NCG060384_2021 DMR_20210312

NCDEQ Division of Energy, Mineral and Land Resources
5tormwater 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: Guilford 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?
es
®No
If so, which Tier
(I, II, or III)?
N/A
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks In (Red)
Parameter
Code
Parameter
Outfall 001
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
WS-Iv
N/A
Date Sample Collected MM/DD/YYYY
02/26/2021
46529
24-Hour Rainfall in inches
0,83
00556
Oil & Grease in mg/L (30)
No Detect
C0530
TSSin mg/L(100 or50*)
42.8
00400
pH in standard units (6.0-9,0)
8.51
31616
Fecal Coliform per 100 ml of
freshwater (1000)
N/A
61211
Enterococci per 100 ml of saltwater
(500)
N/A
00340
Chemical Oxygen Demand in mg/L
No Detect
(120)
arc o: vemcie ar equipment maintenance Areas — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
00552
Non -Polar Oil & Grease in mg/L (15)
NCOIL
New Motor/Hydraulic Oil Usage in
gal/month
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HOW), 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
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
or Delegated Authorized Individual
3 /2 2az(
Date