WQ0005699_Residual Annual Report 2014_20150109

N, luvw L1PLL JJ18j'=.UTiQN. AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORK!
WQ0005690 FACILITY NAME: cPek 6270.
r.C1.tY- .,, ,_..
PHO1�TEs _ C1/1) -.gam ,COUNTY: Columbus O TOR: �w s. �'�N f2e� ,- cvk rk
FACILITY TYPE (please,check one): Snrface,Dieposal (complete Part A (Source(s) and "Resldnei In" Volume only) and Fart C)
L7 Distribution and Marketin (complete Parts A, B,:and:C)
Was the facility in operation during the past calendar ear? D Yee Na No If No ski naWo A H C a d c "146 On . I w
. Part A*:beo
.
Part H .
Month
Sources(s) (include NPDES # if
applicable)
Volumed
tons)
.Reci' ient Information
Admendment/
Hulking Agent
.
Residual in
Product Out
Names)
Volyrne (dry
tons)
Intended use(s)
January.•
Februa
March
A ril
June
y
August
September
LAu
Annual d tons :
men ment s use
0
ent
0 . r4 ;;; ^,:•";
<a; : ;f,:, pk\I;t; '•:' ki 171,1
s -- ,
>:r:,;a; :k,:•, f:,.,,.:.. ;
ONB e*oAUnA
s' 1f more space than given is required, please, attach additional iffin
iatlori sheettsl..• rut if adkiltintnal O' hOA+ial
i - - + - - - -- --- ,- -\-/• � �r��yr.r .r MMM.aYMMi WNrYY`7� Ni V K.KiViiVY
Part C:
Feelilty was compliant during calendar years with all conditions of the permit ((Including but not limited to items 1.3 below) Issued;by the
Division of water lQuality. Cj Yes C3 No If No, please provide a written description why the :facility was not con>tpliant.
1. All monitoring was done to accordance with the permit and reported for -the yeu,.0 required and three .(3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation,•prior authorisation was received $om the Division:of Water
Quality,
3, No contravention of Ground Water Quality Standards occurred at.a monitoring well.
"I certify►„under penalty of law, that the above Information is, to :the best of my knowledge: ad belief, true, accurate and complete..I am aware
togt,thwe,are slgpiticirpt „ apesfor submitting false I nformaiton, including ;the possibility of fines and Imprison
ment for knowing violations."
Signature o rtnitteo ;Date Signature. of Preparer**
p Date
`` ((If different froin Permittee) **Preparer.is defined in 40 ZFR Part 503.9(i)
DENR FORM QM:3DF (6/20.03) /

10-January-2015
Oak -Bark Corporation
333 Neils Eddy Rd.
Riegelwood -N.C. 28456
Mr. Ed Hardee
Division of Water Quality
Aquifer Protection Section
1636 -Mail Service Center
Raleigh N.C. 27699-1636
Ref: 2014 Annual Report for Monofill
Permit No. WQ0005699
To Whom It May Concern
This letter and attachments serve as Oak-Bark's annual report for the on -site Monofill
covered under Permit Number WQ0005699
During the year 2014 no solid / sludge residuals or leachate liquids were added or
removed from this Monofill.
Attached you will find three (3) copies of the Annual Distribution -and Marketing Surf- ace
Disposal Certification Form.
Please do not hesitate to -contact `me if there are any questions. -1 -can -be -reached at
[phone] or [phone]
Respectfully
W.-E. Lewis
Plant Manager
Oak -Bark Corporation
PMWEDIDB R OR
JAw 0 9 2015
n'�FINIMU n

AINA UAL 4 ; ISTMUTION AND rv%MTING/ gUIMACE DISPOSAL CERT ]FICATION .AND SUMMMMY FORM
PERMIT #: WQ0005699 FACILITY NAME: Or
c .
PONE: ' �// GT /'
�/9-.aZ6':zt �,COUIVT�Y: Columbus rst��_—__�
_�_.. O RATOR. eLA j . �ON fee 4 r- (9v rk -
FACIi.ITY TYPE (please,check ones Surtisce,Disposal (complete Part A (Source(e) and "Residual In" Volume only) apd Part C)
C1 Distrlbutlon and Marketin (complete Parts A, B,:and:C)
Was the fadU 1p o oration duriq the ast calendar ar? 1.7 YesTa No If No ski arts
B, C and cerMf form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volumed
Admendment/
13ulkin Agent
g
tons
.
Residual In Product Out
Reci' lent Information
Name(s) Volume (dry Intended use(s)
tons
Janua
�
�'
Februa
�,
March
Ma
June
Jul
August
,
Se tember
October
November
December
Tot s:
ACIrnn
,Annual dry tom):,-
ment s use
0
HA ent
0
s used:
O
aNA A#ankaA
If more space than given is required, please atteoh' additional information
sheet(s). in Chan► hnY If DA41#6"al Anaffe%
PortCs • - , -.-,- —------- --- ..�...---..�. ,..__•..,, �._ ......_.,__
FaeWty was compliant during calendar year ,_/4 , with all conditions of the permit ((Including but not limited to items 1.3 below) issued fby ;the
Division of Water Quality. Q Yes C] No If No, please provide a written dekriptlon why the facliity was not compliant.
1, All snonitor)ng was done in accordance with the permit and reported for -the year;as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation,•,prior authorization was received -from thwDivision:of Water
!Quality,
3, No contraventlon of:Ground Water Quality Standards occurred at.a monitoring well,
"I certify►„dader penalty of law, .that the above information is, to the best of my knowledgsand belief, true, accurate:and complete. �I am aware
t6slt ;thgre,are slodflept a�ties for submliti�pg false ianforroaiton, iucluding.-the possibility of fines and imprisonment for knowing violations."
Signature o rtnstteo Date Signature of Propar
e►** Date
(if different from Permittee) "Preparer is defined in 40:CFR Part 503.90)
DENR FORM DMSDF (6/20.03) r