NCG060182_2023 DMR_20230918

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. NCGO6 0 1 8 © Person Collecting Samples: Yin-Pong 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
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?❑Yes ❑� No
If so,which Tier(I, II,or 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 08/10/2023
46529 24-Hour Rainfall in inches 0.75
00556 Oil&Grease in mg/L(30) <6 3
C0530 TSS in mg/L(100 or 50') 56
00400 pH in standard units(6.0. 9.0) 7.2
31616 Fecal Coliform per 100 ml of est > 600
freshwater(10001
61211 Enterococci per 100 ml of saltwater
(500)
00340 Chemical Oxygen Demand in mg/L <1 O
0 20)
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)
NCOIL New Motor/Hydraulic Oil Usage in
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/:.All other water classifications have a benchmark of 100 rrg/I.
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 Delegated Au orized Individual Date

��, K & W Laboratories Results Report
i i ; 1121 Hwy 24/27 W
Midland,North Carolina 28107
Tel[phone] Fax[phone]
Client: Pilgrims Pride Corp. Date: 18-Seo-23
PO Box 668 Order ID: 23081010
Marshville,NC 28103
Project: Marshville Stormwater Collect Date: 8/10/2023
Location: Outfall#001 Collect Time: 9:45:00 AM
REPORTING ANALYSIS
SAMPLE# PARAMETER RESULT UNITS METHOD UMIT DATE
23081010-01 COD <10 mg/L SM5220D 10 8/17/2023
23081010-01 Fecal Coliform est>600 colony/100m1 SM9222D(MF) 1 8/10/2023
23081010-01 0118Grease <6.3 mg/L EPA16648 6.3 8/28/2023
23081010-01 pH 7.2 units SM4500H+B 0.1 8/10/2023
23081010-01 TSS 56 mg/L SM2540D 2.8 8/11/2023
1,
I
pH analysis initiated more than 15 minutes after sample collection.
Fecal Coliform: Estimated Result.All dilutions produced too many colonies to count.
NC Certification:S59 SC Certification: 99051
Certified By 6.K,,.,,,kzi,
G. Kraska/Lab Director

K & W Laboratories Tel:[phone]
1121 Hwy 24/27 W Midland, NC Fax: [phone] Chain of Custody Record
ClienuCompany Pilgrims Pride Report To: ! .a Ce (H L$, ? Remarks:
Address: PO Box 668 "U� �J7
Marshville,NC 28103_ Copy To.
BHI To: Is pH<2? 9/N
Comas: — -_ Is Residual Chlorine ND? D/N
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