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HomeMy WebLinkAbout8602_SurryCountyMtAiry_CDLF_AFR14-15CDLF 2015 Page 1 C&D 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 Airspace (Capacity): Questions in this section relate to all cells/units of the C&D 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 weekly, intermediate and final cover. 5. Date Facility Last Surveyed: 7. Total Tons Disposed in Airspace Used (tons): 6. Airspace Used (cubic yards): State of North Carolina Department of Environment and Natural Resources Division of Waste Management CONSTRUCTION & DEMOLITION WASTE LANDFILL Facility Annual Report For the period of July 1, 2014-June 30, 2015 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. 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 and amount collected: (check all that apply and provide tonnages) 3. Did your facility stop receiving waste during this past Fiscal Year? Yes No If so, please report the date this occurred: Carpet tons Wood tons Concrete/rubble/asphalt tons Gypsum/drywall tons Cardboard tons Electronics tons Other Metal tons Other Plastic tonsShinglestons Other (specify) 8602-CDLF-2001 Surry County Mt. Airy C&D Landfill (Closed) 8602-CDLF-2001 237 Landfill Road Mt. Airy North Carolina 27030 Surry PO Box 342 Dobson North Carolina 27017 Dennis Bledsoe (336) 401-8375 (336) 401-8380 bledsoed@co.surry.nc.us Dennis Bledsoe (336) 401-8375 (330) 401-8380 bledsoed@co.surr.nc.us 0.00 CDLF 2015 Page 2 8. 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 9. 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 8602-CDLF-2001 000000000000 0 0 CDLF 2015 Page 3 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. CERTIFICATION: I certify that the information provided is an accurate representation of the activity at this facility. Signature:Date: Name: Phone Number:Email: Title: Please return your completed report to: 10. Are there SWANA or other certified operator(s) at this facility?Yes NoIf 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: 11. Comments, suggestions or notes: 8602-CDLF-2001 Jul 9, 2015 Dennis Bledsoe (336) 401-8375 bledsoed@co.surry.nc.us Director C.T. Gerstell 610 East Center Avenue Mooresville, NC 28115 phone: 704.235.2144 email: Charles.Gerstell@ncdenr.gov CDLF 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 8602-CDLF-2001 Surry County Mt. Airy C&D Landfill (Closed) 8602-CDLF-2001 237 Landfill Road Mt. Airy North Carolina 27030 Jul 9, 2015Dennis Bledsoe (336) 401-8375 (336) 401-8380 bledsoed@co.surry.nc.us 5 800 1050 1450 6 800 1100 1400 4 400 650 515 Ararat River and Tributaries of Stony Creek Injection