NCG120057_DMR_20211119

NC Department of
Environmental Quality
Received
NCDEQ Division of Energy, Mineral and Land Resources
OCT 0 t c021
Stormwater Discharge Monitoring Report(DMR) Form for NCG120000
Landfills Winston-Selem
Click here for instructions Regional Office
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 0 0 5 7 Person Collecting Samples: Michael Rutherford
Facility Name: Ashe County Landfill Laboratory Name: WaterTech
Facility County: Ashe Laboratory Cert. No.: 50
Discharge during this period:E Yes ❑ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances?❑Yes ❑� No
If so,which Tier(I, II,or III)?
Part A:Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall 1 Outfall 3 Outfall Outfall Outfall
Code
N/A Receiving Stream Class C C
N/A Date Sample Collected MM/DD/YYYY 09/01/2021 09/01/2021
46529 24-Hour Rainfall in inches
C0530 TSS in mg/L(100 or 50*) 75 67.5
00400 pH in standard units(6.0-9.0)
31616 Fecal Coliform per 100 ml of 2800 2600
freshwater(1000)
00340 Chemical Oxygen Demand in mg/L <20 <20
(120)
Part B:Vehicle&Equipment Maintenance Areas—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
00552 Non-Polar Oil&Grease in mg/L(15)
NCOIL 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):First benchmark exceedance. FC is suspected to originate from animal excrement and not industrial activities.
"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 th are significant penalties for submitting false information,including the possibility of fines and imprisonment for
knowing vi ions."
G /i) /
9/ /ai
Signature of Permit ee or Delegat Authorized Individual Date