HomeMy WebLinkAboutNCG060021_MONITORING INFO_20191125NSW
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
❑'MONITORING REPORTS
DOC DATE
❑ o) a s
YYYYMMDD
T
Tyson
November 18, 2019
North Carolina Department of Environment, Health and Natural Resources
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Subject: General Permit No. NCG060000
Tyson Foods, Roaring River Feed Mill
COC NCG060021
Wilkes County
Dear Madam or Sir:
RECFIvFr)
NOV 2 5 2019
CEN i Vi L HLES
DN/R SECTION
Enclosed are two copies of the required storm water sampling results.
For the outfalls Covered under the above subject permit and certificate of coverage.
Tyson Farms, Inc. Storm water sampling Period 2 semi-annual monitoring. Data receive for
PRISM labs indicated parameters was below the benchmark.
Tyson Foods, Inc. has made significant improvements to reduce the concentrations of the
parameter of concern.
Please contact me at 336- 651.2871 should you have any questions.
Si
.lames Brown
Complex Environmental Manager
Tyson Farms Inc. Fresh Retail Division 704 Factory Wilkesboro, N.C. 28697
336-651-3836 336.838.2171 Fax: 33.651.3867 w .tysonfoods.com
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
For North Carolina Division of Water Quality General Permit No NCG060000
Date submitted: 11-18- 2019
OF COVEAGE
SAMPLE
YEAR 2019
FACILITY
CERTIFICATENAME TyssonFarms Inc. 060021 RECEIVE® FACILITY ACTIVITIEOSNNCLUDE (check all that apply):
Roaring River Feed Mill NOV 2 5 2019 ❑ use/process meats ® use animal fats/byproducts
COUNTY Wilkes DISCHARGING TO SALTWATERS? []YES ®NO
PERSON COLLECTING SAMPLES James Brown CENTRALFILES
LABORATORY Prism Labs Lab Cert. # 402 WM SECTION; PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Storm water Benchmarks and Monitoring Results
Total event r ' 112100 ❑
Outfall No.
Benchmark300
TSS,
mg/L
or 504
pH,
Standard units
Within 6.0 — 9.0
COD,
mg/L
120
oinfa
Oil and Grease,
mg/L
30
or No discharge
Fecal Coliform',
Colonies per 100 ml
1000
this perioa-
Enterococci3,
Colonies per 100 ml
500
RRIV-01
U,
60
6.77
59
5.0
NA
ryA
RRIV - 02
74
6.89
89
5.0
NA
NA
RRIV - 04
62
6.99
54
5.0
NA
NA
� .�.....i_------
—
..., .. re....., ... 'ups um t uoq process meets.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ® Yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for farilitipc ayaravinn � cc ..I �r n ... __+ u r .
(if yes• complete Part B)
Outfall No.
Sample Collected,
Mo./dd./yr.
Oil and Grease,
mg/L
Non Polar Oil
&Grease/TPH
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
15
100orW
6.0-9.0
-
RRIV-04
10/30/2019
5.0
5.0
62
6.99
215
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
'See General Permit text table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
SWU-249
Last Revised: October 18, 2012
Pagel of2
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1REQUIREMENTS. SEE PERMIT PART II SECTION B.
* 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO IrCJa'
1:1Ixe1[iI�Ll�ilyy[y�K�1P�lfe[�1� �I_\tail i
Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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."
/L/F5-/9
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.ora/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2
WDENR
Storm water Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: http://12ortal.ncdenr.grg/web/wg/ws/su/npdessw#tab-4
Permit No: N/C/G/0/6/0/0/0/0 or Certificate of Coverage No. N/C/G/0/6/0/0/2/1
Facility Name: Tyson Farms Inc Roaring River Feed Mill
County: Wilkes
Phone No: 336.696.2741
Inspector: Raymond Nichols
Date of Inspection: 10/30/2019
Time of Inspection: Lk 0p t1'\
Total Event Precipitation (inches): 2.00
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See
information below.)
Vyes Q No
Please verify whether Qualitative Monitoring must be performed during a "representative storm event"or
"measureable storm event" (requirements vary, dependingon thepermit). ,
quantattve monitoring requirements vary. Most permits require qualitative monitoring to be performed
during a "representative storm event" or during a "measureable storm event." However, some permits do not
have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is
preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event' is a storm event that results in an actual discharge from the permitted
site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is
representative for local storm events during the sampling period, and the permittee obtains approval from the
local DWQ Regional Office.
By this s"ture, I certify t )at this report is accurate and complete to the best of my knowledge:
Permittee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012
1. Outfall Description:
Outfall No. KKIv - d Structure (pipe, ditch, etc.) �e l'E
Receiving Stream: �li�rrt.rttC L �f:li�lwH Ao A-
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: L-:5h F
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): (\ vyt f
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and
5 is very cloudy:
1 0 3 4 5
5. Floating Solids: Choose the number which best describes the amount of Floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 02 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 u2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 1�
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes 'C%
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
5WU-242, Last modified 10/25/2012
NCDENR ,
Storm water Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form, please visit: htto://nortal.ncdenr org/web/wq/ws/suu/nodessw#tab-4
Permit No: N/C/G/0/6/0/0/0/0 or Certificate of Coverage No. N/C/G/0/6/0/0/2/1
Facility Name: Tyson Farms Inc Roaring River Feed Mill
County: Wilkes
Phone No: 336.696.2741
Inspector: Raymond Nichols
Date of Inspection: 10/30/2019
Time of Inspection: tE .lo Q M
Total Event Precipitation (inches): 2.00
Was this a "Representative Storm Event" or" Measureable Storm Event" as defined by the permit? (See
information below.)
Yes ❑ No
Please verify whether Qualitative Monitoring must be performed d uring a "representative storm event" or
"measureablestorm event" (requirements vary, depending on the permit).
ttuautanve monitoring requirements vary. Most permits require qualitative monitoring to be performed
during a "representative storm event" or during a "measureable storm event" However, some permits do not
have this requirement. Please refer to these definitions, if applicable.
A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall and that is
preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event' is a storm event that results in an actual discharge from the permitted
site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is
representative for local storm events during the sampling period, and the permittee obtains approval from the
local DWQ Regional Office.
By this sig Lure, I certify that this report is accurate and complete to the best of my knowledge:
(Signature ff Permittee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012
1. Outfall Description:
�\y _p )\ Outfall No. . Structure (pipe, ditch, etc.) 'VCt% �. t—
ReceivingStream: Mima:1n "Vtr
Describe the industrial activities that occur within the outfall drainage area: A •, n
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: L ; S h E
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): h A Z
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and
5 is very cloudy:
1 0 3 4 5
S. Floating Solids: Choose the number which best describes the amount of Floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with Floating solids:
1 0 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 0 3 4 5
7. Is there any foam in the stormwater discharge? Yes /No
8. Is there an oil sheen in the stormwater discharge? Yes I�
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012
NC ENR
Storm water Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this farm, please visit: httR//portal ncdenr ore/w b/wa/wc/s t/nadessw#tab-4
Permit No: N/C/G/0/6/0/0/0/0 or Certificate of Coverage No. N/C/G/0/6/0/0/2/1
Facility Name: Tyson Farms Inc. Roaring River Feed Mill
County: Wilkes
Phone No: 336.696.2741
Inspector: Raymond Nichols
Date of Inspection: 1 30 2019
Time of Inspection: fa
Total Event Precipitation (inches): 2.00
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See
information below.)
nYes No
Please verify whether Qualitative Monitoring must be performed during a "representative storm event"or
"measureablestorm event" (requirements vary, depending on the permit).
ltuamanve monitoring requirements vary. Most permits require qualitative monitoring to be performed
during a "representative storm event' or during a "measureable storm event" However, some permits do not
have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is
preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the permitted
site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is
representative for local storm events during the sampling period, and the permittee obtains approval from the
local DWQ Regional Office.
By this g,ature, I certif ghat this report is accurate and complete to the best of my knowledge:
Permittee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012
1. Outiall D_escript'on:
OutfallNo, V-O� Structure (pipe, ditch, etc.) 5kc ko6; swe.kl,
Receiving Stream: 11.Anumec.'tt' h44c � 41, Nac 'Vex
Describe the industrial activities that occur within the outfall drainage area: a of
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: l—, Sh 4
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): V%Un e-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and
5 is very cloudy: 1 V ,Z1�1
3 4 5
5. Floating Solids: Choose the number which best describes the amount of Floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with Floating solids:
1 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012
Roaring River Storm Water Calu. Sheet
Date 10-30-2019
Rain Begin: 3:25 PM iightonandoff
Runoff Begin: 3:30 PM
Grab Samples: 4:00 PM
Rain at end of
Storm Event: 2.00
Sampling Point RRIV- 01 Drainage Area = (150 acres *43560) Ft 2
Q = CIA
1 = 2.00 " (Total)
C = 0.35
Q = 0.35(2.00/12)(6,534,000-7.5)/1,000,000
= 2.859 MG
Sampling Point RRIV- 02 Drainage Area = (96485) Ft 2
Q = CIA
I = 2.00 " (Total)
C = 0.95
Q = 0.95(2.00/12)(96485-7.5)/1,000,000
= 0.115 MG
Sampling Point RRIV- 04 Drainage Area = (75,085) Ft 2
Q = CIA
I = 2.00" (Total)
C = 0.95
Q = 0.95(2.00/12)(75,085`7.5)/1,000,000
= 0.089 MG
/"RISM
®OIA90NNTeNIE$ ING
Full -Service Analytical &
Environmental Solutions
Tyson Farms, Inc. -Roaring River
Raymond Nichols
179 Roaring River Rd.
Roaring River, NC 28669
NC certification No. 402
NC Drinking Water Can No. 37735
SC Certification No. 99012
Project: Stormwater
Lab Submittal Date: 10/31/2019
Prism Work Order: 9110017
Case Narrative
11/14/19 10:37
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are Flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
Terri W. Cole
Project Manager
Data Qualifiers Key Reference
Reviewed By Terri W. Cole
Project Manager
OG HEM O&G is less than the reporting limit, therefore TPH (SGT-HEM) is less than the reporting limit. Sample not
extracted for TPH (SGT-HEM).
BRL Below Reporting Limit
MDL Method Detection Limit
RPD Relative Percent Difference
Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: 704/529.6364 - Toll Free Number: 1-8001629-6364 - Fax: 704/625-0409 Page 1 of 8
/EP Fi I S M I Full -Service al Solutions
s
Envtronmentel aoWeons
®Uuew�rwn&wc
Tyson Farms, Inc. -Roaring River
Attn: Raymond Nichols
179 Roaring River Rd.
Roaring River, NC 28669
Laboratory Report
11/14/2019
Project: Stormwater Client Sample ID: RRIV-01
Prism Sample ID: 9110017-01
Prism Work Order: 9110017
Sample Matrix: Water Time Collected: 10/30/19 16:00
Time Submitted: 10/31/19 17:45
Parameter
Result
Units
Report
MOIL
Dilution
Method
Analysis Analyst
Batch
Limit
Factor
Datefrime
ID
General Chemistry Parameters
Chemical Oxygen Demand
59
mglL
60
10
1
'SM6220 D
1116/19 11:14 SLS
P9K0114
Oil & Grease (HEM)
BRL
mg/L
5.0
1.7
1
'1664B
11/12/19 9:15 SLS
P91<0229
Total Suspended Solids
60
mg/L
12
0.70
1
'SM2540 D
1114119 14:65 CBM
P9K0053
This report should not be reproduced, except in its entirety, without the written consent of Pnsm Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0543
Phone: 7041529.6364-Toll Free Number: t-8001629-6364-Fax: 7041626-0409 Page 3 Df 8
Sample Receipt Summary
I S M �
Fu166orvmee Analytical a
Environmenlel Solutions
Quaaurw,ca ixc
11114/2019
Prism Work Order: 9110017
Client Sample ID
Lab Sample ID
Matrix
DatelTime Sampled Date/Time Received
RRIV-01
9110017-01
Water
10/30/19 16:00 10/31/19 17:45
RRIV-02
9110017-02
Water
10/30/19 16:10 10/31/19 17:45
RRIV-04
9110017-03
Water
10/30/19 16:20 10/31/19 17:45
Samples were received in good condition at 5.0 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, INC 28224-0543
Phone: 704/529-6364 - Toll Free Number: i-8001629-6364-Fax: 7041625-0409 Page 2 of 8
/1
/P R I S M I FWI_6ervlce Analytical a
1 Environmental Solution.
Tyson Farms, Inc. -Roaring River
Attn: Raymond Nichols
179 Roaring River Rd.
Roaring River, NC 28669
Laboratory Report
11/14/2019
Project: Stormwater Client Sample ID: RRIV-02
Prism Sample ID: 9110017-02
Prism Work Order: 9110017
Sample Matrix: Water Time Collected: 10/30/19 16:10
Time Submitted: 10/31/19 17:45
Parameter
Result
Units
Report
MDL
Dilution
Method
Analysis Analyst
Batch
Limit
Factor
Date/Time
ID
General Chemistry Parameters
Chemical Oxygen Demand
89
mg/L
60
10
1
'SM5220 D
11/6119 11:14 SLS
P9K0114
Oil & Grease (HEM)
BRL
mg/L
5.0
1.7
1
'1664B
11/12/19 9,15 SLS
P91<0229
Total Suspended Solids
74
mg/L
12
0.70
1
'SM2640 D
1114119 14:55 CBM
P9K0063
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: 704IS29-6364 - Toll Free Number: 1-800/629-6364 - Fax: 704/626-0409 Page 4 of 8
Laboratory Report
I S M Full-Sarvica Analytical 8
GP R
usauron,ea,xc Environmental
Solutions
11/14/2019
Tyson Farms, Inc. -Roaring River
Project: Stormwater
Client Sample ID: RRIV-04
Attn: Raymond Nichols
Prism Sample ID: 9110017-03 '
179 Roaring River Rd.
Prism Work Order: 9110017
Roaring River, NC 28669
Sample Matrix: Water
Time Collected: 10/30/19 16:20
Time Submitted: 10/31/19 17:45
Parameter
Result Units
Report
MDL
Dilution Method Analysis Analyst
Batch
Limit
Factor Date/Time
ID
General Chemistry Parameters
Chemical Oxygen Demand
54 mg1L
60
10
1 'SM6220 D 11/6/19 11:14 SLS
P9K0114
Oil B Grease(SGT-HEM)
BRLOG mg/L
5.0
1.6
1 '16648 11/12/19 9.15 SLS
P9K0230
Total Suspended Solids
62 mg/L
12
0.70
1 'SM2640 D 11/4119 14:65 CBM
P9K0063
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 29224-0543
Phone: 7041529-6364- Toll Free Number: 1-800/629-6364 - Fax: 7041525-0409 Page 5 Df 8
n Full -Service Analytical &
dP R I S M I Evlronmemal Solutions
Level II QC Report
11/14/19
Tyson Farms, Inc. -Roaring River
Attn: Raymond Nichols
179 Roaring River Rd.
Roaring River, NC 28669
General Chemistry Parameters - Quality Control
Analyte
Batch PSK0053 - NO PREP
Project: Stormwater
Reporting
Result Limit Units
Prism Work Order: 9110017
Time Submitted: 10/31/2019 5:45:OOPM
Spike Source %REC RPD
Level Result %REC Limits RPD Limit Notes
Blank (P9KO053-BLK1i Prepared & Analyzed: 11/04/19
Total Suspended Solids BRL 5.0 mg/L
LCS (P9K0053-BS1) Prepared & Analyzed: 11/04/19
Total Suspended Solids 480 5.0 mg/L 477.0 101 90-110
Duplicate (P9K0063-DUP1) Source: 9110017-03 Prepared & Analyzed: 11/04/19
Total Suspended Solids 70 5.0 mg/L 62 11 20
Batch P9K0114 - NO PREP
Blank (P9KO114-BLK1)
Prepared &
Analyzed:
11/06/19
Chemical Oxygen Demand
BRL 50 mg/L
LCS (1391<0114-BSI)
Prepared &
Analyzed:
11/06/19
Chemical Oxygen Demand
508 50 mg/L
500.0
102 90-1 to
Matrix Spike (P9KO114-MS1)
Source: 9110017-02
Prepared &
Analyzed:
11/06/19
Chemical Oxygen Demand
565 50 mg/L
500.0
89.4
95 80-120
Matrix Spike Cup (P9KO114-MSD1) Source: 9110017-02 Prepared & Analyzed: 11/06/19
Chemical Oxygen Demand 551 50 mg/L 500.0 89.4 92 80-120 3 20
Batch P9K0229 - NO PREP
Blank (P9K0229-BLK1) Prepared & Analyzed: 11/12/19
Oil & Grease (HEM) BRL 20 mg/L
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, INC 28224-0643
Phone: 7041629.6364-Tall Free Number: l-8001629.6364-Fax: 7041626-0409 Page 6 0f 8
Level II QC Report
Full -Service Analytical 8
Env1 Full-SnmentelticalSolutions 11/14/19
�9ueauroa,u ixc
Tyson Farms, Inc. -Roaring River Project: Stormwater Prism Work Order: 9110017
Attn: Raymond Nichols Time Submitted: 10/31/2019 5:45:00PM
179 Roaring River Rd.
Roaring River, NC 28669
General Chemistry Parameters - Quality Control
Reporting Spike Source %REC RPD
Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch P9K0229 - NO PREP
Blank (P9K0229-BLK2) Prepared & Analyzed: 11/12/19
Oil & Grease (HEM) BRL 5.0 mg/L
LCS (P9K0229-BS1) Prepared & Analyzed: 11/12/19
Oil & Grease (HEM) 160 20 mg/L 160.0 100 78-114
Batch P91K0230 - NO PREP
Blank (P9K0230-BLK1) Prepared & Analyzed: 11/12/19
Oil & Grease (SGT-HEM) BRL 20 mg/L
LCS (PSK0230-BS1)
Oil & Grease (SGT-HEM)
Prepared & Analyzed: 11/12/19
62A 20 mg/L 80.00 78 64-132
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: 7041529-6364 - Toll Free Number: l-800/629-6364-Fax: 7041626-0409 Page 7 of 8
CHAIN OF CUSTODY RECORD
:
,s``/A,Full-Service Analytical&
R I S, I
/rik
YES NO
tl , Environmental Solutions
PAGE_ OF QUOTE k TO ENSURE PROPER BILLINGr
Samples INTACT upon arrival? I_
00
VuoosnrdmEs n+c
T ..
Project Name:
Received ON WET ICE? _�
m
449 Spring
Phone 7041U529fi36{ Fax: 7tW52552 Road • Charlotte, 282t7
-0e09
Short Hold Analysis: (Yes) (No) USTProject: (Yes) (NO)
PROPER PRESERVATIVES indicated?. j,
'Please ATTACH any project specific reporting (QC LEVEL 1 II III IV)
Received WITHIN, HOLDING TIMES?
m
Client Company Name:
provisions and/or OC Requirements
CUSTODY SEALS INTACT? - ;- =
Q_
Report To/Contact Name:
Invoice To:
VOLATILES reed HEADSPACE?
-
rr
R Orting Ad/)dfBas: l Q ACiAc
Address:
_W/OUT
.;
PROPER CONTAINERS used?
• `i\l L[_ 'r1�(p1✓Ct
.TEMP: Therm,ID(-
/
Phone:I'l ax (Yes) (No): ON Purchase Order No./Billing Reference TO BE FILLED IN BY CLIENTISAMPLING PER _ NEL
Email Address: . ►S GIu(.i lia i4WL e01%
Requested Due Date O 1 Day O 2 Days Cl 3 Days O 4 Days ❑ 5 Days Certification: NELAC_ DOD FL_ INC
EDD Type: PDF eel Other
YP �E
"Working Days" O 6-9 Days O Standard 10 days ❑ Rush Work Must Be
Site Location Name: K—alej f i de
Pre -Approved
Samples received after 14:00 will be processed next business day.
SC_ OTHER N/A
n �C
Site Location Physical Address: JCI F40Wi Aa:l ` V et P&Turnanxind
time is based on business days, "riuding weekends and holidays.
Water Chlorinated: YES_ NO —
(SEE
RENDS E BY PRISM RSE FOR TERMS
LABORATORIES INC. TOIONS REGARDING
CLIENT)SERVICES Sample Iced Upon Collection: YES_ Nn_
CLIENT
SAMPLE DESCRIPTION
I DATE
COLLECTED
TIME
COLLECTED
MILITARY
MATRIX
(SOIL,
WATER OR
SAMPLE CONTAINER
PRESERVA-
TIVES
ANALYSIS REQUESTED
/ REMARKS
PLAB RISM
-TYPE
NO.
SIZE
to NO.
HOURS
SLUDGE)
SEE BELOW
QLU -� 1
iD 30' tq
q ov Pm
Q
3 c
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locc:
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FINS
CG
—I
cm Lu t
10-3GL`\
W
P
IOcC
`(1py1,G
iS�
cc,r
Sampler's Signature Sampled By
(Print Name) C.— r, Affiliation
Upon relinquishing, this CWain of Custody is your authorization for Prism to proceed with the analyses as requested above. Any changes must be
submitted in writing to the Prism Project Manager. There will he charges for any changes after analyses have been Initialized.
y:( R
BY 19Pdm Deb ^
r Additional Comments: Site Arrival Time:
Z
_
e lnC' YI R
Y• Sgnaturei
'Site Depadure Time: I:
1 �
Lim
Field Tech Fee:
Inau %:( ) Rvrnvotl IF. BY Date 1
(�
`.--y-._� IA"JI-li
`
(7-15 Mileage:
ethod a SNpmenc NOTE: ALL SAMPLECOOLERS O LD B AP M W
U DY S La FOR TMNSPORTATION TO THE LABORATORY. a/�Gmup No.
SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST CDCV
,l �/1
RECEIVED AT THE LABORATORY -I I'OtJ I /
O Fed E• O UPS O HanEEelivered Prism Field Service OOthar
NPDES: UST: GR NDWATER: DRINKING WATER: SOLID WASTE: RCRACERCLA LANDFU-L OTHER:
`I
I
❑NCOSC ❑NC❑SC ❑ C ❑SC ❑NC ❑SC
❑NC ❑SC ❑NC❑SCI O❑NC ❑SC ❑❑NC ❑SCI ❑❑NC❑SC
n n ❑ ❑
❑ ❑
— 'CONTAINER TYPE CODES: A = Amber C = Clear G= Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space) ORIGINAL
9
Tyson.
November 18,20i9
North Carolina Department of Environment, Health and Natural Resources
Division of Water Qualliy
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh NC 27699-1617
Subject: General Permit No. NCG060000
Tyson Foods, Roaring River Feed Mill
COC NCG060021
Wilkes County
Dear Madam or Sir:
Enclosed are two CC^y:es of the required storm water sampling results.
For the outfalls Covered under the above subject permit and certificate of coverage.
Tyson Farms, Inc. Storm water sampling Period 2 semi-annual monitoring. Data receive for
PPI 1i 1 labs indicated parameters vvas below the be ie.umar lC.
Tyson Foods, Inc. has made significant improvements to reduce the concentrations of the
parameter of concern.
Please contact me at 336- 651.2871 should you have any questions.
lSincerely.
James Brown
Complex Environmental Manager
Tyson Farms Inc. Fresh Retail Division 704 FactoryWilkesboro, N.C. 28697
336-651-3836 336.838.2171 Fa :33.651.3867 w .tysonfoods.com
NNUAL STORMVVATER DISCHARGE MONITORING
CERTIFICATE OF COVERAGE NO. NC:G06002.1
FACILITY NAME Tyson Farms In(. -
Roaring liiver Feed Mill
COUNTY Wilkes
PERSON COLLECTING SAMPLES James Brown
LABORATORY Prism Labs Lab Cert. It 402
Part A: Storm water Benchmarks and Monitorin Re It
71
Date submitted: 11-18- 2019
SAMPLE COLLECTION YEAR 2019
FACILITY ACTIVITIES INCLUDE (check all that
0 use/process meats ® use animal
DISCHARGING TO SACFWATERS? EYES F
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Outfall Plo.
RRIV-Ol
RRIV - 02
RRIV - 04
!iample Collected,
Mo./dd./yr.
10/30/2019
10/30/2019
10/30/2019
TSS,
mg/L
100 or 50'
60
74
62
su s
l pH,
- -Standard units
.Within 6.0 - 9 0
_ 6.77
6.89
6.99
COD,Fa6nd
. mg/L.Benchmark
_ 120 ,�
59
g9NA
54
I otal event rainfall 22.00 or L No discharge
Fecal Coliform',
Colonies p_r 10(1 ml
_100�0•500
NPR
NAOnly
this period'
Enterocoaci';•
Coloniesper-100 ml
A
applies to facilities that use/process meats. -- The total precipitation must be recorded using data from an on -site rain gauge.
nFor sampling periods with no discharge at anv outfalls. You must still submit this discharge monitoring report with a checkmarl; here.
See General Permit text, "fable 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? 0 Yes ❑
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
o. Sample Collected, Oil and Grease, Non Polar Oil TSS,—
PJHNMotor
Mo./dd./yr. mg/L &Grease/TPH mg/L Standal
FBenchinbrk30rng/L —15 100 or 50° 6.010/:30/20].9 .5.0=-- 5.0 62 6.--
-
no (if es, complete Pa
Oil Usage,
average gal/mo
215
Only applies to facilities
that use/process meats.
—
rt B)
'The total precipitation must be recorded using data from an on -site rain gauge.
' For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
See General Permit text table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
S W U-249
Last Revised: October 18, 2012
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1REQUIREMENTS, SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES L_j NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO j/
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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."
(SignatuFe of
(Date)
Additional copies of this form may be downloaded at: htt.n_//Iiortal.ticdetir.org/web/w ws/su idesswtttab-4
SWU-249
Last Revised: October 18. 2012
Pa,-e 2 of 2
NEW
Storm water Discharge Outfall (SDO)
oaitiA>Mnnrg pp, --falatp ;..6 .�a-tsc:a a
Forguidanceonjulingouttnisform,please visit: http://Dortal.ncdenr-ore/web/wn/ws/s i.pde �
ss•�•#._.
Permit No: N/C/G/0/6/0/0ID/nV or Certificate of Coverage No. N/C/G/0/6/0/0/2/1
Facility Name: Tyson Farms Inc. RoarinL7 River FPPd Min
County: Wilkes
Phone No: 336.6962741
Inspector: Raymond Nichols
Date of Inspection: 10/30/2019
Time Of Inspection' Lk<.tb
Total Event Precipitation (inches): 2.00
Was this a'Repr eseatatiyz Storm Event" or Measureable Storm Event" as defined by the permit? (See
information below.)
dYes ` [:] No
Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or
"measureahlestorm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed
during a "representative storm event" or during a "measureable storm event." However, some permits do not
have this requirement. Please refer to these definitions, if aDolicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is
preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the permitted
site outfall. The previous measurable storm event must have been at least 72 hour s
Drior. The 72-hour storm . interval terval dies ,.;;• nn,.! ,: i, "1e „o_,,,:..,.
-rry Y`-`--•. �.�2 i5 aui2 to d6CllIIlent thata SilOfCer Interval is
representative for local storm events during the sampling period, and the permittee obtains approval from the !
local DWQ Regional Office.
By thi sigyure, I certify lthat this report is accurate and complete to the best of my knowledge:
Permi—LLee or Designee)
Page 1 of 2
SWU-242, Last modified 1012512012
1. Outfall Description:
Outfall No. KNt - L Structure (pipe, ditch, etc.) U V t'i
ReceivingStream: V.rl�e� %t�"-A �1� --i VtC-
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: (--t -,h ir
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): 1 � tk e
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and
5 is very cloudy: /
1 2! 3 4 5
5. PloatingSolids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 L) 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwaterdischarge, where 1 is no solids and 5 is extremely muddy:
1 VI 3 4 5
7. Is there any foam in the stmrmwater (Iischarge? Yes No
v
8. Is there an oil sheen in the stormwater discharge? Yes N
9. Is there evidence of erosion or deposition at the outfall? Yes N��
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/20 12
MC® NR
Storm water Discharge Outfall (SDO)
Qualitative Monitorine Re1Dort
Forouidonce on filling out thisform, please visit: http:l/12ortal.ncdenr.org/web/wq/ws/su/npdessw#tah-4
Permit No: N%C/G/O/6/0/0/0/0 or Certificate of Coverage No. NBC/G!0/6/0/0/2/1
Facility Name: Tyson Farms Inc Roaring River Feed Mill
County: Wilkes
Phone No: 336.696.2741
Inspector: Raymond Nichols
Date of Inspection: 10/30/901 Q
Time of Inspection: q le V n
Total Event Precipitation (inches): 2.00
Was this a "Representative Storm Event" or " Measureable Storm Event" as defined by the permit? (See
information below.)
�H/Yes ❑ No
Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or
"measureablestorm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed
during a "representative storm event" or during a "measureable storm event" However, some permits do not
have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is
preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the permitted
site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is
representative for local storm events during the sampling period, and the permittee obtains approval from the
local DWQ Regional Office.
By this stggature,l certify th5t this report is accurate and complete to the best of my knowledge:
(Signature
Permittee or Designee)
Pagel of 2
SWU-242, Last modified 10/25/2012
1. Outfa�lll_Descripttiion: V
Outfall No. )1'--t-� -� �lx Structure (pipe, ditch, etc.) � VE[ Jr —1�•-� Receiving Stream: 1)'Jg 1 Au Describe the industrial activities that occur within the outfall drainage area: �ic�Ak-, nc; eC
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: L t S h 1,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
4. Clarity: Choose the numberwhich bestdescribes the clarity of the discharge, where 1 is clearand
5 is very cloudy:
1 �2� 3 4 5
5. Floating Solids: Choose the number which best describes the amount of Floating solids in the
stormwater discharge, where 1 is no solids and 5is the surface covered with Floating solids:
1 2) 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
I
1 2 3 4 5
7. Is there any foam in the stormwaterdischarge? Yes N�o
8. Is therein oil sheen in the stormwaterdischarge? Yes No
v
9. Is there evidence of erosion or deposition at the outfall? Yes No
v
10. Other Obvious indicators ofStormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SwU-242, Last modified 10/25/2012
NC®ENR
Storm water Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on.Filling out thisf rm, please visit. htto:/!Portal ncdenr orgjwebjwgjws/sujnodessw#tab-4
Permit No: NiCiG/0/6/0/0/0/0 or Certificate of Coverage No. N/C/G/OL'0/0/7/1
Facility Name: Tyson Farms Inc Roaring River Feed Mill
County: Wilkes
Phone No: 336.6962741
Inspector: Raymond Nichols
Date of Inspection: 10// 30/20�)19
Time of Inspection:
Total Event Precipitation -(inches): 2.00
Was this a "Representative Storm Event" or "Measureabie Storm Evert as defined by the permit? (See
information below-)
dYes No
Please verify whether Qualitative Monitoring must be performed during a "representative storm event"or
"measureablestorm event" (requirements vary, depending on the permit).
Qualitative monitoring requirements vary. Most Permits require qualitative monitoring to be performed
during a "representative storm event" or during a "measureable storm event." However, some permits do not
have this requirement. Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0-1 inches of rainfall and that is
preceded by at least 72 hours (3 days) in which no storm event measuring greater than
0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the permitted
site outfall. The previous measurable storm event must have been at least 72 hours
prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is
representative for local storm events during the sampling period, and the permittee obtains approval from the
local DWQ Regional Office.
By this signature, I certify/tlhat this report is accurate and complete to the best of my knowledge:
or Designee)
Page 1 of 2
SWU-242, Last modified 10/25/2012
1. Outfall Description:
Outfall No. \l -OC` Structure (pipe, ditch, etc.) S 11C o w JC
L.; kk
Receiving Stream: �Aj�r1C mr3 iif' (i -1--- 4 }-L �a(�K 1
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and not
(light, medium, dark) as descriptors: L, c IN r
3. Odor: Describe any distinct odors that he discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): A t;11 C-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and
5 is very cloudy:
1 \2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of Floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with Floating solids:
1 U, 3 4 5
v
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
r
1 2J 3 4 5
i
7. Is there any foam in the stormwater discharge? Yes No
L�
8. Is there an oil sheen in the stormwater discharge? Yes No
i;
9. Is there evidence of erosion or deposition aC the outfall? Yes No
v
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 10/25/2012
Roaring River Storm Water Calu. Sheet
Date 1 n-'I()-9n_ 19
Rain Begin 3:25 PM light.8M off
Runoff Begin: 3:30 PM
Grab Samples: 4:00 PM
Rain at and of
Storm Event: 2.00
Sampling
- Point RRIV- 01 Dr ain, age Area _ (1 s0 .... `435e0) ct 9
Q = CIA
1 = 2.00 " (Total)
C = 0.35
Q = 0.35(2.v0ii2)(6,534,CCC'7.511,000,^.00
= 2.859 MG
Sampling Point RRIV- 02 Drainage Area = (96485) Ft 2
Q = CIA
1 = 2.00 " (Total)
C = 0.95
Q = 0.95(2.00/12)(96485'7.5)/1,000,000
= 0.115 MG
Sampling Point RRIV- 04 Drainage Area = (75,085) Ft 2
Q = CIA
I = 2.00" (Total)
C = 0.95
Q = 0.95(2.00/12)(75,085'7.5)/1,000,000
= 0,089 MG
LIRISM
�OiL ATMIEs,we
Full -Service Analytical &
Environmental Solutions
Tyson Farms, Inc. -Roaring River
Raymond Nichols
179 Roaring River Rd.
Roaring River, NC 28669
NC Certification No. 402
NC Drinking Water Cent No. 37735
SC Certification No. 99012
Project: Stormwater
Lab Submittal Date: 10/31/2019
Prism Work Order: 9110017
Case Narrative
11/14/19 10:37
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
.Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
Terri W. Cole
Project Manager
Reviewed By Terri W. Cole
Project Manager
Data Qualifiers Key Reference:
OG HEM 0&G is less than the reporting limit, therefore TPH (SGT-HEM) is less than the reporting limit. Sample not
extracted for TPH (SGT-HEM).
BRL Below Reporting Limit
MOIL Method Detection Limit
RPD Relative Percent Difference
Results reported to the reporting limit. All other results are reported to the MDL with values between MOIL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0643
Phone: 7041529-6364 - Toll Free Number: 1-8001629-6364 - Fax: 7041626-0409 Page 1 of B
n aP
snalyt ds\R ISM I Mirounnnernel Solutions
Sample Receipt Summary
11/14/2019
Prism Work Order: 9110017
Client Sample ID
Lab Sample ID
Matrix
Date/Time Sampled
Date/Time Received
RRIV-01
9110017-01
Water
10/30/19 16:00
10/31/19 17:45
RRIV-02
9110017-02
Water
10/30/19 16:10
10/31/19 17:45
RRIV-04
9110017-03
Water
10/30/19 16:20
10/31/19 17:45
Samples were received in good condition at 5.0 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 29224-0643
Phone: 7041629-6364 - Toll Free Number: 1-80016296364 - Fax: 7041625-0409
Page 2 of S
6P R I S M I Full-eenice Analytical 8
Laboratory Report
6nmroementei Solutions i l /14/2019
Tyson Farms, Inc. -Roaring River Project: Stormwater Client Sample ID: RRIV-01
Attn: Raymond Nichols Prism Sample ID: 9110017-01
179 Roaring River Rd. Prism Work Order: 9110017
Roaring River, NC 28669 Sample Matrix: Water Time Collected: 10/30/19 16:00
Time Submitted: 10/31/19 17:45
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor DatelTime ID
General Chemistry Parameters
Chemical Oxygen Demand 59 mg/L 50 10 1 'SM6220 D 11/6119 11:14 SLS P91(0114
Oil & Grease (HEM) BRL mg/L 5.0 1.7 1 '1664B 11/12/19 9:15 SLS P91<0229
Total Suspended Solids 60 mg/L 12 0.70 1 'SM2640 D 11/4119 14:56 CBM PSK0053
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0643
Phone: 7041629.6364 - Toll Free Number: 1-8001629-6364 - Fax: 704/625-0409 Page 3 of 8
^ Full -service Analytical &
4P R I S M environmental Solutions
Q..eoaooa,e, a�
Tyson Farms, Inc. -Roaring River
Attn: Raymond Nichols
179 Roaring River Rd.
Roaring River, NC 28669
Laboratory Report
11/14/2019
Project: Stormwater Client Sample ID: RRIV-02
Prism Sample ID: 9110017-02
Prism Work Order: 9110017
Sample Matrix: Water Time Collected: 10/30/19 16:10
Time Submitted: 10/31/19 17:45
Parameter
Result
Units
Report
MDL
Dilution
Method
Analysis Analyst
Batch
Limit
Factor
Date/Time
ID
General Chemistry Parameters
Chemical Oxygen Demand
99
mg/L
50
10
1
'SM5220 D
11/6119 11:14 SLS
P9K0114
Oil & Grease (HEM)
BRL
mg/L
5.0
1.7
1
'1664B
11/12/19 915 SLS
P91<0229
Total Suspended Solids
74
mg/L
12
0.70
1
'SM2540 D
11/4119 14:66 CBM
P9K0053
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, INC 29224-0643
Phone: 7041529-6364-Tell Free Number: 1-8001529-6364 - Fax: 704/626-0409 Page 4 of 8
PRISM- Laboratory Report
Full -Service Analytical a
Env ronmentel Solutions 11114/2019
`7 t,•c
Tyson Farms, Inc. -Roaring River Project: Stonnwater Client Sample ID: RRIV-04
Attn: Raymond Nichols Prism Sample ID: 9110017-03
179 Roaring River Rd. Prism Work Order: 9110017
Roaring River, NC 28669 Sample Matrix: Water Time Collected: 10/30/19 16:20
Time Submitted: 10/31/19 17:45
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor Datefrime ID
General Chemistry Parameters
Chemical Oxygen Demand
64
mg/L
50 10 1 'SM5220 D 11/6/19 11:14 SLS P91(0114
Oil & Grease (SGT-HEM)
BRLOG
mg/L
5.0 1.6 1 '1664B 11/12/19 9:15 SLS P91<0230
Total Suspended Solids
62
mg/L
12 0.70 1 'SM2640 D 11/4119 14:55 CBM P9K0063
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: 7041629-6364 -Toll Free Number: 1-8001629-6364 - Fax: 704/626-0409 Page 5 Gf 8
mA
iP R I S M Full -Service Analytical 8
Environmental Solutions
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Tyson Farms, Inc. -Roaring River
Attn: Raymond Nichols
179 Roaring River Rd.
Roaring River, NC 28669
General Chemistry Parameters - Quality Control
AnaNte
Project: Stormwater
Level II QC Report
11/14/19
Prism Work Order: 9110017
Time Submitted: 10/31/2019 5:45:OOPM
Reporting Spike Source %REC RPD
Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch PS K0053 - NO PREP
Blank (P9K0053-BLK1) Prepared & Analyzed: 11/04/19
Total Suspended Solids BRL 5.0 mg/L
LCS (P9K0053-BSI) Prepared & Analyzed: 11/04/19
Total Suspended Solids 480 5.0 mg/L 477.0 101 90-110
Duplicate (PSK0053-DUPt) Source: 9110017-03 Prepared & Analyzed: 11/04/19
Total Suspended Solids 70 5.0 mg/L 62 11 20
Batch P91<0114 - NO PREP
Blank (P9K0114-BLK1)
Prepared & Analyzed: 11/06/19
Chemical Oxygen Demand
BRL 50 mg/L
LCS (PSK0114-BSI)
Prepared & Analyzed: 11/06/19
Chemical Oxygen Demand
508 50 mg/L
500.0 102 90-110
Matrix Spike (139K0114-MS1)
Source: 9110017-02
Prepared & Analyzed: 11/06/19
Chemical Oxygen Demand
565 50 mg/L
500.0 894 95 80-120
Matrix Spike Dup (P9K0114-MSD1)
Source: 9110017-02
Prepared & Analyzed: 11/06/19
Chemical Oxygen Demand
551 50 mg/L
500.0 89.4 92 80-120 3 20
Batch 1391<0229 - NO PREP
Blank (P9KO229-BLKI) Prepared & Analyzed: 11/12/19
Oil & Grease (HEM) BRL 20 mg/L
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240643 - Charlotte, NC 28224-0543
Phone: 70416296364 - Toll Free Number: 1-800/629-6364 - Fax: 7041526-0409 Page 6 of 8
17
&K02-RrI S M
Full -Service Analytical &
Envi onmental Solutions
lusonnxa¢x�wc
Tyson Farms, Inc. -Roaring River
Attn: Raymond Nichols
179 Roaring River Rd.
Roaring River, NC 28669
General Chemistry Parameters - Quality Control
Batch P91<0229 - NO PREP
Project: Stormwater
Reporting
Result Limit Units
Level II QC Report
11/14/19
Prism Work Order: 9110017
Time Submitted: 10/31/2019 5:45:OOPM
Spike Source %REC RPO
Level Result %REC Limits RPO Limit Notes
Blank (P9K0229-BLK2) Prepared & Analyzed: 11/12/19
Oil & Grease (HEM) BRL 5.0 mg/L
LCS (P9K0229-BS1) Prepared & Analyzed: 11/12/19
Oil & Grease (HEM) 160 20 mg/L 160.0 100 78-114
Batch P9K0230 - NO PREP
Blank (P9K0230-BLK1) Prepared & Analyzed: 11/12/19
Oil & Grease (SGT-HEM) BRL 20 mg/L
LCS (P9K0230-BS1) Prepared & Analyzed: 11/12/19
Oil & Grease (SGT-HEM) 62.4 20 mg/L 80.00 78 64-132
This report should not be reproduced, except in its entirety, without the wntten consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0643
Phone: 7041529.6364 - Toll Free Number: 1-8001529-6364 - Fax: 7041626-0409 Page 7 of 8
CHAIN OF CUSTODY RECORD
LAB USE ONLY , E
> t Full -Service Analytical &
YES NO N/A
-
Environmental Solutions PAGE_ OF _ GUMS a To ENSURE PROPER BILLING.
Samples INTACT upon aniviil? ✓ _. __
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Project Name:.
Received ON WET ICE?
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449 Springbrook Road • Charlotte, NC 28217 Short Hold Analysis: (Yes) No UST PFO ect: es NO
y ( ) ( ) i (Yes)( )
PROPER PRESERVATIVES indkated?: ., % _ ,_
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Phone 70M529-6364 • Fax: 7041525-0409
'Please ATTACH any project specific reporting (QC LEVEL I II III IV)
Received WITHIN HOLDING TIMES?
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Client Company Name: r provisions anNor QC Requirements
CUSTODY SEALS INTACT?
Report TolContact Namrte: '9t Invoice
To:
VOLA.TILES,recd W/OUT HEADSPACE?
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Phone. SI I- FaJ�X( Y S) (No): - Purchase Order No./Billing Reference TO BE FILLED IN BY CLIENT/SAMPLING PE ONNEL '
Email Addre�. A) G U 4 Requested Due Date O 1 Day ❑ 2 Days ❑ 3 Days 134 Days O 5 Days Certification:_ NELAC_ DOD_ FL_ NC_
EDD Type: PDF cel_,,' Other 'Working Days' ❑ 6-9 Days ❑ Standard 10 days ❑ RushPrP�v dust Be
SC_ OTHER N/A
Site Location Name' pth4' LIL'L` Ce[,G ni.• U Samples received after 14:00 will be processed next business day.
` time is based on business days, excluding weekends and holidays.
Water Chlorinated: YES_ NO_
Site Location Physical Address: 1 t(�t (> ,,V; Aci V et aTurnaound
(SEE REVERSE FOR TERMS A CONDITIONS REGARDING SERVICES Sam Ie Iced Upon Collection: YES_ NO
P P NO —
RENDERED BY PRISM LABORATORIES, INC. TO CLIENT)
CLIENT
( DATE
TIME
COLLECTED
MATRIX
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Sampler's Signature Sampled By (Print Name) �..> n. Affiliation`s
Upon relinquishing, this ClWaln of Custody Is your authorization for
Prism to proceed with the analyses as requested above. Any changes must be a
submitted in writing to the Prism Project Manager. There will be charges
for any changes after analyses have been Initialized.
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_ Additional Comments: Site Arrival Time:
'Site Departure Time:
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etrad d repment NO AL AMP A ED H RH u Dr SEALS FOR TRI1�N3`POit/TATION TD THE LABORATORY No.
SAMPLES ARE NOT ACCEPTED AND VERIFIED AGAINST CDC U RECEIVED AT THE LABORATORY. /,� I 1 0
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