(Spec,fy, test and method C Attach 16b report.)
mg/1/l
pH (when arialyzed) 5
unit's
Ba -.13rarium-
method 0
mg/l
TOC Z
mg/l
Ca - Calcium
MIg/}
'Chloride
MCl/I
Cd - Cadmi
Chromium, Total
A I a
rng/l
ArseniCmg/l,
Grease anti Oils
mg/{Cu
- Copper
Mg/l
Phenol
Sulfate
mg/I'
M,
mg/l
Fe r Iron
Ng - Mercury
Specific Conductance _uMhos
K- Potassium-
- Mg/l
Mg/j
Total AmmonirCl
mg/I
Mg - Magnesium
'Mn
in
TKN as N
mg/1
- Manganese
1911
YES N, 0).
Ni - Nickel- -
mg) it
P I b - Lead
Mg/l
Zn - Zinc
mgll
Ammonia Nitrogen �' . �. _
Mg/l
Other (Specify Compounds and Concentration Units)
013G. NICS.- (&C,,, C/M8.HPLO)
(Spec,fy, test and method C Attach 16b report.)
Report Attached? Yes. (1) NO
—M
VOC method ff
method 0
method #=
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMAfi ION • , Please Print
FacilityName:
'Permit Name (if different
F fitly Address: -�
t0'7J 664rn
Contact Person:
Well Location/ Site Name:
or Type
County r�'.c� r•�
Telephone fl:9�a
No. of Wells to be Sampled:
Well Identification Number from Permit): FX 2-- For Groundwater Treatment Systems
Welf Depth: It. Well Dlameter: in, CheckOne:0 Influent (98)
Screened Interval: ff. to it. []" Effluent (99)
Depth to Water Level: (o tt. below measuring point.
Measuring Poiret (M.P.) is: -3Z- It. above land surface. n Relative M.P. Elevation in it.:
Gallons of water4pumpedlballed before sampling:_ Date sample cplfected:% % O
Field analysis,,,.' `::; `' Specific Conductance uMhos
7el Odor-� Appearance Al— -
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER _ ,..,..•
PERMIT it: W&____()01 31 !Kj EXPIRATION DATE:._
Non -Discharge UiC
NPDES
TYPE OF agBMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor ._ . n._ Land Application: of Sludge
other: _ Dl d I �'�'/ CSC I n a
NOTE: values should reflect dissolved and
colloidal concentrations.
Date sample analy22d: 20I
Laboratory Name:
Certification No. _�—
PARAMETEB:9 (Samples for metals were collected untiltered YES
NO and field acidified
COD
mg/I
/i OOml
Nitrite(NO2) as N.
Nitrate (W03) as N
Z6 .o mg/i
Coliform: MF Fecal 46-d
Coliform: MF Total
/100ml
Phosphorus: Total as P
• G mg/1
Use MPN method for' highly turbid samples)
Dissolved Solids: Total q_
mg/i
Orthophosphate
Al - Aluminum
mg/1
pH (when analyzed) S. ��
units
Ba --Barium
g/I
mn-ig/t
TOCmg/I
Ca - Calcium
mg(I
Chloride
Arsenic
mg/f
mg/I
Cd - Cadmium
Chromium: Total
mg/I
Grease and Oils
mg/l
Cu -Copper
mg/I
111M.1 a :�n�9 mg/1
Phenol
Sulfate
mg/I
mg/l
Fe - iron,
Hg - Mercury
_
`"• mg/I
Specific Conductance
uMhos
K - Potassium
mg/1'
mg/1
Total Ammonia
mg/I
Mg - Magnesium
mg/l
TKN as N
mg/I
Mn - Manganese
YES
NO)
Ni -. Nickel
mg/l .
Pb - Lea
mg/i
mg/I
Zn - Zinc
Ammonia Nitrogen ' A `Lmg/I
.Other (Specify
compounds and Concentration Units)
.ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach tab report-)
Report Attached? Yes (1) No (0)
VOC method # =
method # =
: method H=
Rev. 03/2000 ' il" 1 2 1017 • •
Information Processing Unit
DWR Section
GROUNDWATER QUALITY MONiTORING
COMPLIANCE REPORT FORM - -
Ar`11 ITV INFOPMATIDN Please
Facility Name; j"' "-;p -
"Permit Name (if diiferent), _
Fpflfity Address: ✓`' +te"e"
i -_ -
- (City � Sloss)
Contact Person: ^ Well Location/ Site Narne:_ov 3 -
Type
County . t -El ef/ __-
Telephone #: f% �2'��1'
No. of Welts to be Sampled e T
Well identification umber (from Permit): 3 For Groundwater Treatment Systems
Well Depth: ARW J6e %2 ft. Well Diameter,_ in, ChecROne: ❑ Influent (98)
Screened Interval: ff: to ft. 11 Effluent (99)
Depth to Water Level:` -'=--ft. below measuring point.
Measuring Point (MR.) is: E1 1-_ 4t. above land surface. Relative M.P. 1 levalion in ft.:
Gallons of water pumped/bailed before sampling: _ - Date sample collected.1
Field analysis .° pH ;-Specific Conductance uMhos
Temp„ --C. Odor Appearance _ ri'e�r
DEPARTMENT OF ENVIRONMENT 8, HATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: Wa- 00/ 312 1 EXPIRATION BATE.
Non -Discharge -- __. UIC
NPDES
TYPE OF, PERMITTED OPERATION BEiNG MONITORED
Lagoon - - Remediation: Infiltration Gallery
Spray Field _ . Remediation:
Rotary Distributor _Land Application of Sludge
�blhef: _Jt.L%�_ rsa awP _
NOTE: Values should reflect disalved and
Colloidal concentrations.
LLaboDate sample analyzed: I 7 A d IL-
Laboratory
ratory Name:
Gertification No. _
PABAMETERS (Samples for metals Were collected unfiltered YES -NO and field
acidified
COD
mg/I
1100mi
Nitrite (NO2) as N -
Nitrate (NOS) as N__C3,ct - _
mg/1
mg/!
Coliform: MF Fecal
Coliform: MF Total __
/100ml
Phosphorus: Total as P
mg/1
(Mote: Use MPH method for highly turbid samp)es)
Dissolved Soiids: Total 77
trig/I
Orthophosphate - -
Al - Aluminum -
mg/1
mg/l
_ = _
pH (when analyzed) — - y_
units
Ba -Barium _
mg/1
m9/1.
TOCe
mg/i
Ca - Calcium - _
mg/1.
ChloridI-
� _
mg/I
mg/I
Cd - Cadmium -
Chromium: Total' "
mg/1
Arsenic _
Grease and Oils -
-
mg/I
Cu - Copper _-
r
Mg/1
mg/1
Phenol
mg/I
Fe - iron _
mg/1
_ -
Sulfate
Specific Conductance -
mg/I
uMhos
Hg - Mercury--
K - Potassium
rng/1
__
Total Ammonia ----
mg_/I
Mg -Magnesium
mg/1
mg/l
TKN as N
mg/I
Mn - Manganese
YES NO)
Ni - Nickel- _
mg/I
Pb - Lea
mg/l
Zn - Zinc _ -
mg/I
Ammonia Nitrogen ` =
mcg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GCJMS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes- -- -(1) No _ (0)
VOC . method tt =ry
method # =
method It=
Permittee (or Aolhonzea Agent) rva+ne n,+v +i.o— "e-
GW -5$ Signature of Permillee (or Authorized Agent) - - (Date)
Rev. 03/2000