NCG060182_2021 DMR_20210617

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 Monitor ng 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
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: ❑■ Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? 0 Yes ❑ No
If so, which Tier (1, Il, or Ill)? 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
06/02/2021
46529
24-Hour Rainfall in inches
0.2
00556
Oil & Grease in mg/L (10)
75.4
C0530
TSS in mg/L (100 or 50*)
1290
00400
pH in standard units (6.0-9.0)
6.2
31616
Fecal Coliform per 100 ml of
3000
freshwater (1000)
Enterococci per 100 ml of saltwater
61211
(500)
00340
Chemical Oxygen Demand in mg/L
1410
(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 (1SI
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): -71
"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 Del ated Authorized Individual Date

Lenvirochem
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab 1. 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 Pride-Marshville Date of Report: Jun 10, 2021
5901 West Marshville Blvd. Customer PO #:
Marshville NC 28103 Customer 1D: 17040005
Attention: Report #: 2021-08887
Project ID: Marshville Storm Water
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-22104 Site: Outfall #1
602021 12:30 PM Water George Chang
Test Method Results Date Analyzed
Oil & Grease (O&G)
EPA 1664
Residue Suspended (TSS) SM 2540 D
pal SM 4500 H B
Result estimated. Analyzed out of 15 minutes hold time.
COD
Fecal Coliform
Comment:
Reviewed by:
SM 52200
SM 92220 MF
75.4 mg/L
1290 mg1L
6.2 units
06/03/2021
06/03/2021
06/04/2021
1410 mg/L 06/03/2021
3000 Colonies1100ml- 06/02/2021
Report V 2021.08887 Page 1 of 1

---71
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
ksm 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Pilgrim's QC - 2021-08887
LCS
Parameter
True Value
Result
% True Value Limits
m IL
m /L
%
COD
1000
968
97 90-1 10
Fecal
NA
N'A
N.-A NA
TSS
92.5
92.0
99 82.4-1 18
pH
10.0
9.97
too 90-1 10
OIL & GREASE
40.0
31.2
178
78-1 14
MS/MSD
Parameter
True Value Recovery
% Recovery
%
Limits % Limits %
mg :'L
mg/L
Difference Recovery Di erence
COD
50.0
54,53
108.']06
2
80-120 520
Fecal
NIA
N+A
N!A
NA
N A NeA
TSS
NrA
NA
N.--A
NiA
N'A NA
pH
N?A
NSA
N. A
NA
N A NIA
OIL & GREASE
40.0
31.3
78
NA
78-1 14 < 18
DUPLICATE SAMPLES
Results
Parameter
% Difference
Limits %
mg.'L
COD
N. A
WA
NA
< 10
Fecal
<2
<2
0
< 30
TSS
190.0
202.0
6
< 10
pH
N+A
NA
NiA
< 1 Q
OIL & GREASE
<5.0 7
<5.0
0
< 10

:envirochem']n
ANALYTICAL & CONSULTING CHEMISTS
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]
FLANK
Parameter
Results
Limit
mg1L
mg,L
COD
<10
10
Fecal (Start Control)
0
0
TS S
<2.5
2.5
PH
N-'A
N'A
OIL & GREASE
<2.5
2.5

Environmental Chemist, Inc., Wilmington, NC Lab #94
Sample Receipt Checklist
6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Client: f' / y -iry 7S I ri �e Date: p tZ 2� 7-11 '?� �
ReportNumber:
Receipt of sample: ECHEM Pickup Client Delivery ❑ uPS ❑ FedEx ❑ Other ❑
❑ YES ❑ NO N/A 11. Were custody seals present on the cooler?
❑ YES 10 NO A N/A 12. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt D °C Corrected temperature upon receipt
How temperature taken: ❑ Temperature Blank Against Bottles
IR Gun 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?
Ur YES ❑ NO 5 Were sample ID's listed on the COC?
YES
❑
NO
YES
❑
NO
YES
❑
NO
YES
❑
NO
YES
❑
NO
YES
I0
NO
YES i ❑ NO
,V�
YES
❑
NO
❑
YES
❑
NO
❑
YES
❑
NO
❑
YES
❑
NO
❑
YES
10
NO
❑
YES
I
❑
NO
6. Were samples ID's listed on sample containers?
7. Were collection date and time listed on the COC?
8. Were tests to be performed listed on the COC?
9. Did samples arrive in proper containers for each test?
10. Did samples arrive in good condition for each test?
11. Was adequate sample volume available?'
12. Were samples received within proper holding time for requested tests?
13. Were acid preserved samples received at a pH of <2?
14. Were cyanide samples received at a pH >12?
15. Were sulfide samples received at a pH >9?
16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? **
17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
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:
Sample(s)
by adding (circle one):
of
(Must be completed for any sample(s) incorrectly preserved or with head pace)
were received incorrectly preserved and were adjusted ac ardingly
H2SO4 HNO3 HCI NaOH
If more than one preservative is needed, notate in comments below
Notify customer service immediately for Incorrectly preserved samples. Obtain anew sample or
the state lab if directed to analyzed by the customer. Who was notified, date and time:
lies Sample(s) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1
°C

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