NCG120072_2021 DMR_20220131

NCDEQ Division of Energy, Mineral and Land Resources
Cora piete, sign., sca n a nd sul rnit the DM R via the
o days of receiving sampling results. Mail the prig i n a 1, signed hard copy of the DIMR to the
.0
Certificate of Coverage No. NCG120072
Person Collecting amplest
Facility Name: Cleveland County Landfill
Laboratory Name: NIA
Facility County: Gleveland County
Laboratory Gera No.: N/
Discharge d uri n g this period:
Yes
N o (if n o, skip
to sig n ig ture and dote)
Has your facility im plemented rn a rid atory Tier response
If so, which Tier (1, 11, or 111)?
actions this yarn p11e period for a ny benchmark a eeeda noes? Yes N o
copy of this DER has been uploaded electronically is
Date Uploaded: 01131 / 0
Yes No
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks In
Parameter
Code
Parameter
outfall 001
utfall 002
Outfall 00
utfall 004
Outfall00
1
Receiving Strea rn Class
N/A
Date Sample Collected I[ 1 DD YYYY
4
-Dour Rainfall in inches
COS30
TSS in m L
00400
H in standard units
00340
Chemical Oxygen Demand in mg/L
31616
Fecal Coliform in # per 100 r l
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552
Non -Polar Oil & Grease in mL
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
Outfalis to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary {Nursery Areas (PNA)
have a benchmark T s limit of
(Freshwater) (Saltwater)
. All other water classifications have a benchmark of
Notes (optional): Drought Conditions
••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
i nqui ry of the person or persons wh o man age the s ste m, o r those p e rsons directly responsi ble for Bathe H ng the information, the information
submitted is, to the best of my knowledge and belief, true, accurate, and cony plete, I am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations."
40
i nature of Pe rm ittee or Dele at
I afar
rrtt-moor. corn
Email Address
Authorized Individual
01l312022
1 -738-9583
Phone Number

NCDEQ Division of Energy, Mineral and Land Resources
Corn plete.. sign, scan a nd submit the DM R via the
0 days of receiving sampling results. Mail the original, signed hard copy of the DIVIR to the
I"thin
f
Certificate of Coverage No. NCG120072 Person Colleting Samples:
Facility Name; Cleveland County Landfill Laboratory Name: N/
Facility Count : Cleveland Counter Laboratory Cart. No.: /
Discharge during this period Yes jNo (i
no, skip to signature and dote)
Has your facility implemented mandator Tier response actions this sample period for any benchmark a ceedances? Yes No
if so, which Tier (I, ii, or Ill)?
copy of this Dl lR has been uploaded electronically via Yes No
Date Up]oaded: 011110
Analytical Monitoring Requirements for Outfalls with industrial Activities — Benchmarks in
Parameter
Code
Parameter
Outfall 006
outfall 007
Outfall 008
Outfall 009
Outfall
N
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainftill ire inches
C0530
TSS in mg/L
00400
pH in standard units
00340
Chemical Oxygen Demand in mg L
31616
Fecal Coliform in # per 100 m I
Additional parameters for outfaIN in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552
ion -Polar Oil & Grease in mg1L
NCOstimated
I
New i otor/Hydraulic oil
Usage in gal/month
outfalls to Outs nding Resource Waters (OR ), High Quality Waters (H ), Trout haters (Tr) and Primary Nursery Areas (PNA)
have a benchmark limit of
(Freshwater) (Saltwater)
. All other water classifications have a benchmark of
Notes (optional): Drought Conditions
"I certify by my signature below, under penalty of law, that this document and all attachments were prepared under my direction or supervision ire
accordance with a system designed to assure that qualified personal properly gather and evaluate the information submitted, Based on m
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 ray l nowledge aced belief, true, accurate, and cormsplete. I am aware that there are significarat penalties for snub itting
false information,, including the possibility of fines and imprisonment for knowing vloladori.s."
go
ignature'of Pe rim ittee or De(Ogated Authorized Individual
[e-mail]
Email Address
01/312022
Date
919-738-9583
Phone Number
01
41