NCG060184_2021 DMR_20210706

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 0 1 8 4 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)
l Has your facility implemented mandatory Tier response actions for any benchmark exceedances? Q Yes ❑ No
II If so, which Tier (1,11, or Ill)? III
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
Outfall to
Outfall 2A
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
Rays Fork Creek
Rays Fork Creek
N/A
Date Sample Collected MM/DD/YYYY
06/22/2021
06/22/2021
46529
24-Hour Rainfall in inches
1.2
1.2
00556
Oil & Grease in mg/L (30)
< 5.0
< 5.0
C0530
TSS in mg/L (100 or 50*1
16.2
69.2
00400
pH in standard units (6.0-9.0)
6.6
7.6
31616
Fecal Coliform per 100 ml of
>60,000
25,000
freshwater (1000)
61211
Enterococci per 100 ml of saltwater
(S00)
00340
Chemical Oxygen Demand in mg/L
36
32
(120)
Part B: Vehicle & Equipment Maintenance Areas — Benchmarks in (Red)
Parameter
Parameter
Outfall
Outfall
Dutfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
06/22/2021
06/22/2021
00552
Non -Polar Oil & Grease in mg/L (15)
< 5.0
< 5.0
NCOIL
New Motor/Hydraulic Oil Usage in
GG
VV
GG
VV
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."
__.A� �_ _z�z_�
Signature of Permittee or Delegated Authorized Individual Date oC

Lenvirochem
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 . 910.392.0223 Lab . 910.392.4424 Fax
710 Bow5ertown 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 - Wingate Feed Mill Date of Report, Jul 02, 2021
205 Edgewater Dr. Customer PO #:
Wingate NC 28174 Customer ID: 18020004
Attention: Jeremy Spencer Report #: 2021-10275
Project ID: Wingate Feed Mill-Stormwater
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-25571 Site: Outfall #001A 6/22/2021 9:45 AM Water Yin-Pong Chang
Test Method Results Date Analyzed
Oil & Grease (O&G)
EPA 1664 Rev. B
<5.0 mg/L 06/29/2021
Residue Suspended (TSS) SM 2540 D-2011 16.2 mg/L 06/23/2021
pH SM 4500 H B-2011 6.6 units 06/28/2021
COD SM 5220 D-2011 36 mg/L 06/23/2021
Fecal Coliform SM 9222 D-2006 MF >60000 Colonies/100ml- 06/22/2021
Lab ID Sample ID: Collect Daterrime Matrix Sampled by
21-25572 Site: Outfall #002A 6/22/2021 9:35 AM Water Yin-Pong Chang
Test
Method
Oil & Grease (O&G)
EPA 1664 Rev B
Residue Suspended (TSS)
SM 2540 D-2o11
pH
SM 4500 H B-2011
COD
SM 5220 D-2011
Fecal Coliform
SM 9222 D-2006 MF
Comment:
Reviewed by: N�OLAL�� Q'X-kA CA n
Results Date Analyzed
<5.0 mg/L
06/29/2021
69.2 mg/L
06/23/2021
7.6 units
06/28/2021
32 mg/L
06/23/2021
25000 Colonies1100mL
06/22/2021
Report 0. 2021-10275 Page 1 or 1

renviroche6m
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
infofd environmentalchemtsts.com
Pilgrim's QC - 2021-10275
Parameter
True Value
In .L
Result
mgL
% True Value
Limits
%
COD
1000
966
97
90-110
Fecal
WA
N'A
NA
NA
TSS
92.5
92.0
99
82.4-1 18
pH
10.0
9.96
100
90-110
OIL & GREASE
40.0
31.3
78
78-1 14
MS/MSD
Parameter
True Value
mg. L
Recovery
mg, L
% Recovery
%
Difference
Limits %
Recovery
Limits %
Difference
COD
50.0
47'54
94:108
14
80-120
<20
Fecal
N±A
N. A
NA
N. A
NA
NA
TSS
NA
NA
N.:A
N A
NA
N A
pH
N-'A
N A
N'A
N A
N A
NA
OIL & GREASE
40.0
29.2
73*
N A
78-1 14
518
* Batch accepted based on all other passing QC s
DUPLICATE SAMPLES
Parameter
Results
mg, -L
% Difference
Limits %
COD
N?A
N A
N'A
< 10
Fecal
>600
.}600
0
< 30
TSS
16.5
16.0
3
< 10
pH
N'A
N A
N A
< 10
OIL & GREASE
=<5<5
0
5 to

[envirochem
ANALYTICAL & CONSULTING CHEMISTS
BLANK
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 . 910.392.0223 Lab . 910.392.4424 Fax
710 8owsertown Road, Manteo, NC 27954 . 252.473,5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910 347.5843 Lab/Fax
info -a environmentalchemists.com
Parameter
Results
mg• L
Limit
mg. L
COD
<10
10
Fecal (Start Control)
0
0
TSS
z.5
2.5
pH
N A
N:A
OIL & GREASE
• 5.0
5

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
l
Client:?1k-CV-A% 5 P241)G Date: Report Number.
Receipt of sample: ECHEM Pickup Client Delivery ❑ 1UPS ❑ FedEx ❑ Other ❑
❑ YES
10 NO
K N/A
1. Were custody seals present on the cooler?
❑ YES
10 NO
N/A
2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt °C Corrected temperature upon receipt °C
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 VC, was Project Mgr./QA notified?
YES ❑ NO 4. Were proper custody procedures (relinquished/received) followed?
Ep YES
13 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 COO
1p YES
❑ NO
8. Were tests to be performed listed on the COC?
YES
❑ NO
9. Did samples arrive in proper containers for each test?
41 YES
❑ NO
10. Did samples arrive in good condition for each test?
YES
❑ NO
11. Was adequate sample volume availableT
YES
❑ NO 112.
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 10
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.
mple Preservation:
Sample(s)
by adding (circle one)
Time of preservation:
(Must be completed for any sample(s) incorrectly preserved or with headspace)
H2SO4
were received incorrectly preserved and were adjusted accordingly
HNO3 HCl NaOH
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
the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Sample
were received with headspace
COMMENTS:
DOC. QA.002 Rev 1

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