NCG060394_2021 DMR_20211012

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 0394 Person Collecting Samples: Doug Goodwin
Facility Name: Mountaire Farms - Mount Vernon Hatchery Laboratory Name: Cameron Testing Services, Inc.
Facility County: Chatham Laboratory Cert. No.: 654
Discharge during this period: Yes Lj No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? _ . Yes + No
If so, which Tier (1, 11, or Ill)?
A copy of this DMR has been uploaded electronically via httl2s://edocs.deg.nc.gov/Forms/SW-DMR EjYes a No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code Parameter Outfall 01 Outfall Outfall Outfall Outfall
N/A Receiving Stream Gass C
N/A Date Sample Collected MM/DD/YYYY 09124/2021
46529 24-Hour Rainfall in inches 1.25
C0530 TSS in mg/L (100 or 50*) <2.94
00400 pH in standard units (6.0 — 9.0 FW,
6.8 — 8.5 5W) 7.2
00556 Oil & Grease in mg/L (30) <6.00
31616 Fecal Coliform per 100 ml of
freshwater (if required) (1000)
61211 Enterococci per 100 ml of saltwater
(if required) (500)
00340 Chemical Oxygen Demand in mg/L
<10.D
(120)
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
NCOIL Estimated New Motor/Hydraulic Oil
Usage in gal/month
00552 1Non-Polar Oil & Grease in mg/L (15)
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
FW (Freshwater) SW (Saltwater)
Notes (optional): 3rd Quarter
"I certify by my signature below, under penalty of law, that this document and all attachments were prepared under mydirection orsupervision 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 forgathering 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�jr prisonment for knowing violations."
Signature of Permit t or Delegated AutKp�zed Individual
[e-mail]
Email Address
/?
Date
910-974-3232
Phone Number