NCG060382_MONITORING INFO_20200123

Miz C)
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
nj(-G % 02-)
DOC TYPE
❑ HISTORICAL FILE
(� MONITORING REPORTS
DOC DATE
❑ U� ��
YYYYMMDD

STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000
CERTIFICATE OF COVERAGE NO. NCGO6 0 3 8 2
FACILITY NAME Mountaire Farms Inc. - Statesville Breeder Feed Mill
COUNTY tredell
PERSON COLLECTING SAMPLES John Jacobs
Date submitted 01114r1020
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June ❑ July -Dec
or Q Monthly' December (month)
LABORATORY Statesville Analytical Lab Cert. p 440 DISCHARGING TO CLASS ❑ORW ❑HOW ❑Trout ❑PNA
RCn ❑Zero -flow ❑Water Supply []SA
AAA D QOtherC
JAN 2 'FACILITY ACTIVITIES INCLUDE (check all that apply):
CENT;-Cxk C� use/process meats Q use animal fats/byproducts
UDR S L FILES
C7 ON
Part A: Stormwater Benchmarks and Monitorine Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rain/all 2 N/A or ❑ No discharge this period'
Outfall No.
Date Sample
Collected, mo/dd/yr
TSs, V
m L
pH,
Standard units
CAD,
m L .
Oil and Grease,
m L
Feral Coliform,
Colonies per 100 ml
Enterococci,
Colonies per 100 ml
Benchmark
-
100 or So'
Wkhin 6A-9.0
120
30
1o001
5001
Parameter Code
-
COS30
004M
00340
DUSS6
31616
61211
02
Unable to obtain a
representative
sample
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.
4See 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 *no (if ves, complete Part B)
Permit Date: 11/1/2018.05/31/2021
SWU-249, Last Revised 11/5/2018
Page 1 of 2

Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaeine > 55 gal of new motor oil/month
Outfall No.
Date Sample Collected
(mo/dd/yr)
24-hour rainfall amount,
Inches=
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/Total
Petroleum Hydrocarbons
Total Suspended solids
Benchmarks
- -
-
15 mg/L
IM mg/L or So mg/N
parameter Code
-
46529
NCOIL
00552
CO530
Footnotes Trom 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 ANYONE OUTFALL? YES Q NO ❑
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE? YES Q NO ❑
REGIONAL OFFICE CONTACT NAME: James Moore
Mail an original cony of this DMR indudina all "No Discharge" reports within 30 days of receipt of the lob results for 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
imprisonrngpt for knowing violations."
of Permittee
Permit Date: 11/1/2018-05/31/2021
/4 z n
Date
SWU-249, Last Revised 11/5/2018
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