HomeMy WebLinkAbout8602_Surry_MtAiry_MSWLF_CDLF_Oct23LFG_FID1819579_20231025DocuSign Envelope ID: DD1604D1-7784-4DFB-9E5A-4C2E008FF688
DENR USE ONLY ❑Paper Report ❑Electronic Data - Email CD (data loaded: Yes / No Doc/Event #:
NC DENR I I Environmental Monitoring
Division of Waste Management - Solid Waste Reporting Form
Notice: This form and any information attached to it are "Public Records" as defined in NC General Statute 132-1. As such, these documents are
available for inspection and examination by any person upon request (NC General Statute 132-6).
Instructions:
Prepare one form for each individually monitored unit.
Please type or print legibly.
Attach a notification table with values that attain or exceed NC 2L groundwater standards or NC 2B surface water standards. The notification
must include a preliminary analysis of the cause and significance of each value. (e.g. naturally occurring, off -site source, pre-existing
condition, etc.).
Attach a notification table of any groundwater or surface water values that equal or exceed the reporting limits.
Attach a notification table of any methane gas values that attain or exceed explosive gas levels. This includes any structures on or nearby the
facility (NCAC 13B .1629 (4)(a)(i).
Send the original signed and sealed form, any tables, and Electronic Data Deliverable to: Compliance Unit, NCDENR-DWM, Solid Waste
Section, 1646 Mail Service Center, Raleigh, NC 27699-1646.
Solid Waste Monitoring Data Submittal Information
Name of entity submitting data (laboratory, consultant, facility owner):
Smith Gardner, Inc.
Contact for questions about data formatting. Include data preparer's name, telephone number and E-mail address:
Name: Seth C. Rickerts, P.G.
E-mail: seth@smithgardnerinc.com
Phone: 919-828-0577 x135
NC Landfill Rule: Actual sampling dates (e.g.,
Facility name: Facility Address: Facility Permit # (.0500 or .1600) October 20-24, 2006)
Surry County Landfill 237 Landfill Rd. Mt Airy, NC 27030 86-02 .0500 October 18, 2023
Environmental Status: (Check all that apply)
❑ Initial/Background Monitoring ❑X Detection Monitoring ❑ Assessment Monitoring Corrective Action
of data submitted: (Check all that apply)
Groundwater monitoring data from monitoring wells ❑X
Groundwater monitoring data from private water supply wells ❑
Leachate monitoring data El
water monitoring data
Methane gas monitoring data
Corrective action data (specify)
Other(specify)
Notification attached?
e No. No groundwater or surface water standards were exceeded.
Yes, a notification of values exceeding a groundwater or surface water standard is attached. It includes a list of groundwater and surface water
monitoring points, dates, analytical values, NC 2L groundwater standard, NC 2B surface water standard or NC Solid Waste GWPS and
preliminary analysis of the cause and significance of any concentration.
❑X Yes, a notification of values exceeding an explosive methane gas limit is attached. It includes the methane monitoring points, dates, sample
values and explosive methane gas limits.
Certification
To the best of my knowledge, the information reported and statements made on this data submittal and attachments are true and correct.
Furthermore, I have attached complete notification of any sampling values meeting or exceeding groundwater standards or explosive gas
levels, and a preliminary analysis of the cause and significance of concentrations exceeding groundwater standards. I am aware that there
are significant penalties for making any false statement, representation, or certification including the possibility of a fine and imprisonment.
Seth C. Rickerts, P.G. Project Geologist 919-828-0577 x135
Facility Representative Name (Print)
Title
10/25/2023
Signature BB05C9>aE Es Date
14 N Boylan Ave. Raleigh, NC 27603
Facility Representative Address
F1370
NC PE Firm License Number (if applicable effective May 1, 2009)
Revised 6/2009
(Area Code) Telephone Number
Affix NC Licensed/ Professional Geologist Seal
SEA
10 5/�-023
r
OW q-
Id—
C. Rtc
DocuSign Envelope ID: DD1604D1-7784-4DFB-9E5A-4C2E008FF688
This page intentionally left blank.
DocuSign Envelope ID: DD1604D1-7784-4DFB-9E5A-4C2E008FF688
NC Division of Waste Management - Solid Waste Section
Landfill Gas Monitoring Data Form
Notice: This form and any information attached to it are 'Public Records" as defined in NC General Statute 132-1. As such, these documents are
available for inspection and examination by any person upon request (NC General Statute 132-6).
Facility Name: SUrry County Landfill Permit Number: 86-02
Sampling Date: 1 0/1 8/2023 NC Landfill Rule (.0500 or .1600):
Sample Collector Name & Position: Kyle M. Bonnett - Environmental Technician
Gas Meter Type & Serial Number: GEM 5000, G506472 Gas Meter Calibration Date:
Field Calibration Date & Time: 1 0/1 8/2023, 1305
Field Calibration Gas Type (15115 or35/50): 35/50
Gas Meter Pump Rate:
0.5 L/min
01 /2023
ield Calibration Gas Canister Expiration Date: 02/26
Ambient Air Temperature: 59 F Barometric Pressure (in. or mm Hg): 29.01 Weather Conditions: Sunny
Instructions: Under "Location or LFG Well", list monitoring well # or describe monitoring location (e.g., inside field office).
Attach a test location map or drawing. Report methane readings as both % LEL and % CH4 by volume.
Convert % CH4 (by volume) to % LEL as follows: % methane (by volume)/20 = % LEL.
*Hydrogen Sulfide (H2S) gas monitoring may be required for Construction & Demolition Landfills (CDLFs). See
individual permit conditions and/or Facility LFG monitoring plan.
Location or
LFG Well ID
S ample
Tube
Purge
Time of
Day
Time
Pumped
(sec)
Initial
o
�o LEL
Stabilized
/o LEL
% CH4
(volume)
% 02
(volume)
% CO2
(volume)
% H2S*
(volume)
NOTES
MGP-2R
>60s
-
>60s
-
-
-
-
-
-
Inaccessible
MGP-3
I >60s
1549
>60s
0.0
0.0
0.0
16.9
1 4.3
0
MGP-4
>60s
1545
>60s
8
8
0.4
19.3
1.4
0
MGP-5
>60s
1540
>60s
0.0
0.0
0.0
19.4
1.1
0
MGP-6
>60s
1542
>60s
0.0
0.0
0.0
14.9
6.4
0
MGP-7
>60s
1556
>60s
158
158
7.9
13.0
7.3
0
MGP-8
>60s
1554
>60s
0.0
0.0
0.0
15.6
6.9
0
New Scalehouse
>60S
1607
>60S
0.0
0.0
0.0
20.8
0.0
0
Old Scalehouse
>60s
1612
>60s
0.0
0.0
0.0
20.8
0.0
0
Bailing Shed
>60s
1615
>60s
0.0
0.0
0.0
20.8
0.0
0
Attendant Building
>60S
1617
>60s
0.0
0.0
0.0
20.8
0.0
0
Page 1 of 2
NOTE: If needed, attach additional data forms to include additional LFG monitoring data locations for the facility.
ACTION LEVELS: Methane: >1.25% by volume (inside structures) AND >5% by volume (at facility boundary)
Hydrogen Sulfide: >1 % by volume (inside structures) AND >4% by volume (at facility boundary)
Certification
To the best of my knowledge, the information reported and statements made on this data submittal and attachments
are true and correct. I am aware that there are significant penalties for making any false statement, representation,
or certification including the possibility of a fine and imprisonment.
4& 8-aa
Environmental Technician
SIGNATURE
TITLE
Revised - March 6, 2017
DocuSign Envelope ID: DD1604D1-7784-4DFB-9E5A-4C2E008FF688
NC Division of Waste Management - Solid Waste Section
Landfill Gas Monitoring Data Form
Notice. Thisform and any information attached to it are 'Tublic Records" as defined in NC General Statute 132-1. As such, these documents are
available for inspection and examination by any person upon request (NC General Statute 132-6).
Surry County Landfill 86-02
Facility Name: Permit Number:
Sampling Date: 10/18/2023 NC Landfill Rule (.0500 or.1600):
Sample collector Name & Position: Kyle M. Bonnett - Environmental Technician
Gas Meter Type & Serial Number: GEM 5000, G506472 Gas Meter Calibration Date:
Field Calibration Date & Time: 10/18/2023, 1305
01 /2023
Field Calibration Gas Type (15115 or 35/50): 35/50 Field Calibration Gas Canister Expiration Date: 02/26
Gas Meter Pump Rate:
0.5 L/min
Ambient Air Temperature: 59 F Barometric Pressure (in. or mm Hg): 29.01 Weather Conditions: Sunny
Instructions: Under "Location or LFG Well", list monitoring well # or describe monitoring location (e.g., inside field office).
Attach a test location map or drawing. Report methane readings as both % LEL and % CH4 by volume.
Convert % CH4 (by volume) to % LEL as follows: % methane (by volume)/20 = % LEL.
*Hydrogen Sulfide (H2S) gas monitoring may be required for Construction & Demolition Landfills (CDLFs). See
individual permit conditions and/or Facility LFG monitoring plan.
Location or
LFG Well ID
S ample
Tube
Purge
Time of
Day
Time
Pumped
(sec)
Initial
% LEL
Stabilized
% LEL
% CH4
volume
(volume)
% 02
(volume)
% CO2
(volume)
% H2S*
(volume)
NOTES
Page 2 of 2
Attendant Building 3
>60s
1609
>60s
0.0
0.0
0.0
20.8
0.0
0
New Shop
>60s
1603
>60s
0.0
0.0
0.0
20.8
0.0
0
Shop Shed
>60s
1605
>60s
0.0
0.0
0.0
20.8
0.0
0
Shop
>60s
1602
>60s
0.0
0.0
0.0
20.8
0.0
0
LFGE Office
>60s
1600
>60s
0.0
0.0
0.0
20.8
0.0
0
NOTE: If needed, attach additional data forms to include additional LFG monitoring data locations for the facility.
ACTION LEVELS: Methane: >1.25% by volume (inside structures) AND >5% by volume (at facility boundary)
Hydrogen Sulfide: >1% by volume (inside structures) AND >4% by volume (at facility boundary)
Certification
To the best of my knowledge, the information reported and statements made on this data submittal and attachments
are true and correct. I am aware that there are significant penalties for making any false statement, representation,
or certification including the possibility of a fine and imprisonment.
so.. a
SIGNATURE"0B 6EEF9�34ED
TITLE
Environmental Technician
Revised - March 6, 2017
DocuSign Envelope ID: DD1604D1-7784-4DFB-9E5A-4C2E008FF688
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ESTIMATED EXTENT OF WASTE
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SCALE: 1 = 300'
DATE: 111112021
DRWN. BY: E. LAMBERT
CHKD. BY: J. PFOHL
PROJECT NUMBER
G20032.0
DRAWING NO. SHEET NO.
SHEET 1 1 OF 1