NCG060382_MRO Copy MONITORING REPORT_20201231

NCDEQ Division of Energy, Mineral and Land Resources ;
Stormwater Discharge Monitoring Report (DMR) Form for NCGO60000 � 9
Food and Kindred �®
Click here for instructions
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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 0 3 8 2
Facility Name: Mountaire Farms Inc. - Statesville Breeder Feed Mill
Facility County: Iredell
Discharge during this period: A Yes ❑ No (if no, skip to
Person Collecting Samples: John Jacobs
Laboratory Name: Statesville Analytical
Laboratory Cert. No.: 440
and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? QQ Yes ❑ No
If so, which Tier (I, II, or III)? III
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Radt
Parameter
Code
Parameter
utfa1102
T
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
11/29/2020
46529
24-Hour Rainfall in inches
>1
00556
Oil & Grease in mg/L (30)
<8.85
C0530
TSS in mg/L (100 or 50*)
59.54
00400
pH in standard units (6.0 — 9.0)
7.08
31616
Fecal Coliform per 100 ml of
freshwater (1000)
61211
Enterococci per 100 ml of saltwater
(500)
Chemical Oxygen Demand in mg/L
00340
(120)
58
rat L a; vemcie of 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)
i
NCOIL
New Motor/Hydraulic Oil Usage in
gal/month
* Outfalls 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
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 or Delegated Authorized Individual
t-`� v
Date