NCG060384_2020 DMR_20210204

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report DMR Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG06 03 4 Person Collecting Samples: Tara Early
Facility Name: Mondelez Global, LLC - Greensboro Laboratory Name: Pace Analytical
Facility County: Guliford I Laboratory Cert. No.: 37706
Discharge during this period: X❑ Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? ❑ Yes ® No
If sa, which Tier (I, II, or 111)? N/A
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
Outfall 001
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
WS-Iv
N/A
Date Sample Collected MM/DD/YYYY
12/20/2020
46529
24-Hour Rainfall in inches
0.18
00556
Oil & Grease in mg/L (30)
No Detect
C0530
TSS in mg/L (100 or 50*)
56.0
00400
pH in standard units (6.0-9.0)
8.76
Fecal Coliform per 100 ml of
31616
freshwater(1000)
N/ A
Enterococci per 100 ml of saltwater
61211
(500)
N/A
00340
Chemical Oxygen Demand in mg/L
27 9
(120)
Part B. Vehicle & Equipment Maintenance Areas— Benchmarks in (Red)
Parameter
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
00552
Non -Polar Oil & Grease in mg/L (15)
New Motor/Hydraulic Oil Usage in
NCOIL
gal/month
* Outralls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L.
Notes (optional):
"I certify by my signature below, under penalty of law, that this document and all attachments were prepared under my direction or
supervi ' n 'n accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submi ed. on m inquiry of the person or persons who manage the system, or those persons directly responsible for
gathe i he 'nformation the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aw a that the a are signifi ant penalties for submitting false information, including the possibility of fines an�1 impgisonment for
owi violati ni / I
-3 -Zo z !
Signature o ermitt e r Delegated Authorized Individual Date