NCG060182_MRO Copy MONITORING REPORT_20210526

Submission Completed
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NOh I CAROLINA
E-Im W.1(2 liry
Stormwater NPDES Permit Data Monitoring
Report (DMR) Upload
Permit and Facility Information:
a
boo eSiQ
R y <
Please enter the permit number and other details for this upload O
IMPORTANT. Until the eDMR system is implemented for DEMLR Stormwater Program
permits, an original signed hardcopy of the DMR MUST be mailed to the address in your
permit, in addition to this electronic upload.
Fields marked with a red asterisk* are required.
Permit Number* Enter COC or Individual Permit Number (NOT General Permit number with all O's)
NCG060182
Must begin with NCS or NCG
Facility Name:* Pllgrim's Pride Corporation - Marshville Processing Plant
County: * Union
After uploading here, the original signed hardcopy must be mailed to:
DEQ Mooresville Regional Office
Attn: DEMLR Stormwater Program
610 East Center Avenue
Suite 301
Mooresville, NC 28115
Further contact details at https:Hdeq.nc.gov/contact/regional-
offices/mooresville
Monitoring Period Information:
Monitoring Period What is the YEAR of the sample date(s)?
Year:* 2021
Multiple DMRs from sampling periods within the same year can be uploaded together, but please
upload different years with a new submittal form.
https:Hedoes.deq.nc.gov/Forms/Form/showformsubmissionl400e490f-42ca-43b3-85b2-77... 5/24/2021

Submission Completed
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Also, copies of the lab results and qualitative (visual) monitoring should NOT be submitted
unless specifically requested by DEQ staff. Only upload the completed and signed DMR forms.
DMR Upload* Click the upload button or drag and drop files here to attach document.
Signed May 2021 SW DMR.pdf 180.04KB
Only PDFs are accepted.
Comments: For your review and approval!
* ® By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this Data Monitoring Report (DMR) upload form is a "transaction" subject
to Chapter 66, Article 40 of the NC General Statutes (the "Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the
NC General Statutes (the "Uniform Electronic Transactions Act");
• I understand that an electronic signature on this upload form has the same legal effect and can be
enforced in the same way as a written signature; AND
• I intend to electronically sign and submit this DMR upload form.
Full Name:* Yin-Pong George Chang, P. E.
Name of person submitting this form
Email Address: * [e-mail]
Phone Number: * [phone]
Signature: *
Date: * 05/24/2021
https:Hedocs.deq.nc.gov/Forms/Form/showformsubmissionl400e490f-42ca-43 b3-85b2-77... 5/24/2021

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000 °"doaFti , !�
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 4hin
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 1 8 2 Person Collecting Samples: Yin-Pong George CHANG, P. E.
Facility Name: Pilgrim's Pride Corporation, Marshville Processing Plant Laboratory Name: Environmental Chemists, Inc.
Facility County: Union Laboratory Cert, No.: 94
Discharge during this period: U Yes U No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? ❑■ Yes ❑ No
If so, which Tier (I, II, or III)? III
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Code
Parameter
Outfall #1
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
Salem Creek
N/A
Date Sample Collected MM/DD/YYYY
05/03/2021
46529
24-Hour Rainfall in inches
0.3
00556
Oil & Grease in mg/L (30)
< 5.0
C0530
TSS in mg/L (100 or 50*)
90.0
00400
pH in standard units (6.0 — 9.0)
6.7
31616
Fecal Coliform per 100 ml of
21 000
freshwater (1000)
61211
Enterococci per 100 ml of saltwater
(500)
00340
Chemical Oxygen Demand in mg/L
226
(120)
Part B: Vehicle & 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)
New Motor/Hydraulic Oil Usage in
NCOIL
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
5-jy-,�2 a
Date

envirochem
(SM)
ANALYTICAL & CONSULTING CHEMISTS
Pilgrim's Pride-Marshville
5901 West Marshville Blvd.
Marshville NC 28103
Attention:
Lab ID Sample ID:
21-17353 Site: Ouffall #1
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
[e-mail]
Test Method
Oil & Grease (O&G) EPA 1664
Residue Suspended (TSS) SM 2540 D
pH SM 4500 H B
Estimated, outside of 15 minute hold time.
COD
Fecal Coliform
Comment:
Reviewed by:
SM 5220D
SM 9222D MF
Date of Report: May 12, 2021
Customer PO M
Customer ID: 17040005
Report M 2021-06998
Project ID: Marshville Storm Water
Collect Date/Time Matrix Sampled by
5/3/2021 10:30 AM Water Yin-Pong Chang
Results Date Analyzed
<5.0 mg/L
05/03/2021
90.0 mg/L
05/04/2021
6.7 units
05/05/2021
226mg/L 05/11/2021
21000 Colonies/100mL 05/03/2021
Report #., 2021-06998 Page 1 of 1

row"W7
enviroc lem
ANALYTICAL & CONSULTING CHEMISTS
LCS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
[e-mail]
Pilgrim's QC - 2021-06998
Parameter
True Value
mg/L
Result
mg/L
% True Value
Limits
COD
1000
970
97
90- l 10
Fecal
N/A
N/A
N/A
N/A
TSS
92.5
93.0
100
82.4-1 18
PH
10.0
9.95
100
90-1 10
OIL & GREASE
40.0
39.2
98
78-1 14
MS/MSD
Parameter
True Value
mg/L
Recovery
mg/L
I %Recovery
%
Difference
Limits %
Recovery
Limits
Difference
COD
50.0
52/53
104/106
2
80-120
< 20
Fecal
N/A
N/A
N/A
N/A
N/A
N/A
TSS
N/A
N/A
N/A
N/A
N/A
N/A
pH
N/A
N/A
N/A
N/A
N/A
N/A
OIL & GREASE
40.0
35.0
88
N/A
78-1 14
< 18
DUPLICATE SAMPLES
Parameter
Results
Resesuu
% Difference
Limits
COD
N/A
N/A
N/A
< 10
Fecal
18000
16000
12
< 30
TSS
350.0
360.0
3
< 10
pH
N/A
N/A
N/A
< 10
OIL & GREASE
N/A
N/A
N/A
N/A

LirochenvI.,e
ANALYTICAL 8 CONSULTING CHEMISTS
BLANK
Envirronmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
[e-mail]
Parameter
Results
mg/L
Limit
mg/L
COD
<10
10
Fecal (Start Control)
0
0
TSS
<2.5
2.5
pH
N/A
N/A
OIL & GREASE
<2.5
2.5

Environmental Chemist, Inc., Wilmington, NC Lab #94 6602 Windmill Way
Wilmington, NC 28405
910.392,0223
Sample Receipt Checklist
Client: 1 1"1 (}�
q
5 I Date: �J 21 Report Number: 2l J��
Client Delivery ❑ UPS ❑ FedEx ❑ Other ❑
Wnq
custody seals present on the cooler?
XNP�tTtocly
seals were present, were they intact/unbroken?
erature upon recCorrected temperature upon receipt °C
How temperature taken: ❑ Temperature Blank Against Bottles
G IR,un ID: Thomas Traceable S/N 192511657 IR Gun Correction Factor °C: 0.0
YES ❑ NO
3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
YES ❑ NO
4. Were proper custody procedures (relinquished/received) followed?
YES ❑ NO
5. Were sample ID's listed on the COC?
YES ❑ NO
6. Were samples ID's listed on sample containers?
YES ❑ NO
7. Were collection date and time listed on the COC?
YES ❑ NO
8. Were tests to be performed listed on the COC?
YES ❑ NO
9. Did samples arrive in proper containers for each test?
YES ❑ NO
10. Did samples arrive in good condition for each test?
YES ❑ NO
11. Was adequate sample volume available?'
YES ❑ NO
12. Were samples received within proper holding time for requested tests?
YES ❑ NO
13. Were acid preserved samples received at a pH of <2?
❑ YES ❑ NO
14. Were cyanide samples received at a pH >12?
❑ YES ❑ NO
15. Were sulfide samples received at a pH >9?
YES ❑ NO
16. Were NH3/TKN/Phenol received at a chlorine residual of <0,5 m/L? **
❑ YES ❑ NO
17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑ YES ❑ NO
18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Samples) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): H2SO4 HNO3 HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples. Obtain a new sample or
notify the state lab if directed to analyzed by the customer, Who was notified, date and time:
Volatiles Samples) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1

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