NCG120105_2022 (Oct) DMR (Orig Signed)_20230519

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 0105
Person Collecting Samples:
Facility Name: Kersey Valley Landfill
Laboratory Name: City of High Point Water Quality
Facility County: Guilford
Laboratory Cert. No.: 55
Discharge during this period: EjYes +
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? E]Yes '.. No
If so, which Tier (I, II, or III)? 11
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR Yes 17No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities - Benchmarks in (Red)
Parameter
. Code
parameter
Outfall.
Outfall
Outfall
Outfall
.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 FW,
6.8 - 8.5 S W)
00340
Chemical Oxygen Demand in mg/L
(120)
31616
1 Fecal Coliform in # per 100 ml (10tl0)
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552
1 Non -Polar Oil & Grease in mg/L (15)
NCOIL
Estimated New Motor/Hydraulic Oil
Usage in gal/month
- Otntalls 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.
FW (Freshwater) SW (Saltwater)
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 the possibility of fines and imprisonment for knowing violations."
Signature of Permittee or Delegated Authorized Individual
[e-mail]
Email Address
11-02-2022
Date
336-883-3433
Phone Number

Georgoulias, Bethany
From: Amanda Madden <[e-mail]>
Sent: Thursday, May 18, 2023 4:13 PM
To: Georgoulias, Bethany
Subject: Re: [External] Fw: DMR Upload Not Accepted
Attachments: NCDEQ11022022.pdf
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Good afternoon!,
We had two more rejection emails today -
I have attached the reports - If I need to send them to someone else just let me know; since I sent you the
ones earlier I sent these to you as well @
Amanda Madden
r?, . 111 win -
CITY OF HIGH POINT
Kersey Valley Landfill; Ingleside Compost Facility
Administrative Specialist I
3940 Kivett Dr l Jamestown NC, 27282
336.883.3468 I fax:[phone]
a [e-mail] I www.highpointnc.gov
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Please be aware that e-mail and attachments sent to and from this address are subject to the North Carolina Public Records Law
and may be disclosed to third parties.
<[e-mail]>
Sent: Friday, May 5, 2023 8:19 AM
To: Amanda Madden <amanda.madden@high poi ntnc.gov>
Subject: RE: [External] Fw: DMR Upload Not Accepted
From: Georgoulias,
Bethany
CAUTION: This message has originated from an External Source. Please use proper judgment and caution when opening attachments,
clicking links, or responding to this email.
Thankyou!
Bethany Georgoulias (she/her)
Environmental Engineer, Stormwater Program
DEMLR Laserfiche Administrator
Division of Energy, Mineral, and Land Resources
N.C. Department of Environmental Quality
919 707 3641 office

[e-mail]
512 N. Salisbury Street, Raleigh, NC 27604 (location)
1612 Mail Service Center, Raleigh, NC 27699-1612 (mailing)
Website: http://deq.nc.gov/about/divisions/energy-mineral-land-resources/stormwater
D_E
NORTH CAROLINA
Department of Environmental quality
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
From: Amanda Madden <amanda.madden@high poi ntnc.gov>
Sent: Thursday, May 4, 2023 4:41 PM
To: Georgoulias, Bethany <[e-mail]>
Subject: Re: [External] Fw: DMR Upload Not Accepted
CAUTION: External email. Do not click links or open attachments unless verified. Report suspicious emails with the Report Message
button located on your Outlook menu bar on the Home tab.
Found it -
Amanda Madden