NCG060182_2022 DMR_20220228

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO60000
Food and Kindred
Click here for instruct-ons
Complete, sign, scan and submit the DMR via the Stormwater NPDES Perm,t 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. NCG06 0 1 8 2 Person Collecting Samples: Yin -Fong George CHANG, P. E.
Facility Name: Pilgrim's Pride Corporation, Marshville Processing Plant Laboratory Name: K & W Laboratories
Facility County: Union Laboratory Cert. No.: 559
Discha ge during this period: ❑■ Yes ❑ No (if no, skip to signature and date)
Has r facility implemented m datory Tier response actions for any benchmark exceedances? ❑■ Yes ❑ No ef
If so,%hich Tier (I, II, or III)? III ' +�
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Code
Parameter
Outfall #1
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
Salem Creek
N/A
Date Sample Collected MM/DD/YYYY
02/04/2022
46529
24-Hour Rainfall in inches
0.2
00556
Oil & Grease in mg/L W1
< 5.9
C0530
TSS in mg/L (100 or 50*)
18
00400
pH in standard units (6.0-9.0)
6.3
31616
Fecal Coliform per 100 ml of
4 85�
freshwater (1000)
61211
Enterococci per 100 ml of saltwater
(500)
00340
Chemical Oxygen Demand in mg/L
� 4
18
V
(120)
Part B: Vehicle & Equipment Maintenance Areas — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
00552
Non -Polar Oil & Grease in mg/L J1S)
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 (PNA)
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."
"), - js -.1 �
Signature of Permittee or Delegated Authorized dividual Date

K & W Laboratories
1121 Hwy 24/27 w
Midland, North Carolina 28107
Tel [phone] Fax [phone]
Client: Pilgrims Pride Corp.
PO Box 668
Marshville, NC 28103
Project: Stormwater # 1
Location: Outfall #001
SAMPLE # PARAMETER RESULT
22020411-01
COD
18
22020411-01
Fecal Coliform
4850
22020411-01
0116Grease
<5.9
22020411-01
PH
6.3
22020411-01
TSS
18
Results Report
Date: 22-Feb-22
Order ID: 22020411
Collect Date:
2/4/2022
Collect Time:
8:10:00 AM
REPORTING ANALYSIS
UNITS
METHOD
LIMIT
DATE
mg1L
SM5220D
10
219/2022
colony/100ml
SM9222D (MF)
1
21412022
mg/L
EPA1864B
5.9
2/712022
units
SM45001-1+8
0.1
214/2022
mglL
SM2540D
2.5
2/6/2022
pH analysis Initiated more than 15 minutes after sample collection.
NC Certification: 559 SC Certification: 99061
Certified By k�
G. Kraske / Lab Director

Tel: [phone]
Fax: [phone]
K & W Laboratories
1121 Hwy 24/27 W Midland, NC
28107
Address: PO Box 668
Maishville, NC 28103
Chain of Custody Record
lRemarks:
OuNall # 001
H:
Tem :