NCG060349_MONITORING INFO_20191209

'W �-o
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NC
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑
YYYYMMDD

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted 11/18/2019
CERTIFICATE OF COVERAGE NO. NCG060349 SAMPLE COLLECTION YEAR 2019
FACILITY NAME Ann's House of Nuts FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Martin RECEIVECP use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES Michael Speller DISCHARGING TO SALTWATERS? DYES ®NO
LABORATORY Environment 1 Lab Cert. # 10 DEC 0 9 2019
CGN"PLEASE REMEMBER TO SIGN ON THE REVERSE 4
I+�.SECTION L FILES
D-... n. br..m...�.n. Rnnrr.m�r4c ..el Mnnitnrinv ReadGW1tc •• TOTOI event rOln%pfi or n No discharge this periods
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliformt,
Colonies per 100 ml
Enterococci',
Colonies per 100 ml
Benchmark
-
100or50'
Within6.0-9.0
120
30
-3000
500
1
11/12/2019
38
6.5
64
<6
2
11/12/2019
5.0
6.2
2100
<6
3
11/12/2019
3.0
6.6
35
<6
4
11/12/2019
2.7
6.5
20
<5
1 Only applies to facilities that use/process meats.
' 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes X no (if yes, complete Part B)
D... R. 11 k; .ie nnointnnnnro Aram Mnnitnrinc Readtc• only for facilities averaeine > 55 eal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100or50'
6.0-9.0
-
' Only applies to facilities that use/process meats.
'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
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. 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 ❑
REGIONAL OFFICE CONTACT NAME: Thom Edgerton 01/31/19
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 attachmentswere 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)
ii-l3-19
(Date)
Additional copies of this form may be downloaded at: http://Aortal ncdenr org/web/wg/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 18. 2012
Pa,-e 3 of 2

ERAmmman Flo
14
ID## : 72
FLAGSTONE FOODS=STORMWATER
ATTN: RICKY COOKE
201 EAST 3RD ST. DATE COLLECTED: 11/12/19
P.O. BOX 70 DATE REPORTED 11/15/19
ROBERSONVILLE ,NC 27871
REVIEWED BY:
Stormwa(er Stornmmater Stormwater Slornmater Analysis
/Method
PARAMETERS (NI, Crab) 02, Grab) (0, Grab) (N4, Crab) Date Analyst Code
I'll (not to be used 1'01' rep(rting)
6.5
6.2
6.6
6.5
11/12/19
GNB
45001113-II
COD, mg/1
64
2100
35
20
11/15/19
SE,1
1i8000-79
Total Suspended Residue, mg/I
38
5.0
3.0
2.7
11/13/19
I4d0
2540D-II
TPH (1664R), mg/I
<6
<6
<6
<5
11/13/19
SE-)
RPA 1664E

'Environment'1, Inc.. CHAIN. OF CUSTODY RECORD
of
PU`&x 7085. 114 Oakmont Dr. Page
�o_E
:;menville. NC 27858
:nvironment 1 inc.com
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone [phone] • Fax [phone]
CHLORINE
pHCHECK (LAB)
CLIENT: 72 Week:39
Ij
I
❑ Uv
P
P
P
G
CONTAINERTYPE,P/G
^`
t—`C� S}C,,,•C..
=STORNIWVATER
NONE
TTN: RICKY COOKE
CHEMICALPRESERVATION
)I EAST 3RD ST.
A
C
A
C
.O. BOX 70
OBERSONWLLE NC 27871
A-NONE D-NAOH
�z
,a o
W
b�
¢
3
U
O
N
N B-HNO, E-HCL
152) 795-6500
••
¢
ov
¢ O
w�
z
¢
(5
a
w '
r C-HtSO, F-ZINC ACETAT&NAOH
COLLECTION
`
8.
FL
=
..,
a G-NATHIOSULFATE
�8
0
q
F
r
SAMPLE LOCATION
DATE
TIME
oQ
r o
¢
U
Via.,
CLASSIFlCATIOht
Stotmwater W, Grab)
11112
4
?-z'sz
s;,.s
It
00
4
IBM
'
L
Ij WASTEWATER(NPDES)
Stormwater (N2, Grab)
❑ DRINKINGWATER
Stormwater p3 Grab)
t
(
�S7
4
-
Stormwater (44, Grab)
`
��Q
4\
-
DINR/GW
SOLD WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
Y N
SAMPLES COLLECTED BY:
SAMPLES RECEIVED IN LABATW'C
U FD SAM )
DA1FlRME
BY(
�I TEnIME
ci
rL
ED )
DAIE/TIME
RECEIVED By
TIN1E04
c
b 3. °e
RELINQUISHED BY (SIG.)
DATEITIME
RECENED BY (SIG.)
DATTJTIME
L N,
PLEASE READ Instructions for completing this form on the reverse side.
FORM C5
Sampler must place a'C" for composite sample or a U Tor
Grab sample in the blocks above for each parameter requested. N 0
369989