NCG060184_Monitoring Report_20211012

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Stormwater NPDES Permit Data Monitoring Report
(DMR) Upload
Permit and Facility Information:
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IMPORTANT. Until the eDMR system is implemented for DEMLR Stormwater Program permits, an original
signed hardcopy of the DMR MUST be mailed to the address in your permit, in addition to this electronic
upload.
Fields marked with a red asterisk are required.
Permit Number* Enter COC or Individual Permit Number (NOT General Permit number with all 0's)
NCG060184
Must begin with NCS or NCG
Facility Name:* Pilgrim's Pride Corporation, Wingate Feed Mill
County:* Union
After uploading here, the original signed hardcopy must be mailed to:
DEQ Mooresville Regional Office
Attn: DEMLR Stormwater Program
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Further contact details at https:Hdeq.nc.gov/contact/regional-offices/mooresville
Monitoring Period Information:
Monitoring Period b7hat is the YEAR of the sample date(s)?
Year:* 2021
Multiple DMRs from sampling periods within the same year can be uploaded together, but please upload different
years with a new submittal form.
https://edocs.deq.nc.gov/Forms/Form/Submit 112

10/6/2021
Submission Completed
Also, copies of the lab results and qualitative (visual) monitoring should NOT be submitted unless specifically
requested by DEQ staff Only upload the completed and signed DMR forms.
DMR Upload * Click the upload button or drag and drop files here to attach document.
Signed 3rd Quarter 2021 SW DMR.pdf 32KB
Only PDFs are accepted.
Comments: For your review and approval!
* v By checking the box and signing box below, I certify that:
o I have given true, accurate, and complete information on this form;
• I agree that submission of this Data Monitoring Report (DMR) upload form is a "transaction" subject to Chapter 66,
Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General
Statutes (the "Uniform Electronic Transactions Act");
o I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the
same way as a written signature; AND
o I intend to electronically sign and submit this DMR upload form.
Full Name:* Yin-Pong George Chang
Name of person submitting this form
Email Address: * [e-mail]
Phone Number: * 7046244317
Signature:
Date: * 10/06/2021
https://edoes.deq.nc.gov/Forms/FomVSubmit 2/2

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 DEMUR Regional Office.
Certificate of Coverage No. NCG061 0 11 18 14 Person Collecting Samples: Yin•Pong George CHANG, P. E.
Facility Name: Pilgrim's Pride Corporation, Wingate Feed Mill Laboratory Name: Environmental Chemists, Inc.
Facility County: Union Laboratory Cart. No.: 94
Discharge during this period: M Yes ❑ No (if no, skip to signature and date) 3
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? U Yes LJ'lg o 1�
If so, which Tier (I, II, or III)? III pz . I T
m i—
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red) o m? N
=mr p rS
Parameter
Parameter
Outfa111A
Outfall2A
Outfall
po
Outfall
—� (�
Outfall
Code
n=
N/A
Receiving Stream Class
Rays Fork Creek
Rays Fork Creek
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
00556
Oil & Grease in mg/L (30)
C0530
TSSin mg/L (100 or SO*)
00400
pH in standard units (6.0-9.0)
Fecal Coliform per 100 ml of
31616
freshwater (1000)
Enterococci per 100 ml of saltwater
61231
(500)
Chemical Oxygen Demand in mg/L
00340
(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 (HOW), 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 (optiona I): No qualified rainfallevents In the miniquarter zozi dueto either no discharge from Outfalls or during "ekend rainfall events bot iabomtory was •Nor o0ea.
"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." _
of Permittee or Delegated
10 -6 -a
Date