7304_UpperPiedmont_MSWLF_AFR14-15

MSW 2015 Page 1
MSW State of North Carolina
Department of Environment and Natural Resources
Division of Waste Management
According to (G.S. 130A-309.09D(b)) completed forms must be returned by August 1, 2015 and a copy of this report must be sent to the
County Manager of each county from which waste was received. If you have questions or require assistance in completing this report, contact
your Regional Environmental Senior Specialist.
Facility Name:Permit:
Physical Address
Street 1:
Street 2:
City:
State:Zip:
County:
Mailing Address
Street 1:
Street 2:
City:
State:Zip:
Primary Facility Contact Person
Name:
Phone:Fax:
Email:
Billing Contact Person
Name:
Phone:Fax:
Email:
1. Tipping Fee: $per Ton (Attach a schedule of tipping fees if appropriate.)
2. Does the tip fee above include the $2.00 Solid Waste Tax?Yes No
5. Date Facility Last Surveyed:
7. Total Tons Disposed in
Airspace Used (tons):
6. Airspace Used (cubic yards):
Airspace (Capacity): Questions in this section relate to all cells/units of
the lined facility operated under the current 4-digit permit number
regardless of whether the cells/units are closed or are not contiguous
at the time of this report. Tonnage questions must be based on scale
records and cover the period between the opening date and the date of
the last survey unless another time period is approved. Airspace
measurements include daily, intermediate and final cover.
MUNICIPAL SOLID WASTE LANDFILL
Facility Annual Report
For the period of July 1, 2014-June 30, 2015
4. What other activities occur at this facility? (check all that apply)
Scrap Tire Collection White Goods Collection Household Hazardous Waste CollectionRecycling/Reuse Collection
If you checked Recycling/Reuse Collection, please indicate the materials accepted: (check all that apply)
Paper Wood Concrete/rubble/asphalt Gypsum/drywall
Cardboard Glass Aluminum Cans Steel Cans
PETE (#1) Plastic HDPE (#2) Plastic Computer Equipment Televisions
Fluorescent lightbulbs Used oil/oil filters Other Metal Other Plastic
Other (specify)
3. Did your facility stop receiving waste during this past Fiscal Year? Yes No
If so, please report the date this occurred:
8. How is your leachate transported to the waste water treatment plant? Sewer Connection Pump Truck
7304-MSWLF-1997
Upper Piedmont Regional Landfill 7304-MSWLF-1997
9650 Oxford Road
Rougemont
North Carolina 27572
Person
9650 Oxford Road
Rougemont
North Carolina 27572
Christopher J. Gustin
[phone] [phone]
[e-mail]
Shelby Locklear
[phone] [phone]
[e-mail]
38.14
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02/04/2015
3,966,185
5,277,612
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MSW 2015 Page 2
9. Total waste landfilled at this facility during the period of July 1, 2014, through June 30, 2015. Indicate tonnage received by COUNTY of
waste origin. If waste was received from a transfer station, indicate the COUNTY LOCATION OF THE TRANSFER STATION. Do not
include waste diverted for recycling, reuse, mulching, or composting. Please indicate COUNTY and STATE, if received from another state.
Received from Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May June Total
Grand Total
10. If required to file NC E-500K forms with NC Dept. of Revenue, provide the four quarterly tonnages this facility reported for fiscal year
2014-2015.
Quarter Tons Reported
July 1 - September 30
October 1 - December 31
January 1 - March 31
April 1 - June 30
Total
7304-MSWLF-1997
Alamance 397.52 333.69 295.94 335.89 386.66 374.42 386.25 340.94 554.03 407.53 393.52 356.63 4,563.02
Campbell 224.96 244.67 224.48 194.2 166.07 206.38 194.17 147.38 172.86 200.55 166.66 218.2 2,360.58
Caswell 409.27 383.52 332.96 380.83 308.69 397.16 379.6 272.37 363.52 371.6 380.55 374.9 4,354.97
Chatham 56.22 56.22
Danville 614.06 8.14 35.38 7.73 9.15 9.68 684.14
Durham 51.05 170.69 48.15 148.7 41.77 239.63 4,773.29 1,572.9 867.64 112.16 198.54 397.41 8,621.93
Franklin 3,019.77 2,472.32 563.18 2,090.56 2,482.98 2,873.49 2,613.08 2,020.72 2,978.76 3,292.4 3,724 3,723.3 31,854.56
Granville 1,279.02 1,090.12 1,199.84 1,205.37 994.38 1,035.1 891.55 736.48 1,028.28 964.42 945.05 988.21 12,357.82
Guilford 8.94 12.51 9.48 11.21 2.28 1.8 46.22
Halifax 36.41 8.86 11.44 9.14 65.85
Harnett 0.04 8.79 8.83
Henry 4,068.07 3,768.46 3,642.63 3,688.59 3,258.45 3,928.81 3,643.95 2,950.63 4,050 3,962.2 3,821.74 4,222.01 45,005.54
Orange 247.84 200.37 228.58 247.25 223.59 209.06 312.48 125.13 331.53 370.6 203.68 220.82 2,920.93
Patrick 1.34 320.41 24.73 346.48
Person 3,626.09 4,010.05 4,275.18 5,107.97 3,177.52 3,647.05 3,549.15 3,005.44 3,267.39 3,820.4 3,342.28 5,729.44 46,557.96
Pittsylavina 2,894.61 3,023.39 2,860.63 2,959.89 2,495.29 3,089.22 2,762.01 2,344.65 2,929.4 2,924.85 2,864.2 2,957.62 34,105.76
Rockingham 71.49 9.96 7.84 26.07 3.51 22.73 362.44 1,235.23 5.26 866.07 18.52 18.58 2,647.7
Vance 3,863.47 3,092.1 5,520.28 8,766.87 6,993.64 7,725.06 5,032.57 3,088.3 4,144.87 3,838.85 3,020.89 2,954.94 58,041.84
Wake 822.17 757.19 305.93 514.62 346.26 2,494.62 310.44 502.94 24.39 16.35 1,940.76 697.49 8,733.16
Forsyth 6.82 12.76 11.3 30.88
Johnston 19.61 19.61
Lynchburg 12.83 12.83
263,396.83
51,748.98
53,215.53
45,652
53,800.02
204,416.53
MSW 2015 Page 3
CERTIFICATION: I certify that the information provided is an accurate representation of the activity at this facility.
Signature:Date:
Name:
Phone Number:Email:
Title:
REMINDER: According to (G.S. 130A-309.09D(b)), this
report must be sent to the Regional Environmental Senior
Specialist for your area and a copy of this report must be
sent to the County Manager of each county from which
waste was received.
Please return your completed report to:
11. Are there SWANA or other certified operator(s) at this facility?Yes No
If yes, indicate the following:
Name:
Certification type and expiration date:
Name:
Certification type and expiration date:
Name:
Certification type and expiration date:
Name:Certification type and expiration date:
Name:Certification type and expiration date:
12. Comments, suggestions or notes:
7304-MSWLF-1997
Gustin, Christopher Digitally signed by Gustin, Christopher DN: dc=com, dc=repsrv, ou=Archive, cn=Gustin, Christopher Date: 2015.07.09 13:58:33 -04'00'Jul 9, 2015
Christopher J. Gustin
[phone] [e-mail]
Operations Manager
John Patrone
PO Box 5123
High Point, NC 27262
phone: [phone] email: [e-mail]
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Ronald Gregory
LF Operator April 15, 2017
Jeffrey Hawley
LF Operator February 27, 2018
Larry Elliott
LF Operator March 16, 2016
Micheal Jackson LF Operator May 9, 2016
George Palmer LF Operator May 8, 2017
Matt Einsmann, MOLO expires June 6, 2017
Christopher Gustin, MOLO expires June 26, 2018
MSW 2015 Page 4
Instructions:
NC DENR
Division of Waste Management - Solid Waste Section Risk Assessment Form
Facility Name:Permit:
Address:
City:State:Zip:
Date:Person completing Assessment:
Phone Number:Fax:Email:
Please indicate either Yes or No for each Receptor and Post Closure Maintenance question. Then please
determine the distance or distances for each Receptor from the Edge of Waste (using range finders and/or GIS
maps) and type that information into the form. Please attach additional information including GIS maps, lists of
potable well locations, etc.
Receptors
1. Are there Residential Dwellings Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many?
What are the three closest distances from the Edge of Waste?Feet Feet Feet
2. Are there Potable Wells Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many?
What are the three closest distances from the Edge of Waste?Feet Feet Feet
3. Are there Community/Municipal Wells Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many?
What are the three closest distances from the Edge of Waste?Feet Feet Feet
4. Are there Surface Water Bodies Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many?
What are the three closest distances from the Edge of Waste?Feet Feet Feet
Please list the names of the water bodies:
5. Is Public Water Available Within 1,500 feet of the Edge of Waste?Yes No
If Yes, how many of the Residential Dwellings noted above are connected?
Corrective Measures
6. Is there an active methane extraction system (blower, flare, etc.)?Yes No
7. Is there a passive methane extraction system (trench, vents in cap, flare, etc.)?Yes No
8. Is there groundwater remediation taking place on site?Yes No
If Yes, what is the specific remedial technology used?
Comments
7304-MSWLF-1997
Upper Piedmont Regional Landfill 7304-MSWLF-1997
9650 Oxford Road
Rougemont North Carolina 27572
Christopher J. Gustin
[phone] [phone] [e-mail]
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