NCG060184_Monitoring Report_20211209

12/6/2021
Submission Completed
M1ORIN CAROLINA �C ` O
EnHgM1II,laIQtlCG1Y ` O 9 9
M o"aS a,Q q-�S�CO`j
e96oa1ctloo
Permit and Facility Information: Once
Please enter the permit number and other details for this upload.
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)
NCGO60184
Must begin with NCS or NCG
Facility Name: * Pilgrim's Pride Corporation, Wingate Feed Mill/Truck Shop
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 What 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.

12/6/2021
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 4th Quarter 2021 SW DMR.pdf 124.05KB
Only PDFs are accepted.
Comments: For your review and approval!
* By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
o 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');
• 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
• I intend to electronically sign and submit this DMR upload form.
Full Name:* Yin-Pong Chang
Name of person submitting this form
Email Address:* [e-mail]
Phone Number: * 7046244317
Signature: *
.r fir.• '/ry,,mi-•'.•••e i ;e.ueor, '��','
Date: * 12/06/2021

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. NCG060184
Person Collecting Samples:Jermy Specer.
Facility Name: Pilgrim's Pride Corp., Wingate Feed Mill
Laboratory Name: K & W Laboratories
Facility County: Union
Laboratory Cert. No.: 559 'N d
Discharge during this period: El Yes ❑ No (if no, skip to signature and date) v s"M1
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances7 a_%es
If so, which Tier (I, ll, or 111)7 c
❑ No
A copy of this DMR has been uploaded electronically via https:Hedocs.deg.nc.gov/Forms/SW-DMR ❑✓ Yes
Date Uploaded: December 6, 2021
❑ No
Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
Outfall#001A
Outfall#002A
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
Rays Fork Creek
Rays Fork Creek
N/A
Date Sample Collected MM/DD/YYYY
11/22/2021
11/22/2021
46529
24-Hour Rainfall in inches
0.1
0.1
C0530
TSS in mg/L (100 or 50')
11
5.5
00400
pH in standard units (6.0-9.0)
7.8
7.6
00556
Oil & Grease in mg/L (30)
<5.6
<5.6
31616
Fecal Coliform per 100 ml of
82
42
freshwater (if required) (1000)
61211
Enterococci per 100 ml of saltwater
(if required) (500)
00340
Chemical Oxygen Demand in mg/L
42
0
(120)
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in gal/month
66
66
00552
1 Non -Polar Oil & Grease in mg/L (15)
<5.6
<5.6
s 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."
Signature of Permittee or)6elegated Authorized Individual
Email Address [e-mail]
/.?-6-.)
Date
Phone Number [phone]

K & W Laboratories
1121 Hwy 24/27 W
Midland, North Carolina 28107
Tel [phone] l 1 Fax [phone]
Client: Pilgrims Pride Corp.
PO Box 668
Marshville, NC 28103
Project: Wingate Feed Mill Stormwater
Location: Outfall #002A
SAMPLE #
PARAMETER
RESULT
21112208-01
COD
50
21112208-01
Fecal Coliform
42
21112208-01
Oil&Grease
<5.6
21112208-01
pH
7.6
21112208-01
SGT HEM, TPH
<5.6
21112208-01
TSS
5.5
Results Report
Date: 02-Dec-21
Order ID: 21112208
Collect Date:
Collect Time:
UNITS
METHOD
mg/L
SM5220D
colony/100ml
SM9222D (MF)
mg/L
EPA1664A
units
SM45001-1+13
mg/L
EPA1664B
mg/L
SM2540D
pH analysis initiated more than 15 minutes after sample collection.
11 /22/2021
9:32:00 AM
REPORTING
ANALYSIS
LIMIT
DATE
10
12/1 /2021
1
11 /22/2021
5.6
11 /24/2021
0.1
11 /22/2021
5.6
11 /24/2021
2.5
11 /24/2021
NC Certification: 659 SC Certification: 99051
Certified By rv,lt►cska
G. Kraska / Lab Director

K & W Laboratories
1121 Hwy 24127 W Midland, NC 28107
Pilgrims Pride
205 Edgewood Dr.
Wingate, NC 28174
Jeremy Spencer
803-968-0508
P►o" Name Wvwle Feed lull Slorrrrwater
8asss d By
m m
Item Sample ID:
up Grab
No. Aawn Coup
1 Outfall # 001A G
2 G
3 G
4 G
5
6
7 Oulfall # 002A
8 "
9 "
10 "
11
Tel: [phone]
Fax: [phone]
Report To:
I>:m9U. Yin -Pa g.Changna Piiorims com
Copy To. Jeremy Sosncer(31,-pi1grims.com
Bill To.
PO C
Chain of Custody Record
Mum types D V43nnkagWaeer M.
Wawa Vftm GWdam M T,pe o! Ccx�t
or• oar,
P-Massc G•Gsass
r
eservatives
o
C PG ` date Tome
1 P tl(22I1-1 C1.1 x
1
1P
i
I i
1 P !x
G sw I
G sw 1 P
G sw 1 G
G sw 1 P
1117-2174 9 : 3 Z
Lab Log Al
ZIIV22u�7
2. l 11220b
tieen4wshe0 8 2_J
Simple Temp oC
On Ice: Y ! N
sate
' DO- Q1
Time:
•
Dal W
T e
e
Ra�nquis»eo B
ate.
Tema:
Aooe"d By.
Dale I
TOW:

K & W Laboratories
1121 Hwy 24/27 W
Midland, North Carolina 28107
Tel [phone] Fax [phone]
Results Report
Client:
Pilgrims Pride Corp.
Date: 02-Dec-21
PO Box 668
Order ID: 21112207
Marshville, NC 28103
Project:
Wingate Feed Mill Stormwater
Collect Date:
11/22/2021
Location:
Outfall #001 A
Collect Time:
9:29:00 AM
REPORTING
ANALYSIS
SAMPLE #
PARAMETER
RESULT
UNITS
METHOD
LIMIT
DATE
21112207-01
COD
42
mg/L
SM5220D
10
12/1/2021
21112207-01
Fecal Coliform
82
colony/100ml
SM9222D (MF)
1
11/22/2021
21112207-01
Oil&Grease
<5.6
mg/L
EPA1664A
5.6
11/24/2021
21112207-01
pH
7.8
units
SM4500H+B
0.1
11 /22/2021
21112207-01
SGT-HEM, TPH
<5.6
mg/L
EPA1664B
5.6
11/24/2021
21112207-01
TSS
11
mg/L
SM2540D
10
11/24/2021
pH analysis initiated more than 15 minutes after sample collection.
NC Certification: 569 SC Certification: 99061
Certified By C5, x•X-,0sk'2-
G. Kraska / Lab Director