WQ0004823_Monitoring - 11-2016_20170117

SUBMIT FORM ON YELLOW PAPER ONLY Z
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GROUNDWATER QUALITY MONITORING:
, . ....
DEPARTMENT OF. ENVIRONMENT S NATURAL RESOURCE
DMSION OF.WATER QUALiiY4NFORMATION PROCESSING UNI
COMPLIANCE REPORT FORM
617 MAIL SERME CENTER, RALMOH, NC 27:»:1917 Phone: [phone]
i
FACILITY INFORMATION
Please PAntClearly orType j 1 ( 1 u i ;
PERMIT Number: Expiration Date: 2-28-2018
i
Facility Name: Pine Island - Currituck Club LLC
Non -Discharge W00004823 UIC
Permit Name (if different):
UVVR 6E: ; i u' I
''
NPDES Other
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Facility Address: Oki Stoney Rd,
l} '' H '" rr """1 "'
TYPE OF PERMITTED OPERATION BEING MONITORED
i
Corolla cs °° NC
27927 County Curtitudc
❑Lagoon ❑Remediation: Infiltration Gallery
'
rayl tswel
(za)
® Spray Field ❑ Remediation:
Contact Person: William G. Freed
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other.
tram PerrNt
i
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): PI -MW -1
Date sample collected: 11-8-2016
FiELD ANALYSES:
WAS
Well Depth: 23 ft.
Well Diameter. 2 in.
pH oo46o: 6.25 units Temp. 0omo: 18.9 °C
DRY at
i
Depth to Water Level 82546: 9 ft. below measuring point Screened Interval: 12 ft.
to 22 ft. Spec. Cond. 00094: µMhos
time of
'
Measuring Point is 2.25 ft. above land surface
Relative M.P. Elevation:
ft. Odor moss: Faint
sampling,
check
Volume of water pumped/balled before sampling:
6
gallons
Appearance Light
here:
j
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ❑ YES ❑
NO
❑
LABORATORY INFORMATION
Date sample analyzed: 1116-17/2016
Laboratory Name: Universal Laboratories Certification No. 543
}
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
i
COD 00335
mglL
Nitrite (NO2) as N 00615
mg/L Pb - Lead o1o51 ugfL
i
Coliform: MF Fecal 31616 <1
/100ml-
Nitrate (NO3) as N oo62o <o,1
mg/L Zn - Zinc 01092 mg/L
I
Coliform: MF Total 316W
/100mL
Phosphorus: Total as P olfw5
mg/L
{
(Note: Use MPN method for Wi ty hWd samples)
Orthophosphate 70507
mg1L Other (Specify Compounds. a�tcentration Units):
issolved Solids:Total 70300
mg/L
AI - Aluminum 01105
mg1L LJl��
'
pH (Lab) 00403
units
Be - Barium 01007
UgIL `Y 2 r7
JAN n f
1
TOC 00680 6.23
mg/L
Ca - Calcium 00918
d
mg1L
'
Chloride oomo 163.7
mg/L
Cd - Cadmium 01027
ug/L
I�
Arsenic 01002
ug/L
Chromium: Total oio34
ug/L
Grease and Oils 00552
rng/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron o104s
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00946
mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) m No (0)
Specific Conductance oms
µMhos
K - Potassium 00937
mg/L VOC 78732: , method #
Total Ammonia 0o610 0.72
mglL
Mg -Magnesium 00927
mg1L on file in office ,method #
(Ammonia Mhogen NH3 as N; Ammonia Nlhopen, rohd)
Mn - Manganese oloss
ugiL , method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug1L , method #
For Remediation Systems Only (Attach Lab Reports):
I certify that, to the bc;t knowledge belief, the information
Influent Total VOCs: mg/L
in this
Effluent Total VOCs: mg/L VOC Removal%
of my and
I
DWO-cettified laboratory. I am iware that there are significant
I
submitted
penalties
report is true, accurate. and complete, and that
for submitting false information, including the possibility of
the laboratory analytical data was produced using approved methods of analysis by ai
fines and imprisonment for knowirg violations.
I
Permittee (or Authorized Agent) Name and Tice - Please print or type
3lgneture of Permittee (or Authorized Agent) (Date)
i GW -59 Rev. 212010
s

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Name: Pine,lsland - Currituck Club LLC
Name (if different):
Address: Old Stoney Rd;
IS'an:l NC 27927
- County Currituck
act Person: William G. Freed Telephone#: [phone]
Location/Site Name: No. of wells to be sampled: 4
LIDN
Depth:
(from Permit): PI -MW -2
23 ft.
to Water Level 82546: 9.5 ft. below measuring point
FARTMENT OF ENVIRONMENT i NATURAL RESOURCES -
AIS10N OF WAY QUALRYduFORMATION PROCESSING UNIT
17 MAUL SERVICE CENTER, RALEIGH; NC 27ON4617 Phu m: [phone]
PERMIT Number: Expiration Date: 2-28-2018
Non -Discharge W00004823 UIC
NPDES
Date sample collected: 11-8-2016
Well Diameter. 2 in.
Screened Interval: 12 fL to 22 R
ring Point is 2.1 ft. above land surface. Relative M.P. Elevation: ft.
Other
'PE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
BE Spray. Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other.
FIELD ANALYSES: WAS
PH omoo: 8.29 units Temp. cooto: 19.6 OC DRY at
Spec. Cond. 00094: µMhos time of
Odor 000e5: Faint samplin
check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Light
Sem les.for metals werecollected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: 11/8-17/2016 Laboratory Name: Universal Laboratories Certification No. 543
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N aosls mg/L Pb - Lead most ug/L
Coliform: MF Fecal 3161.6 <1 /100mL Nitrate (NO3) as N 00620 7.38 mg/L Zn - Zinc mom mg/L
Coliform: MF Total 31504 /100ml- Phosphorus: Total as P oo665 mg/L
(Note: Use MPN method for highly turbid samples)
Ived Solids:Totai 70300.296
mg/L
PH (Lab) ootm
units
TOC oa68o 6.41
mg/L
Chloride oos4o 80.69
mg/L
Arsenic om
ug/L
Grease and Oils 00552
mg/L
Phenol 32730
ug/L
Sulfate ooms
mg/L
fic Conductance ow9s
µMhos
Total Ammonia oo610 <0.1
mg/L
(Amnonla Mhogen; NH3as N: Ammnla Nitrogen, TOW)
mg/L
TKN as N 00625
mg/L
Orthophosphate 70507
mg/L
Al - Aluminum o11 as
mg/L
Ba - Barium 01007
ug/L
Ca - Calcium 00916
mg/L
Cd - Cadmium 01027
ug/L
Chromium:, Total olo34
ug(L
Cu - Copper 01042
mg/L
Fe - Iron woo
ug/L
Hg - Mercury 71txm
ug/L
K - Potassium oo937
mg/L
Mg - Magnesium 00927
mg/L
Mn - Manganese moss
ug/L
Ni - Nickel 01667
ug/L
ror Kemewauon systems ditty (Attacn LaD Keports): Influent Tota( voCs:
Other (Specify Compounds and Cimcesitratlon Units):
Di
JAN 17 2017
ORGANICS: (by GC, GC/MS, HPLC)
(Specify teat and method M ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes �(1) ® No (0)
VOC 78732. , method #
on file in office , method #
method #
mg/L Effluent Total VOCs:
, method '#
mg/L VOC Removal%
Perrnittes (or Authorized Agent) Name and Title - Please print or type signature of Permittee (or Authorized Agent) '(Date)
GW -59 Rev. 2/2010

i
SUBMIT FORM•ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
-ACILITY INFORMATION nesse Pnnt ueany or type
'acility Name: Pine Island = Cunituck Club LLC
'ermit Name (if different):
acility Address: Old Stoney Rd.
Corolla (Streel) NC 27927 County CUrrituck
(City) Isfalel (Zi°)
Contact Person: William G. Freed Telephone#: [phone]
Well Location/Site Name: No. of wells to be sampled: 4
8 NATURAL RESOURCES.._:
ORMATION PROCESSING UNIT
RMIT Number: Expiration Date: 2-28-2018
n -Discharge WQ0004823 UIC
'DES Other
PE'O.F PERMITTED OPERATION BEING MONITORED.
❑ Lagoon ❑ Remediation: Infiltration Gallery
K Spray Field ❑ Remediation
❑ Rotary Distributor` ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other.
NELL ID NUMBER (from Permit): PI -MW -4 Date sample collected: 11-8-2016
Nell Depth:' 20 ft. Well Diameter. 2 in.
Depth to Water Level 62546: 5 ft. below measuring point Screened Interval: 10 ft. to 20 ft.Spec.
Vdasuring Point is 2.1 ft. above land surface Relative M.P. Elevation: ft.
Jolume of water pumped/balled.before. sampling: 7 gallons
Sam les for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO.
FIELD ANALYSES:
pH`00400:6.52 units Temp. oolllo: 18.3 °C .
Cond. 00094µMhos
Odor Mom; Faint
Appearance Light
WAS
DRY at
time of
sampling,
check
here:a
'
1
LABORATORY INFORMATION
Date 6ample'analyzed:"11/e-17/2016
Laboratory Name: Universal Laboratories
Certification No. 543
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations,
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead 01051 ug1L
Coliform: MF FeC81 31616 <1
/100mL
Nitrate (NO3) as N 00620 c0,1
mg/L
Zn - Zinc 01092 mg/L
i
Coliform:. MF Total 31504
/100mL
Phosphorus: Total as P 00665
mg/L
(Note: We MPN method for highly turbld samples) ,
Orthophosphate 70507
mg/L
Other (Specify Compounds ri �ncentration Units):
i
)issolved Solids:Total 70300 625
mg1L
Al -Aluminum 41105 .
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
1 AN 9 �1 7
TOC oo68o 14.4
mg/L
Ca - Calcium 00916
mg/L
�—
.Chloride 0094o 327,4
mg/L
Cd - Cadmium o1o27
ug/L
Arsenic o1002
ug/Lr
Chromium: Total olo34
ug1L
-
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron o1o4s
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
;
Sulfate o0945
mg/L
Hg - Mercury 71900
ug1L
Lab Report Attached? ❑ Yes (1) © No (0)
Specific Conductance 0oo9s.
µMhos
K- Potassium 00937
mg/L
VOC 78732: ,:method #
Total Ammonia oo610 1,21
mg/L
Mg - Magnesium oo927
mglL
on file in office method #
(Armofda Nitrogen: NH386 M Ammonia Nitrogen, Total)
Mn - Manganese o1o5s
ug1L
method #
'
TKN as N 00625
mgiL
NI - Nickel o1a67
ug/L.
method #
{
For Remedlation Systems Only (Attach Lab Reports):
Influent Total VOCs:
mg/L Effluent Total VOCs: mg/L VOC Removal%
i
Permittee (or Authorized Agent) Name and Title - Please print or type Signature of Permittee (or Authorized Agent) (Date)
GW -59 Rev. 212010

SUBMIT FORM ON YELLOW PAPER ONLY
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs:
mg/L VOC Removal%
Permittee (or Authorized'Agent) Name and Title - Please print or type Signature of Permittee (or Authorized Agent) (Date)
GW -59 Rev. 2/2010
DEPARTMENT OF ENVIRONMENT i NATURAL RESOURMS ; - ,
GROUNDWATER QUALITY MONITORING:
Divisid of WATER OIUAury4NFORMATIONPROCESSING UNIT.
COMPLIANCE REPORT FORM
is t i runt: aERVI E CEt TEtt; RALEM, NC 278'n46i7 ' Fh=9: (!19)733-M1
FACILITY INFORMATION
Please FWntCteartyorType
PERMIT Number. Expiration Date: 2-28-2018
Facility Name: Pine Island - Currituck Club LLC
Non -Discharge WQ0004823 UIC
Permit Name (ii different):
NPDES Other
Facility Address: Old Stoney Rd.
TYPE OF PERMITTED OPERATION BEING MONITORED
Corolla (s:Tn') NC
27927 Coup
County Currituck
El Lagoon ❑Remediation: Infiltration Gallery
ic�yi i�,,,el
iZ„�
® Spray Field ❑ Remediation:
Contact Person: William G. Freed
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
(from Pam*
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): PI -MW -5
Date sample collected: 11-8-2016
FIELD ANALYSES:
WAS
Well Depth: 13 ft.
Well Diameter. 2 in.
pH.00400: 6.08 units Temp. 000lo: 18.4 OC
DRY at
Depth to Water Level 82546:4 ft. below measuring point Screened Interval: 5 ft.
to 13 ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 1.8 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085: Faint
sampling,
check
Volume of water pumped/balled before sampling:
6
gallons
Appearance Light
here:❑
Samples for metals were collected unfiltered: ❑ YES
El NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Datwsample analyzed: 11/8-17/2016
Laboratory Name: Universal Laboratories Certification No. 543
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations..
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L Pb - Lead mo51 ug/L
Coliform: MF Fetal 31616 e1
/100mL
Nitrate (NO3)' as N oo62o <0.1
mg/L Zn - Zinc oio92 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P oows
mg/L
(Note: Use MPN method for highly hxbid samples)
Orthophosphate 70507
mg/L Other (Specify Compount Concentration Units):
issolved Solids -Total 70300
mg/L
AI - Aluminum o11os
mg/L
pH (Lab) 00403
units
Be - Barium woo?
ug/LI 7O )'7
f
TOC 6066o 8.42
mg/L
Ca - Calcium oo91s
mg/L
Chloride o094o 19.52
mg/L
Cd - Cadmium o1o27
ug/L
Arsenic olom
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 3273.0
ug/L
Fe - Iron o1045
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 00095
µMhos
K - Potassium 00937
mg/L VOC 78732: , method #
Total Ammonia oo610 3.94
mg1L
Mg - Magnesium oo927
mglL on file in office , method #
(Ammonia Mogan: NH,as N; Ammnnte Nittogen. Total)
Mn - Manganese oiass
ug/L , method #
TKN as N own
mg/L
Ni - Nickel 01067
ug/L , method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs:
mg/L VOC Removal%
Permittee (or Authorized'Agent) Name and Title - Please print or type Signature of Permittee (or Authorized Agent) (Date)
GW -59 Rev. 2/2010