NCG120096_2021 DMR_20211214

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG120000
Landfills
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG12 0096
Person Collecting Samples: Seth C. Rickerts (S+G)
Facility Name: Red Rock Disposal C&D Landfill
Laboratory Name: Pace Analytical
Facility County: Wake
Laboratory Cert. No.: 37738
Discharge during this period: ❑ Yes 0No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ✓❑ Yes ❑ No
If so, which Tier (I, II, or III)? Tier
❑✓ Yes ❑ No
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR
Date Uploaded:
„_ i-.;,..., KA—*.+^,;— D—i;ramantc fir niatfallc with Industrial Activities — Benchmarks in (Red)
* Outfalls to Outstanding Resource Waters ,
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
Notes (optional): November 2021 monitoring results for SB-1; no
"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 designed 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�nd belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
fal�rrffbr�Pnatlon, includAg � possibilXy of fines and imprisonment for knowing violations."
of Permiytee or D
Authorized Individual
Email Address �([e-mail]
Dat
Phone Number