87A-LCID-_FAR-FY17-18

LCID State of North Carolina
Department of Environmental Quality
Division of Waste Management
LAND CLEARING &INERT DEBRIS
LANDFILL
Facility Annual Report
For the period of July 1,2017-June 30,2018
According to G.S,130A-309.09D(b),completed forms must be returned by August I,2018,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:<>C ^<o 4-y Permit:7"~A
Physical Address
Street 1:Qw fcftpf <
Street 2:
Ci<y:[}^SOV\C^y/'
State:North Carolina
Primw-y Facility Contact Person
Name:^\P A"\-H~/,/.
Phone:%'Xb"^fi>fytf(Jtffy ^
Email:^*-k*,-n \^/F\f \*i
County:/^5\jO//^
ziP:^g 7/-?
ax:faA~W#-9b0J
Mailing Address
oil Let i .^^^i i 1 si »«.^f\i I lv^■^—X
Street 2:pQ Q>Q)(£^,£.)
City:/^r-i£0V\<L i ^Y
State:North Carolina Zip:^-/f ~7/j3
Billing Contact Person
Phone:$%£-tfii^fft 7£F«=$^B~^/S&~9(^^/
Email:
.Tipping Fee;$
Tipping Fee:%
Tipping Fee:$
per
per
per
/or\
2.Estimate the amount of waste taken in an average week at this facility?
3.Mow many weeks did you operate this year?^-))^
H-tons
□cubic yards
4.What are the hours/days of operation for this facility?/'O O
5.What is the acreage of the footprint ofthe waste on site as of June 30?jI ■-M_~J?Acre(s)
6.Did your facility stop receiving waste during this past Fiscal Year?rn Yes
Ifso,please report the date this occurred:
KKMINDUK:According to G.S.l3()A-309.09D(b),this
report must be sent to the Regional Environmental Senior
:Mh hiliM I'm ycuii'jiri'ti nnd »i opy of this report musl '"
sent I"Ihe County Manngci ol'ciicli amniy from vvluVli
Please return your completed report to:
CERTIFICATION;I certify that the information provided is an accurate representation ofthe activity at this facility.
Signature:JtQiC&f ^U^\fi^7\y Date:^Z^-*/~j &
Name:7ufpi ^Title:
Number:^-Emai!:h f p^(B £iaM ^C
1,01)2011
AJC $Ql/
NCDEQ
Division of Waste Management -Solid Waste Section Risk Assessment Form
Faci!ity Name:
Address:
Permit:
City:State:North Carolina
Person completing Assessment:
Phone Number:$£$-£/§$--
~~2C-£f'ff~r\Date:
Fax:&%&%$-Email:u
Instructions:
Please indicate either Yes or Wo 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 GlS
maps)and type that information into the form.Please attach additional information including GlS maps,lists of
potable well locations,etc.
Receptors
1.Are there Residential Structures Within 1,500 feet of the Edge of Waste?
If Yes,how many?
Yes
What are the three closest distances from the Edge of Waste?Feet
2.Are there Water Supply Wells Within 1,500 feet of the Edge of Waste?
If Yes,how many?
Yes
What are the three closest distances from the Edge of Waste?j2 0 Q
3.Are there Community/Municipal Wells Within 1,500 feet of the Edge of Waste?
No
Feet
Feet
Feet
Feet
Yes
If Yes,how many?
What are the three closest distances from the Edge of Waste?Feet
4.Are there Surface Water Features Within 1,500 feet of the Edge of Waste?
If Yes,how many?/
What are the three closest distances from the Edge of Waste?C?OD
Yes
Feet
^|No
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
If Yes,how many of the Residential Structures noted above are connected?
Corrective Measures
6.Is there an active methane extraction system (blower,flare,etc.)?Q Yes
7.Is there a passive methane extraction system (trench,vents in cap,flare,etc.)?□Yes
8.Is there groundwater remediation taking place on site?□Yes
If Yes,what is the specific remedial technology used?
Comments
Qisb
No
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Jo