NCG060364_MONITORING INFO_20191108

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
NCG V� b 7 ipy
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ (DOS 9 11 O
YYYYMMDD

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
Date submitted
,S,4,'5v 20/9
CERTIFICATE OF COVERAGE NO. NCG06 0 3 Or cf SAMPLE COLLECTION YEAR Z O / 9
FACILITY NAME 30f ^`°//� F4rn✓I//P 1fte-4117 / SAMPLE PERIOD ❑Jan -June July -Dec
COUNTY PERSON COLLECTor ❑Monthly' (month)
COLLECTING SAMPLES L7°4 Gt°a°r✓4 REC t In
LABORATORYEnrrr(ro ,74 / ebMIXfr Lab Cert. ff ,/ DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
NOV 0 6 2019 ❑Zero -flow ❑Water Supply []SA
CENTRAL FIL
®Other Dr frb
9
DWR 5EC7101%bCILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats &use animal fats/byproducts
Dart n• ftnrmwntpr Rpnrhmnrks and Mnnitorine Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall' 3/1P rror n No discharge this period'
Outfall No.
Date Sample
Collected, mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform,
Colonies per 100 ml
Enterococci,
Colonies per 100 ml
Benchmark
- -
100 or 504
Within 6.0-9.0
120
30
10001
5001
Parameter Code
-
C0530
00400
00340
00556
31616
61211
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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 anv outfalls. You must still submit this discharge monitoring report with a checkmark here.
°See General. Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes 5?'no (if yes, complete Part B)
Permit Date: 11/1/2018-05/31/2021 SWU-249, cast Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Date Sample Collected
(mo/dd/yr)
24-hour rainfall amount,
lnches2
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/Total
Petroleum Hydrocarbons
Total Suspended Solids
Benchmarks
-
-
-
15 mg/L
200 mg/L or 50 mg/L°
Parameter code
-
46529
NCOIL
00552
c0530
Footnotes from Part A also apply to Part B
*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 DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original 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."
Signature of Permittee
Permit Date: 11/1/2018-05/31/2021
Date
SWU-249, Last Revised 11/5/2018
Page 2 of 2

Environmental Chemists, Inc.
4
mc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Mantes, NC 27954 • 252.473.5702 Lab/Fax oo A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Butterball-Farmville
Date of Report:
Nov 01, 2019
3628 South Fields St.
Customer PO #:
Farmville NC 27828
Customer ID:
17080036
Attention: Don Genova
Report #:
2019-18029
Project ID: Storm Water
Lab ID Sample ID: BB-Farmville
Collect DatelTime Matrix
Sampled by
19A5969 Site: outfall 1
10/22/2019 8:00 PM Water
client
Test Method
Oil & Grease (O&G) EPA 1664
Residue Suspended (TSS) SM 2540 D
pH SM 4500 H B
COD SM 5220D
Lab ID Sample ID: BB-Farmville
19-45970 Site: outtall 2
Test Method
Results Date
Collect Date/Time Matrix
10/22/2019 8:00 PM Water
<5 mg/L
10/28/2019
8.5 mg/L
10/25/2019
6.81 units
10/29/2019
28 mg/L
10/29/2019
Sampled by
client
Results Date
Oil & Grease (O&G) EPA 1664
<5 mg/L
10/28/2019
Residue Suspended (TSS) SM2540D
9.1 mg/L
10/25/2019
pH SM 4500 H B
6.76 units
10/29/2019
COD SM 52201)
27 mg/L
10/29/2019
Comment:
Reviewed by: z D I�Ri
Report #:: 2019-18029 Pape 1 of 1