NCG120054_2022 DMR_20221128

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 0054 Person Collecting Samples:Tim Kersesy
Facility Name: Sampson County Disposal, LLC Laboratory Name:N/A
Facility County:Sampson Laboratory Cert. No.: 16
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,II,or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR ✓❑Yes El No
Date Uploaded: 11/tic/
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Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall 1/2 Outfall 6 Outfall 10 Duffel! 14 Outfall
Code
N/A Receiving Stream Class C, SW C, SW C, SW C, SW
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 .All other water classifications have a benchmark of
Notes(optional):October 2022 DMR.Outfalls subject to monthly monitoring.
"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 age e system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my kn dge d belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,including t sibilit f fines and imprisonment for knowing violations."
//. 2/• 2.0dR
Signature of Permittee or Delegated Authorized Individual Date
Email Address [e-mail] Phone Number [phone]