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Home My WebLink AboutNCG060382_MONITORING REPORT_20210607NCDEQ 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 (D 30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriatE Certificate of Coverage No, NCG061 0 13 18 121 Person Collecting Samples: John Jacobs Facility Name: Mountaire Farms Inc. - Statesville Breeder Feed Mill Laboratory Name: Statesville Analytical Facility County: iredell I Laboratory Cert. No.: 440 Discharge during this period: ® Yes W No (if no, skip to signature and dote) Has your facility implemented mandatory Tier response actions for any benchmark exceedances? ■ Yes No If so, which Tier (I,11, or 111)? III Part A: Analytical Monitoring Requirements for Outfalls with industrial Activities— Benchmarks in (Red) Q forte-w'khin Parameter Parameter Outfall02 outfall Outfall Outfall Outfall Code N/A Receiving Stream Class C N/A Date Sample Collected MM/DD/YYYY 46529 24-Hour Rainfall in inches 00556 Oil & Grease in mg/L (30) TSS in mg/L (100 or 50°) pH in standard units (6.0-9.0) F Fecal Coliform per 100 mi of freshwater (1000) Enterococci per 100 ml of saltwater 61211 (50fl) Chemical Oxygen Demand in mg/L 00340 (120 Part B: Vehicle & Equipment Maintenance Areas - Benchmarks in (Red) Parameter Parameter Outfall Outfall Outfall Outfall Outfall Code 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 T55 limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L. Notes (optional): May 2021 "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 Signature of Permittee or Delegated Authorized Individual Date NCDEQ Division of Energy, Mineral and Land Resources Stormwater Discharge Monitoring Report (DMR) Form for NCG0600061 , Food and Kindred <LL Click here for instructions gos�l� o. o Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload f6�"�n within 30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regionel Office. Certificate of Coverage No. Person Collecting Samples: John Jacobs Facility Name: Mountaire Farms Inc. - Statesville Breeder Feed Mill Laboratory Name: Statesville Analytical Facility County: iredeli I Laboratory Cert. No.: 440 Discharge during this period: Q Yes Q No (if no, skip to signature and date) Has your facility implemented mandatory Tier response actions for any benchmark exceedances? Q■ Yes ❑ No If so, which Tier (I, 11, or 111)? Ri Part A: Anaivtical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red) Parameter Parameter Outfall02 Outfail Outfall Outfall Outfall Code N/A Receiving Stream Class C N/A Date Sample Collected MM/DD/YYYY 46529 24-Hour Rainfall in inches 00556 Oil & Grease in mg/L (30) C0530 TSS in mg/L (100 or 50*) 00400 pH in standard units (6.0-9.0) Fecal Coliform per 100 ml of 31616 freshwater (1000) Enterococcl per 100 mi of saltwater 61211 (500) Chemical Oxygen Demand in mg/L 00340 (120 Part R: Vehicle & Equipment Maintenance Areas — Benchmarks in (Red) Parameter Parameter Outfall Outfall Outfall Outfall Outfall Code 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): May 2021 "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 Signature of Permittee or Delegated Authorized Individual Z Date