NCG060182_2020 DMR_20201006

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
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. NCG
Person Collecting Samples: Yin -Fong George CHANG, P E.
Facility Name: Laboratory Name: Environmental Chemists, Inc
Facility County: Laboratory Cert. No.: 94
Discharge during this period: ❑■ Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? 9 Yes ❑ No
If so, which Fier (I, il, or III)? III
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
Outfall #1
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
Salem Creek
N/A
Date Sample Collected MM/DD/YYYY
09/1712020
46S29
24-Hour Rainfall in inches
1.80
00556
Oil & Grease in mg/L (30)
< 5.0
C0530
TSS in mg/L (100 or 50*)
57.3
00400
pH in standard units (6.0-9.0)
7.0
3] 616
Fecal Coliform per 100 ml of
5 100
freshwater (1000)
Enterococci per 100 ml of saltwater
61211
(500)
00340
Chemical Oxygen Demand in mg/L
67
(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)
New Motor/Hydraulic Oil Usage in
NCOIL
gal/month
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (RNA)
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 the possibility of fines and imprisonment for
knowing violations."
Signature of Permittee or Delegateo4uthorized Individual
/a -G -a2
Date

F"00-- 77 Environmental Chemists, Inc.
envirochem 6602 Windmill Way, Wilmington, NC 2B405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Sow5ertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
" 255-A Wilmington Highway, Jacksonville, NC 28340 • 910,347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Pilgrim's Pride-Marshville Date of Report: Oct 05, 2020
5901 West Marshville Blvd. Customer PO #:
Marshville NC 28103 Customer ID: 17040005
Attention: George Chang, PE Report #: 2020-15911
Project ID: Marshville Storm Water
Lab ID Sample ID: Collect DatelTime Matrix Sampled by
20-40571 Site: Outfall #1 9/17/2020 7:40 AM Water Yin -Pang Chang
Test Method Results Date Analyzed
Oil & Grease (O&G) EPA 1664
<5.0 mg/L
09/30/2020
Residue Suspended (TSS) SM 2540 D
57.3 mg/L
09/18/2020
pH SM 4500 H 8
7.0 units
09121/2020
COD SM 5220D
67 mg/L
09/24/2020
Fecal Coliform SM 9222D MF 5100 Colonies/100ml- 09/17/2020
Comment:
Reviewed by:R)aLok/
Repori #:: 2020-15911 Page 1 of 1

Environmental Chemists, Inc,
�:�nvirochem
ANALYTICAL & CONSULTING CHEMISTS
LCS
6602 Windmill Way, Wilmington, NC 28405 • 910.392,0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 + 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 * 910.347.5843 Lab/Fax
[e-mail]
Pilgrim's QC - 2020-15911
Parameter
True Value
rng/L
Result
rng/L
% True Value
Limits
%
COD
1000
990
99
90-1 10
Fecal
NIA
NIA
NIA
NIA
TSS
92.5
94.0
102
82.4-1 18
pH
7.00
7.00
100
90-110
OIL & GREASE
40.0
34.7
87
78-114
MS/MSD
Parameter
True Value
mg/L
Recovery
rng/L
% Recovery
%
Difference
Limits %
Recovery
Limits %
Difference
COD
50.0
48/49
96/98
2
80-120
<20
Fecal
NIA
NIA
N/A
NIA
NIA
NIA
TSS
NIA
NIA
N/A
NIA
N/A
NIA
PH
N/A
NIA
NIA
NIA
NIA
N/A
OR, & GREASE
40.0
28.3
71 *
NIA
78-1 14
< 18
* Batch acceted.
DUPLICATE SAMPLES
Parameter
Results
Resuesu
% Difference
Limits %
COD
NIA
N/A
NIA
5 10
Fecal
5
<5
NIA
:� 30
TSS
22.0
21.5
2
< 10
pH
NIA
N/A
N/A
510
OIL & GREASE
NIA
NIA
N/A
NIA

[envirocohem
ANALYTICAL & CONSULTING CHEMISTS
BLANK
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 . 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
[e-mail]
Parameter
Results
rng/L
Limit
mg/L
COD
<10
10
Fecal (Start Control)
0
0
TSS
<2.5
2.5
pH
NIA
N/A
OIL. & GREASE
<2.5
2.5

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Windmill Wa
Wilmington, NC 2840
94Lv.392.C22,
L Sample Receipt Checklist
Client: rAJ Pairc Date �11�0 Report Number: �t
uesiverecl UPS ❑ FedEx ❑ Other ❑
© YES ❑ NO N/A 1. Were custody seals present�onthecooler?
❑ YES ❑ NO N/A 2. If custody seals were presenthey intact/unbroken?
Original temperature upon receipt °C Corr
o rected temperature upon receipt
How temperature taken: ❑ Temperature Blank Against Bottles
IR Gun lD: Thomas Traceable S/N 192511657 M Gun Correction Factor °C: 0.0
❑ YES ❑ NO 3. If temperature of cooler exceeded 6'C, was Project Mgr./QA notified?
YES ❑ NO 4. Were proper custody procedures (relinquished/received)followed?
YES ❑ NO 5. Were sample ID's listed on the COC?
t1 YES ❑ NO 6. Were samples ID's listed on sample containers?
YES ❑ NO 7. Were collection date and time listed on the COC?
YES ❑ NO 8. Were tests to be performed listed on the COC?
YES ❑ NO 9. Did samples arrive in proper containers for each test?
YES El NO 10. Did samples arrive in good condition for each test?
YES ❑ NO 11. Was adequate sample volume availableT
YES ❑ NO 12. Were samples received within proper holding time for requested tests?
YES ❑ NO 13. Were acid preserved samples received at a pH of <2?
❑ YES ❑ NO 14. Were cyanide samples received at a pH >12?
❑ YES ❑ NO 15, Were sulfide samples received at a pH >9?
❑ YES ❑ NO 16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? *'
❑ YES ❑ NO 17_ Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑ YES ❑ NO 18. Were arthophosphate samples filtered in the field within 15 minutes?
* TOC/Voiatiles are pH checked at time of analysis and recorded on the benchsheet.
* * Bacteria samples are checked for Chlorine at time of analysis and recorded on the t)enchsheet.
Sample Preservation: (Must be completed for anysample(s) incorrectly preserved or with headspace)
Samples) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): H2SOq HNO3 HCI NaOH
Time of preservation; If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved sampies. Obtain a new sample or
notify the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Samples) were received with headspace
COMMENTS:
DOC. QA,002
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