NCG080038_2021 DMR_20220126

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WASTE MANAGEMENT
Winston Salem Hauling
3303 N Glenn Ave
Winston Salem NC 27105
January 26, 2022
Central Files
Division of Water Resources (DWR)
1617 Mail Service Center
Raleigh, NC 27699
Re: Q4 Storm Water Discharge Monitoring Reports
Certificate of Coverage NCG080038
Dear Sir, Madam:
The purpose of this letter is to transmit the Quarterly; Oct -- December 2021, Storm Water
Discharge Monitoring Report (DMR) for Winston Salem Hauling located at 3303 N.
Glenn Ave. Winston Salem, NC. 27105
If you have any questions or require additional information, do not hesitate to contact me by
phone at [phone], or by email at kmertens &wm.com
Sincerely,
Winston Salem Ha ling
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Kyle ertens
Environmental Protection Manager
Attachments -- Q4 2021 DMR Reporting Form
CC: Lionel Jefferson, Waste Management District Manager

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO80000
Transit and Transportation
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.
This DMR form is only applicable to stormwater discharges from the following areas that have been specifically designated by the
Division as subject to the requirements of Part F-1 and brought under NCGO80000: (1) oil water separators (2) containment
structures at petroleum bulk stations and terminals with a total petroleum storage capacity of less than 1 million gallons (3) other
stormwater discharges specifically designated. For stormwater discharges associated with vehicle maintenance areas at
categorically captured facilities under NCG080000, please use the standard NCGO80000 DMR form.
Certificate of Coverage No. NCG080a3 gj
Person Collecting Samples:
Facility Name: VVI'l Lt/ , , cL��•
Laboratory Name:
Facility County: /-o
Laboratory Cert. No.:
Discharge during this period: es
No (if no, skip to signature and date) / d 4
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? LJ Yes LJNo
If so, which Tier (1, II, or III)?
A copy of this DMR has been uploaded electronically via https:Hedocs.deci.nc.gov/Forms/SW-D-MR Yes No
Date Uploaded:
Analytical Monitoring Requirements for Oil/Water Separators and Secondary Containments Areas at Bulk Stations & Terminals
(Those Designated and Brought Under NCG080000) - Effluent Limits in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
46529 1
24-Hour Rainfall in inches
C0530
TSS in mg/L (100 or 50*1
00552
Non -Polar Oil & Grease in mg/L (15)
00400
pH in standard units (6.0 -- 9.0 FW,
6.8 - 8.5)
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of So mg/L. All other water classifications have a benchmark of 100 mg/L
rW (Freshwater) SW 15altwater)
"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 and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false information, including th"ossibility of fines and imprisonment for knowing violations."
Signature of PermitWe-or/Delegated Authorized Individual
li e. k-,3 f vnA, *-1 Ca
Email Address
Date
?,Z /- Ya 7e11 YV
Phone Number