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NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NC 120000
Landfills
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitorir
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the
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Certificate of Coverage No. NCG12 NCG120072
Person Collecting Samples: Steven Powell
Facility Name: Cleveland County Landfill
Laboratory Name: Waypoint Analytical, LLC
Facility County: Cleveland County
Laboratory Cert. No.: 402
Discharge during this period: ❑ Yes ❑✓ No (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, ll, or III)?
A copy of this DMR has been uploaded electronically via ttps:f/eciocs.deo.a?c pov!Fc r _;-V_Al llM4 Yes ❑ No
Date Uploaded: 4/29/2022
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
. Code
parameter
Outfall 006
Outfall 007
Outfall 008 '
Outfall 009
Outfall
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100 or 50*)
00400
pH in standard units (6.0-9.0)
00340
Chemical Oxygen Demand in mg/L
(120)
31616
Fecal Coliform in # per 100 ml (1000)
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 mg/L (15)
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
Notes (optional):
"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 thgpossibility of fines and imprisonment for knowing violations."
Signature of-PArmittee or D eg ed Authorized Individual
111
Email Address bwhitley@withersravenel.com
4/29/2022
Im
Phone Number 919-535-5141
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