HomeMy WebLinkAboutNCG060020_MONITORING INFO_20190219STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V 0 b1z
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ � 0 (�"/�
YYYYMMDD
0
Tyson
February 10, 2020
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 FEB 9 2�19
"Dyson Farms, Inc. - Wilkesboro Complex
COC NCG060020 C�� T `tiL F
Wilkes County ply IL
Dear Madam or Sir:
Enclosed are two copies of the required storm water sampling results.
For the outfalls Covered under the above subject permit and certilicate of coverage.
Tyson Farms, Inc. Monthly Storm water monitoring. Data receive for PRISM labs indicated Wilk — 01
fecal parameters was below the benchmark.
Monthly (analytical and qualitative monitoring) will continue for this parameter until three
consecutive sample results are below the benchmark values or within benchmark range.
Wilk-Ol has achieved three consecutive sample results that are below the benchmark value.
"Tyson Foods, Inc. has made signii icant improvements to reduce the concentrations of the parameter of
concern.
Please contact me at 336- 651- 2871 should you have any questions.
Sincerely,
Kevin Ta lor�
Complex Manager
Tyson Farms Inc. Fresh Retail Division 704 Factory Wilkesboro, N.C. 28697
336-651-3836 336.838.2171 Fax:33.651.3867 www.tysonfoods.com
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
For North Carolina Division of Water Qualitv General Permit No. NCG060000
CERTIFICATE OF COVERAGE NO. NCG060020
FACILITY NAME Tyson Farms Inc.
Wilkesboro Complex
COUNTY Wilkes
PERSON COLLECTING SAMPLES James Brown
LABORATORY Prism Labs Lab Cert. # 402
Part A: Storm water Benchmarks and Monitoring Results
Date submitted: February 10, 2020
SAMPLE COLLECTION YEAR 2020
FACILITY ACTIVITIES INCLUDE (check all that apply):
® use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? EYES ®NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 21.50 or ❑ No discharge this period'
Outfall No.
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
Enterococcii,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
Soo
WILK - 01
1/24/2020
20
NA
NA
NA
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 outfalis. You must still submit this dischar�foring report with a checkmark here.
'See General Permit text,Table 3 identifying the especially sensitive receiving water classiti t o& 2.�p'e the more protective benchmark applies.
r7 r. �.
Did this facility perform Vehicle Maintenance Activities using more than 55�gallans.of ne%W,motor oil per month? ® Yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
(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
100 or 504
6.0 — 9.0
-
' Only applies to facilities that use/process meats.
2The 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.
SWU-249 Last Revised: October 18, 2012
Page 1 of 2
4See General Permit text table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
*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 ❑
REGIONAL OFFICE CONTACT NAME:
Moil an on inal and one copy of this DMR including of "No Discharge" reports, within 30 days of receipt of the lob results or at end o
monitoring period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
IL 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)
;?//a a 0,wo
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/`wq/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit. http://portalmcdennorg/web/wq/ws/su./npdessw#ta -4
Permit No: N/C/G/0/6/0/0/0/0 or Certificate of Coverage No. NIC/G/0/6/0/0/2/0
Facility Name: Tyson Farms Inc.
County: Wilkes
Phone No: 336.838.2171
Inspector: lames Brown
Date of Inspection: 1/24/2020
Time of Inspection: QG� 00
Total Event Precipitation (inches): 1.50
Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
2 Yes ❑ No
PIease 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 t0 consecutive hours of no
precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall.
3' 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, l certify that this report is accurate and complete to the best of my knowledge:
tSignature of Permittee or
Pagel 42
SWU-242, Last modified 10/25/2012
1. Outfall Description:
Outfall No. i, , Structure (pipe, ditch, etc.)
Receiving Stream: �� C' h� +� L4k
Describe the industrial activities that occur within the outfall drainage area: LNtt �P-IwL Rriw
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): rR b nc_
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and
5 is very cloudy:
13 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:
0 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:
1 Q 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 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
Wilkesboro Storm Water Calu. Sheet
Date 01 /24/2020
Rain Begin: 8:00 AM
Run off started 8:45 AM
Grab Samples: 9:00 AM
Rain at end of
Storm Event: 1.50
Sampling Point # Wilk -01 Drainage Area = 140,800 Ft 2
Q = CIA
1 = 1.50 " (Total)
C = 1.0
Q = 1.0(1.50112)(140,800-7.5)11,000,000
0.132 MG
Waypoint.
ANALYTICAL
Tyson Farms, Inc. -Wilkesboro, NC
James Brown
704 Factory Street
Wilkesboro, NC 28697
NC Certification No. 402
NC Drinking Water Cert No. 37735
SC Certification No. 99012
Project: Stormwater
Lab Submittal Date: 01/24/2020
Work Order: 0010379
Case Narrative
217120 13:30
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.
Narrative Notes:
Sample analyzed outside the hold time as instructed by the client.
Please call if you have any questions relating to this analytical report.
Respectfully,
WAYPOINT ANALYTICAL
Terri W. Cole
Project Manager
Data Qualifiers Key Reference:
Reviewed By Terri W. Cole
Project Manager
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 Waypoint Analytical,
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: 7041529-6364 -Toll Free Number: 1-8001529-6364 - Fax: 704/525-0409 Page 1 of 4
0 @
Waypoint.
ANALYTICAL
Sample Receipt Summary
02/07/2020
Work Order: 0010379
Client Sample ID Lab Sample ID Matrix DatelTime Sampled Date/Time Received
SW Wilk-01
0010379-01 Water 01/24/20 9:00 01/24/20 12:00
Samples were received in good condition at 2.9 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 26224-0543
Phone: 704/529-6364 - Toll Free Number: 1-800/52"364 - Fax: 704)525-0409 Page 2 of 4
WayIV @
point_
ANALYTICAL
Tyson Farms, Inc. -Wilkesboro, NC
Attn: James Brown
704 Factory Street
Wilkesboro, NC 28697
Project: Stormwater
Sample Matrix: Water
Laboratory Report
02/07/2020
Client Sample ID: SW Wilk-01
Sample ID: 0010379-01
Work Order: 0010379
Time Collected: 01/24/20 09:00
Time Submitted: 01/24/20 12:00
Parameter Result Units Report MDL Dilution Method Analysis Analyst Batch
Limit Factor Date/Time ID
Microbiological Parameters
Fecal Coliforms BRL CFU1100 ml 20 10 'SM9222 D 1127/20 15:31 BMS POA0479
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 Springb rook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: 7041529.6364 - Toll Free Number: 1-8001529-6364 - Fax: 7041525-0409
Page 3 of 4
-11", 9 IS M 1 Full -Service Analytical sr J I Environmental Solutions
t4 10 9 RATORIES INC
449 Springbrook Road • Chariotte, NC 26217
Phone 704152E-6364 • Fax: 7041525.0409
Client Company Name: �OLM9s D4-OWiIN
Report To/Contact Name:—IS24 �Pxc�CC Tca+
Reporting Address: At szQ %Lqq_
CHAIN OF CUSTODY RECORD
PAGE_ OF _ QUOTE A TO ENSURE PROPER BILLING:
Project Name:
Snort Hold Analysis: (Yes) (No) UST Project: (Yes) (NO)
'Please ATTACH any project specific reporting (QC LEVEL 1 11 III IV)
provisions andlor QC Requirements
invoice To -
Address:
YES NO NIA
Samples INTACT upon arrival?
ReceivedbN WET ICE?
O
PROPER PRESERVATIVES indicated?
Received WITHIN HOLDING TIMES?
CUSTODY SEALS INTACT?
CL
VOLATILES rac'd W/OUT HEADSPACE?
PROPER CONTAINERS used?
TEMP: Therm ED:�Y_I v1 Observed:
3C ! Carr.
"C
Phone: 6 Ne_L05 I,?)ax (Yes) (No): Purchase Order No./Billing Reference
Email Address: rr - Cely., Requested Due Date Q t Day ❑ 2 Days ❑ 3 Days 114 Days ❑ 5 Days
EDD Type: PDFLExcel! Of r "Working Days" ❑ 6-9 Days ❑ Standard 10 days ❑ Rush Must Be
Site Location Name: Sbl1 f115 hC� Samples received after 14:00 will be processed next business day.
TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL
Certification: NELAC DOD FL NC
SC OTHER N/A
Site Location Physical Address' DLi ALACT C c} Turnaround time is based on business days, excluding weekends and holidays.
(SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES
RENDERED BY PRISM LABORATORIES, INC. TO CLIENT)
Water Chlorinated, YES_ NO
Sample Iced Upon Collection: YES NO
CLIENTDATE
SAMPLE DESCESCRIPTION
CDLLECTED
TIME
COLLECTED
MILITARY
HOURS
MATRIX
(SOIL,
WATER DR
SLUDGE)
SAMPLE CONTAINER
PRTIVES •
T1VES
ANALYSIS REQUESTED
f
/ REMARKS
RISM
PLAB
ID NO.
•TYPE
SEE BELOW
NO
SIZE
30
(yvbp
t oAt°
�tti0
�ly,. s_
�cc
D
1
lI
l
I
Sampler's Signature I Y Sampled By (Print Name) LLV rk Affiliation l �SQjt
Upon relinquishing, this gin 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 be charges for any changes after analyses have been initialized.
eAtrival Time:
Rol[rmulshed By: ( tear) Received By: (Signature) Date Mi5UUyM0= Additional Comments; 2t.
7
RekNu ed ByJSlgnatur Recem3d By. (Signature) Date - Departure Time:
/,I // 1A
eknquisned Sy: (Signature) For Prom Labvatones By: Date Field Tech Fee:
Melw at shipment: NOTE: ALL SAMPLE COOLERS SHOULD BE TAPED SHUT WITH CUSTODY SEALS FOR TRANSP TATION TO THE LAB RY. Group No
SAMPLESARE NOT ACCEPTED AND VERIFIED AGAINST CDC UNTIL RECEIVED AT THE LABO TORY.
�
Q Fed Ex Cl UPS 0 Hand -delivered O Prism Field Service ❑ Olhar__ -7 D
USTWATER: DRINKING WATER: D WASTE:r
C�CJ
SCIfLANDFILL
oil ❑NC ❑❑NC ❑NC CI C ❑aNC❑ C a ❑ SC ❑ NC ❑O ❑ NC ❑ SC
5CI ❑SC
❑ ❑ ❑
"CONTAINER 'TYPE CODES: A = Amber C = Clear G= Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Read Space) ORIGINAL
0
Tyson
February 10, 2020
North Carolina Department of Lnvironment, Health and Natural RCSOIII'CCS
Division oMater Quality
nun: DWQ Central Flies
1617 Mail Service Center
Raleigh. NC 27699-1617
Subject: General Permit No. NCG060000
"Tyson I arms, Inc, - Wilkesboro Complex
COC NCG060020
Wilkes County
Dear Madam or Sir:
1;11ClosCd are two copies of the required storm Water sampling results.
For the ontfalls COVCI'Cd under the above subject permit and certtlicate of coverage.
Tysoo Farms, lnc. Monthly Storm writer monitoring, Data receive for PRISM labs indicated Wilk — 01
fecal parameters was below the benchmark.
Monthly (analytical and qualitative monitoring) will continue for this parameter until three
COnSCCCItIVC SamPIC I'CSttlts are below the benchmark values or within benchmark range.
Wilk-01 has achieved three consecutive sample I'esults that arc below the benchmark value.
Tyson I=oods, 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.
Sincere ly,
Kevin Taylor",
Complex Manager
Tyson Farms Inc. Fresh Retail Division 704 Factory Wilkesboro, N.C. 28697
336-651-3836 336.838.2171 Fax: 13.651.3867 m,�w tyson foods. com
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
For North Carolina_ Division of Water Quality General Permit No. NCG060000
Date submitted: February 10. 2020
CERTIFICATE OF COVERAGE NO. 1tCC0600�0
FACILITY NAME Tvson Farms inc.
Wi!kesboro Com.ple>
COUNTY Wilkes
PERSON COLLECTING SAMPLES jarnes Brown
LABORATORY P6sim Labs Lab Cert. # 402
Part A: Storm water Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2020
FACILITY ACTIVITIES INCLUDE (check all that apply):
Ill-] use/process meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? ❑YES ❑X NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z ?. or ❑ No discharge this period3
Outfall No.
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
Enterococcil,
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
S00
WILL - 01
1/24/2020
20
NA
NA
NA
' 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 ❑ no
Part 6: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
(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
1s
100 or 504
6.0 -- 9.0
-
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.
SWU-249 Last Revised: October 18, 2012
Page 1 of 2
4See General Permit text table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
*FOR PARS" A AND PART B MONITORING RESULTS:
• A BEN,.;IMARK EXCEEDANCE TRIGGERS TIER 1REQUIREMENTS. SE! PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER TIER 2 REQUIREMENTS. SEE PERMIT FART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑C
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "'No Discharge" reports, within 30 days of receiet of the lob results for at end of
monitoring period in the case of "No Dischar e" 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)
�1
/7 �.
(Date)
Additional copies of this form may be downloaded at: httD://portal.ncdenr.org/web/wq/ws/su/nodessw#tab-4
SWU-249
Last Revised: October IS., 2012
I'atie 2 of 2
MCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
borguidance on filling nut this form, please visit: httl�: jf hortal,ncdenr.<it'f;/web wtljws/sujnp(�eSswtC� �E)-mil_
Permit No: N_/!:/{;/(a/ ,/{}�{}/{}�{}_or Certificate of Coverage No. NICIC.r10161ILT, :; i{}
facility Name: Tysnn_i�:r_l_in� Iiic. T
County: W_ilkcs.
Phone No::i:�Fi.Si;3fi2"i.%.
Inspector:
Date of Inspection: 1 /1.4 /2020
Time of inspection: GG1- (: o
'total Event Precipitation (inches): 1.50
Was this a "]representative Storm Event" or "Measureable Storm Event" as defined by the permit?
(See information below.)
0 Yes ❑ No
Please verify whethei-Qualitative Monitoring must be petlorined during a "representativestor-in
event"or "measur•eablestorrrr event"(requirements vary, depending on the pet-mit).
Qualitative monitoring re(}uirements vary. Most permits require qualitative monitoring to he performed during a
"re1)resentat.ive storm event" or during a "in easureable storm event." However, sortie permits cla 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
preci pitation.
i
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 ahle to document that a shorter interval is
i representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ
Regional Office.
liy this signature, 1 certily that this report is accurate and complete to the best of my Knowledge:
(Signature of Permittee or Des
Page 1 of 2
CV✓II-247..Lnci mn,lifiied I0/2S12012
1. Outfall Description:
Outfall No. '-11K` cl Structure (pipe, ditch, etc.)
ReceivingStreain: CLV K "Al 'r.- ti "A C"
Describe the industrial activities that occur within the outfall drainage area: l_'."i-f- �c.LAi_ }Lr(-w
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _ Slrl
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): f\ G
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and
5 is very cloudy:
1 3 4 S
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:
j1. 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:
1 C2' 3 4 5
7. Is there any foam in the stormwater discharge? Yes /l�o
i
B. Is there an oil sheen in the stormwater discharge? Yes 9
9. Is there evidence of erosion or deposition at the outfall? Yes '
10. Other Obvious Indicators of Stormwater Pollution: L�
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
Wilkesboro Storm Water Calu. Sheet
Date 01 /24/2020
Rain Begin: 8:00 AM
Run off started 8:45 AM
Grab Samples: 9:00 AM
Rain at end of
Storm Event: 1.50
Sampling Point # Wilk -01 Drainage Area = 140,800 Ft 2
Q = CIA
1 = 1.50 " (Total)
C = 1.0
Q = 1.0(1.50112)(140,800"7.5)11,000,000
0.132 MG
a
Waypoint
Tyson Farms, Inc. -Wilkesboro, NC
James Brown
704 Factory Street
Wilkesboro, NC 28697
NC Certification No. 402
NC Drinking Water Cert No. 37735
SC Certification No. 99012
Project: Stormwater
Lab Submittal Date: 01/24/2020
Work Order: 0010379
Case Narrative
217120 13:30
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 conditlon 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.
Narrative Notes:
Sample analyzed outside the hold time as instructed by the client.
Please call if you have any questions relating to this analytical report.
Respectfully,
WAYPOiNT ANALYTICAL
Terri W. Cole
Project Manager
Data Qualifiers Key Reference:
Reviewed By Terri W. Cole
Project Manager
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 Waypoint Analytical.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: 7041529.6364 -Toll Free Number: 1-8001529.6364 - Fax: 7041525.0409 Page 1 Of 4
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ANAINTICAL
Sample Receipt Summary
02/07/2020
Work Order: 0010379
Client Sample ID Lab Sample ID Matrix Date/Time Sampled Date/Time Received
SW Wilk-01 0010379-01 Water 01/24/20 9:00 01/24/20 12:00
Samples were received in goad condition at 2.9 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analyticai.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: 7041529.6364 - Toll Free Number: 1-800/529-6364 - Fax: 7041525.0409 Page 2 0f 4
A
ANALYTICAL
Tyson Farms, Inc. -Wilkesboro, NC
Attn: James Brown
704 Factory Street
Wilkesboro, INC 28697
Project: Stormwater
Sample Matrix: Water
Laboratory Report
02/07/2021)
Client Sample ID: SW Wilk-01
Sample ID:0010379-01
Work Order: 0010379
Time Collected: 01/24/20 09:00
Time Submitted: 01/24/20 12:00
Parameter Result Units Report MDL Dilution Method Analysis Anaiyst Batch
Limit Factor DatelTime ID
Microbiological Parameters
Fecal Coliforms BRL CFUi100 ml 20 10 SM9222 D 1127120 15:31 BMS POA0479
This report should not be reproduced, except in its entirety, without the written consent of Waypoint Analytical.
449 5pringbrook Road - P.O. Box 240543 - Charlotte, NC 28224.0543
Phone: 7041529.6364 - Toil Free Number: 1.8001529.6364 - Fax: 7041525-0409 Page 3 of 4
CHAON OF CUSTODY RECORD
f I` Full-Seiv-ice Analytical &
P R M r Environmental So:utions PAGE_ OF _ QUOTE A TO ENSURE PROPER BILLING:
449 Sp:inybrook Road • Charlotte, NC 28217 Project Name:
Phone 7041529-6354 Fax: 7ea)'525-e409 Short Hold Analysis: (Yes) (No) UST Project: (Yes) (NO)
`Please ATTACH any project specific reporting (QC LEVEL 1 Il 111 IV)
Client Company Name: �(A h,_Ne5
provisions andlor QC Requirements
Report To/Contact Name" QLA _ riC4-rt=41 Aica,f Invoice To:
Reporting Address: \X _la]7t L T , �L C `'Si: Ci'J
Address:
N/A
Phone:3 � _4p 5 t.ax (Yes) (No): Purchase Order No./Billing Reference TO BE FILLED IN BY CLIENTISAMPLING PERSONNEL
Email Address:_ CcIt" Requested Due Date ❑ 1 Day ❑ 2 Days ❑ 3 Days ❑ 4 Days ❑ 5 Days Certification: NELAC DOD FL NC
EDD Type: PDF - Excel Othgr "Working Days" ❑ 6-9 Days ❑ Standard 10 days ❑ Rush
re Work Must Be Approved SC OTHER NSA
Site Location Na1T1e: SCI l tAC nL5 L �lC Samples received after 14:00 will be processed next business day.
Site Location Physical Address: 0LA Tumaround time is based on business days, excluding weekends and holidays. Water Chlorinated: YES_ NO
(SEE REVERSE FOR TERMS & CONDITIONS REGARDING SERVICES
RENDERED BY PRISM LABORATORIES, INC. TO CLIENT) Sample Iced Upon Collection: YES_ NO_
112111111
TIME
MATRIX SAMPLE CONTAINER
J ANALYSIS REQUESTED
PRISM
CLIENT DATE COLLECTED
SAMPLE DESCRIPTION I COLLECTED MILITARY
I
(SOIL,
I I
I WATER OR *TYPE
PRESERVA-
T1VE5
REMARKS
LASSIZE
i l HOURS
! SLUDGEj 1 SEE BELOW I NO. l
I
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ID NO.
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Sampler's Signature !]iYn�C;� � Lt,�t>''- Sampled By (Print Name) J_A /)� r;'r����"riW/\ Affiliation l �SQn
Upon relinquishing, this 6Aain 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 be charges for any changes after analyses have been initialized.
Additional Comments:
xewz;utshed by: isgmtum) 'ieVer+ed ra PrGm Labornnnes By. / Data
:terra^ a Sh pu=:: NOTE: ALL SAMPLE COOLERS SHOULD Sw t'EU SHUT WITH CUSTODY SEALS FOR TRANSPORTATION TQ THE LABCqAMRY. CL i_ �i wp yo
SAMPLES ARE NOT ACCEPTED AND VERWIEb AGAINST COC UNTIL RECEIVED AT THE LABORATORY,
CI Fed Ex 0 UPS Q Hanedeliv ed ❑ Prism Field Service 1Z
NPDES: r UST: t GROUNDWATER: i DRINKING WATER: SOLID WASTE: RC RA: I CEPLA LANDFILL OTHER:
*NC0SC�❑NC ❑SC � 0NC ❑SC � ❑NC CiSC I ❑NC 0SC I ❑NC❑SC1 UNC ❑SC ❑NC QSCI ❑NC ❑SC
❑ ❑— ❑ l7 El ❑ L7 ❑_ — ❑
'CONTAINER TYPE CODES: A = Amber C = Clear G= Glass P = Plastic; TL = Teflon -Lined Cap VOA = Volatile Organics Analysis (Zero Head Space)
Site Arrival Time:
Site Departure Time:
,Field Tech Fee:
Mileage: —
ORIGINAL