NCS000130 DMR SW (9)

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u i 2016
Central Files
Division of Water Resources
1617 Mail Service Center
Raleigh,NC 27699-1617
Subject: Storm Water Monthly Monitoring Report
Permit No. N :111 1-
Perdue Farms, Rockingham Facility
To Whom It May Concern,
As specified under the Tier Two Storm Water permit requirements, please find
attached two copies of the June monthly storm water monitoring report for the
Perdue Foods LLC facility located at Rockingham,North Carilina.
This monitoring report meets the requirements under Part II; Section B: Analytical
Monitoring Requirements for the facility's Storm Water Permit.
The storm water sample was collected on June 16,2016 during a qualifying rain
event.
If you need any additional information, please do not hesitate to contact me on my
cell phone at [phone].
Sincerely yours, -
Paul Bruce Roberts RECEIVED
Regional Environmental Manager JUL 2915
[e-mail]
CENTRAL FILES
, Oct_LS_ (2,6.
` pWR SECTION
cc: Fayetteville Regional Office
Division of Water Resources
215 Green Street, Suite 714
Fayetteville,NC 28301

STORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT ,�rr��,
Permit Number NCS 00 0 I '3 0 SAMPLES COLLECTED DURING CALENDAR YEAR: cO I/
(This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAMER,!`�(Joe_ C.)Q o P k A-rv\ COUNTY d' 3cQ
�
PERSON COLLECTING SAMPLE(SjaI/ .2.04/1^ OJ � , PHONE NO.( 9 1 U) ei 9 1) — C/3
CERTIFIED LABORATORY(S) Lab#
-qr. I'
1'''2C 4 Lab#46 ,, ..
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A: Specific Monitoring Requirements
1 Outfall Date 50050
No. Sample Total Total ' '~O''A'L t_
vTA-L w___ rte.-CAL K&)
Collected Flow(if app.) Rainfall ��O plies opus f .),<1-1,67t-A) 0,0(1 &VA
��'-I
mo/dd/yr , ' MG inches _ /vL /v ,//, _ ,M5,-IL IT it- CO. C/ I t:?QrnL_ pi 7 .
g Q LJ 1 a / /6/i 1(\)/A 0. 140 V I \ 06 314 9- ♦ Vs- a i s 1, v L ' I .V 9
PECEIVED
JUL 122016
CENTRAL FILES
DWR SECTION
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? Vs _no
(if yes,complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall Date 50050 a 00556 00530 00400
No. Sample Total Flow Total Oil&Grease Non-polar Total pH New Motor
Collected (if applicable) Rainfall . (if appl.) ' O&G/TPH Suspended . Oil Usage
(Method 1664 Solids -
SGT-HEM),if
appl•
mo/dd/yr MG inches mg/I /L mg/I unit gal/mo
r) 0 -4 ( /r('/otc. &)/A _ (i 4 ) , Mix 4,, •..6 lD . f Clic5
Form SWU-247,last revised 2/2/2012
Page 1 of 2

STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Water Quality
Date 6//6/k Attn: Central Files
Total Event Precipitation(inches): (0a 40 1617 Mail Service Center
Event Duration(hours): (only if applicable—see permit.) Raleigh,North Carolina 27699-1617
(if more than one storm event was sampled)
Date
Total Event Precipitation(inches):
Event Duration(hours): (only if applicable—see permit.)
"I certify,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."
pc a . 7/6 7//C
(Signature of Permittee) (Date)
Form SWU-247,last revised 2/2/2012
Page 2 of 2