NCG120057_2021 DMR_20210707

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discha ge Monitoring Report (DMR) Form for NCG120000
Landfills
Click here for instructions
Complete, sign, scan and submit the DMR vi� the Stormwater NPDES Permit Data Monitoring Re ort DMR Upload form within
30 days of receiving sampling results. Mail t e original, signed hard copy of the DMR to the appropriate DEMLR Re ional Office.
Certificate of Coverage No. NCG12 0 0 5 7 Person Collecting Samples: Michael Rutherford
Facility Name: Ashe County Landfill Laboratory Name: Wateriech
Facility County: Ashe Laboratory Cart. No,: 5o
Discharge during this period: F Yes ❑ No (if 10, skip to signature and date)
Has your facility implemented mandatory Tier r sponse actions for any benchmark exceedances? ❑ Yes ❑■ No
If so, which Tier (I, II, or III)?
Part A: Analytical Monitoring Requirements I
0
Parameter
Code
Parameter
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/Yl
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100 or 50*)
00400
pH in standard units (6.0-9.0)
31616
Fecal Coiiform per 100 ml of
freshwater (1000)
Chemical Oxygen Demand in ni
Outfalls with Industrial Activities— Benchmarks in (Red)
Outfall I I Outfall 3 1 Outfall
O
G
06/10/2021
06/1 W2021
1.2
1.2
5.0
4.1
7,12
7.30
265
210
0340 (120) �2a C20
Part B: Vehicle & Equipment MaintenancA Area — :., rn..a,
Outfall I Outfall I
Parameter
Code
Parameter
Outfall
Outfall
Outfall
0Utfa111
Outfall
N/A
Receiving Stream Class
N/A
Late Sample Collected MM/DD/YYYY
00552
Non -Polar Oil & Grease in mg/L (15)
NCO1L
New Motor/Hydraulic Oil Usage in
gal/month
tvnvv�, rn gn c,tuauxy waters (HOW), Trout Waters (Tr) and Primary Nursery Areas [PNA)
have a benchmark TSS limit of 50 rrrg/L. All other w ter classifications have a benchmark of 100 mg/l
"I certify by my signature below, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designec to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that a are signlfic�pt pena
knowin i ations." �jlti or submitting false information, including the possibility of fines and imprisonment for
/ / O_h
ature of Permittee or Delega d Authorized Individual Date