NCG060349_2021 DMR_20211013

Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
Stephen Richards
Flagstone Foods
201 Est 3`d Street
Robersonville, NC 27871
Enclosed is the quarterly Stormwater Discharge Monitoring Report Certificate of Coverage No.
NCG060349.
Reach out to me for any questions or concerns
Stephen Richards
828-925-0572 — Cell
252-795-0830 — Office

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. NCG060349
Person Collecting Samples: Ricky Silverthrone
Facility Name: Flagstone Foods
Laboratory Name: Environmental 1
Facility County: Martin
Laboratory Cert. No.:10
Discharge during this period:
Yes
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? MYes E]No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR E]Yes ®No
Date Uploaded: 10132021
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
OutfallI
Outfall2
Outfall3
Outfall4
Outfall
Code
N/A
Receiving Stream Class
FW
FW
FW
FW
N/A
Date Sample Collected MM/DD/YYYY
9/23/21
9123/21
9/23/21
9/23/21
46529
24-Hour Rainfall in inches
1/10
1/10
1/10
1/10
C0530
TSS in mg/L (100 or 50*)
6.6
4.3
<2.5
4.5
00400
pH in standard units (6.0-9.0 FW,
6.79
7.20
7.17
6.95
6.8 — 8.5 SW)
00556
Oil & Grease in mg/L (30)
<5.0
<5.0
<5.0
<5.0
Fecal Coliform per 100 ml of
31616
freshwater (if required) (1000)
Enterococci per 100 ml of saltwater
61211
(if required) (500)
C ical Oxygen Demand in mg/L
00340
0
42
32
<20
24
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in gal/month
00552
Non -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 TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saltwater)
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 s or those persons directly responsible for gathering the information, the information
submitted is, to the best of my knowled belief, true, aFcurate, and complete. I am aware that there are significant penalties for submitting
false info tiony�cluding`the poystbility of fines and im 'sonment for knowing violations.
10/13/2021
of Permittee uthorized Individual Date
[e-mail]
Email Address
252-795-0830
Phone Number

��doQo��c��� alp D�c�or�poQa��d
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
FLAGSTONE FOODS LLC STORMWATER
ATTN: RICKY COOKE
113 SW RAILROAD STREET #70
ROBERSONVILLE, NC 27871
�W `.
OCTV Drinking Water ID: 37715
Wastewater ID: 10
-^_1' ••---•••••-• PHONE [phone]
...........
FAX [phone]
ID#: 72
DATE COLLECTED: 09/23/21
DATE REPORTED : 10/01/21
REVIEWED BY: ✓/ ,
Stormwater
Stormwater
Stormwater
Stormwater
Analysis
Method
PARAMETERS
(#1, Grab)
(#2, Grab)
(0, Grab)
(#4, Grab)
Date
Analyst Code
PH (not to be used for reporting)
6.5
6.1
5�y`:
6.3
09/23/21
DIJ 4500HB-11
COD, mg/I
42
32
<20
24
09/30/21
HMM H8000-79
Total Suspended Residue, mg/I
6.6
4.3
<2.5
4.5
09/24/21
CAW 2540D-15
TPH (1664B), mg/1
<5.0
<5.0
<5.0
<5.0
09/30/21
HMM EPA1664B

Environment 1, Inc. CHAIN OF CUSTODY RECORD
P.O. Box 7085, 114 Oakmont Dr. Page 1 of 1
rrPP ,,, iiP •Nrr ?'7QSst
environment 1 inc.com
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone [phone] •Fax [phone]
CHLORINE
CLIENT: 72 Week: 39
UV
/
pH CHECK (LAB)
P
P
P
G
CONTAINER TYPE, P/G
FLAGSTONE FOODS LLC STORMWATER
❑ NONE
ATTN: RICKY COOKE
201 EAST 3RD ST.
CHEMICAL PRESERVATION
P.O. BOX 70
A
C
A
C
m zo
ROBERSONVILLE NC 27871
~ A - NONE D - NAOH
[phone]
E
y O
z �
U
z
U)
Ir
''
^'
C7
C
B - HNO, E - HCL
o O 0
cr O
z
C
d
LU C- H,SO, F- ZINC ACETATE/NAOH
COLLECTION
= F--
J Q
a
o
a w
w J
a- p
W a
z
o
o
o
w
n
A
OU
a,
En
�o
C
x
F
w
G- NATHIOSULFATE
SAMPLE LOCATION
DATE
TIME
Stormwater (#1 Grab)
'X -21
/: I tr
4•71
f•3
4
.:
CLASSIFICATION:
Stormwater (#2, Grab)
c- 91
S
7•��
a� •1
4
s
`E `:
`• �?
< +'•:
WASTEWATER(NPDES)
Stormwater 03 Grab
/ • ' ��
4
DRINKING WATER
� •°1
-.S0
A
4
Stormwater (#4 Grab)
DWR/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
OY N
SAMPLES COLLECTED BY:
(Please Print)
✓4v, -0 rn
lv 3
SAMPLES RECEIVED IN LAB AT C
RELINQUISHED BY SIG.) (SAMPLER)
DATElTIME
REC BY (SIG.)
DATEMME
lei
COMMENTS:
6' i % apt- a
RELINO EDBY(SIG.)
DATE/TIME
RECEIVED BY (SIG.)
DATE(IIME
c
ti - H - .4 l e-- 02 a 1. QL
d
t• e✓►,
RELINQUISHED BY (SIG.)
DATE/TIME
RECEIVED BY (SIG.)
DATE/TIME
F — ae'q" -• ,
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for N° 393714
FC RM #5 Grab sample in the blocks above for each parameter requested.

Ell vironrnental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out thisform, please visit https://deq.ne.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/ / / / / / / / or Certificate of Coverage No.: N/C/G/O/`6 /CJ /,'/Ci /� /
Facility Name:
County: - ��r-f -r`,,� Phone No. ash - ? Of S
Inspector:
Date of Inspection: 9 • a 3 , a
Time of Inspection:
Total Event Precipitation (inches): , d®
All permits require qualitative monitoring to be performed during a "measurable storm event.''
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(SignaturSy,rPermittee or Designee)
1. Outfall Description:
Outfall No. V_ Sttucture (pipe, ditch, etc.):
Receiving Stream:
a
Describe the industrial activities that occur within the outfall drainage area: 6qjo ca TV- Cktnd i is
sue.. 4?6Lv'"q AR
Page I of 2
SWL1-242, Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(lig �et, medium, dark) as descriptors; Ue•-e. Z�k-f--
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): At D O'L.,,
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 26 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 Q2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 (D 3 4 5
7. Is there any foam in the stormwater discharge? Q Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? QYes (W No.
9. Is there evidence of erosion or deposition at the outfall? Q Yes 40 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SwU-242, Last modified 06/01/2018

Gnviruntnental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit littps:Hdeq.ne.gov/about/divisions/energy-mineral-land-resources/
npdes-storrnwater-gps
Permit No.: N/C/ / / / / / / / or Certificate of Coverage No,: N_/C/G/CY,C.);3 /3iy/Ct/
Facility Name: C/ c', S4.',.e AW o kS
County: _� ��.-J�.� Phone No. �4'I -
Inspector: ,t�yQ✓�'R„ r.► 2
Date of Inspection: `(• a 3 - a
Time of Inspection:
Total Event Precipitation (inches): Ilb
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event' is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to docurnent that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
or Designee)
I. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.): -e
Receiving Stream:
RIO w � t r. F..
Describe the industrial activi res that occur within the outfall drainage area: K(9 0 4-
c raatK ,�
Page 1 of 2
SWU-242, Lust modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C—/eoa.v,
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): NO 0A., v,
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 O 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where I is no solids and 5 is the surface covered with.floating solids:
0 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
1 L/ 3 4 5
7. Is there any foam in the stormwater discharge? o Yes • No.
8. Is there an oil sheen in the stormwater discharge? oyes • No.
9. Is there evidence of erosion or deposition at the outfall? O Yes • No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 06/O1/2018

Environmental
Qnahly
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance wi filling out this fain, please visit https://deq.iie.goi,/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_/C/ / / / / / / / or Certificate of Coverage No.:
Facility Name: /^Lr�a.l��ot�G� - cQo-_.S
County: M. Phone No. a5
Inspector: fCv S �p r�~i7" r K ,e—
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches)
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my luiowledge:
Perinittee or Designee)
1. Outfall Description:
Outfall No. a Structure (pipe, ditch, etc.): d�— t,a e-
Receiving Stream:
'CI
D 4
Describe the industrial activities that occur within the outfalI drainage area:
11age I of 2
swu-242, Lost modified 06/01/2018

2. Colon: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: G&A.V1
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): & 0 d26p V-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
2 3 4 5
S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids And 5 is the surface covered with floating solids:
1 \1 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 t�2 3 4 5
7. Is there any foam in the stormwater discharge? o Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? QYes 0 No.
9. Is there evidence of erosion or deposition at the outfall? o Yes 40 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Lost modified 06/01/2018

rnV11*0111nental
Quality
Stormwater Discharge Ouffsill (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit https://deq.nc.gov/about/divisions/energy-mineral4and-zesources/
npdes-stormwater-gps
Permit No.: N/C/ / / / / / / / or Certificate of Coverage No.:
Facility Name:
County: a r Phone No. 01 - %QV,S 6 j n c2
Inspector: �Pek„ S'. f'vr ✓� e r N�
Date of Inspection: • 13 • 3
Time of Inspection: 1 S R vh
1
Total Event Precipitation (inches): P®
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior, The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signat�f Permittee or Designee)
1. OutfalI Description:
Outfall No. �_ Structure (pipe, ditch, etc.):
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
Pagel of 2
SWU-242, Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, blown, blue, etc.) and tint
(light, medium, dark) as descriptors: 'b VX9 w w J s • /kA -
3. Odor: Describe any distinct odors that the discharge may have (i.e,, smells strongly of oil, weals
chlorine odor, etc.): _A]() _p_ejo v-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 G S
S. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 0 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 Q 3 4 5
7. Is there any foam in the stormwater discharge? o Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? oYes 0 No.
9. Is there evidence of erosion or deposition at the outfall? o Yes W-No.
10. Other Obvious Indicators of Stormwater pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 06/01/2018