HomeMy WebLinkAboutNCG060382_Monitoring (Report)_20210726NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for N00060006
Food and Kindred
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload orm within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the _appropriate DEMLR Reeio`nal Office.
Certificate of Coverage No. NCG06 0 3 8 2 Person Collecting Samples: John Jacobs
Facility Name: Mountains Farms Inc. - Statesville Breeder Feed Mill Laboratory Name: Statesville Analytical
Facility County: Iredeii Laboratory Cert. No.: 44a
Discharge during this period: 0 Yes Q 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 (1,11, or lil)? 111
Part A: Analytical Monitoring Requirements for Outfalis with Industrial Activities— Benchmarks in tRpdi
Parameter
Code
Parameter
Outfall02
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
06111/202'1
46529
24Hour Rainfall in inches
<1.
00556
Oil & Grease in mg/L (30)
<5.05
C0530
TSS in mg/L (100 or 50")
491
00400
pH in standard units (6.0 — 9.0)
7.38
31616
Fecal Coliform per 100 ml of
freshwater (1000)
61211
Enterococci per 100 ml of saltwater
(500)
00340
D.0 D. 11..L.Iwr..
Chemical Oxygen Demand in mg/L
(120)
o_ e....s�.—..�..
2%8
.... �..�.,...� � a.yu,NuscnL irian1Lcnance Areas — Cencnmants 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)
NCOIL
New Motor/Hydraulic Oil Usage'
gal/month
Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HOW), 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): June 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
knowing violatipns." j f
of Permittee or Delegated Authorized Individual
Da e
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. 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 Laboratory Cert. No.: 440
Discharge during this period: Q Yes X No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances? L Yes Li No
If so, which Tier (I, II, or III)? III
Part A: Analytical Monitoring Requirements for Outfalls with Industrial Activities —Benchmarks in (Red)
Parameter
Parameter
Outfall02
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
06/11/2021
46529
24-Hour Rainfall in inches
<1"
00556
Oil & Grease in mg/L (30)
<5.05
C0530
TSS in mg/L (100 or 50*)
491
00400
pH in standard units (6.0-9.0)
7.38
Fecal Coliform per 100 ml of
31616
freshwater (1000)
Enterococci per 100 ml of saltwater
61211
(500)
00340
Chemical Oxygen Demand in mg/L
278
(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
1 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 TS5 limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L.
Notes (optional): June 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
knowing violatipnp." / 7 ,,
of Permittee or Delegated Authorized Individual
� 7cr
Da e