NCG060295_2021 DMR_20211110

NCDEQ ivision 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 submilt the DM via the Stormwater NPDES Permit Data Monitoring Report DMR Upload form within
30 days of receiving sampling r�sults. Ml it the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG06I0295 Person Collecting Samples: Robert Jackson
Facility Name: Mountaire Farms Inc-. Lumber l0ridge Processing Plant Laboratory Name: Cameron Testing Services, Inc.
Facility County: Robeson I Laboratory Cert. No.: 645
Discharge during this period:0 Yes 0 Nc(if no, skip to signature and date)
Has your facility implemented mandatory Ti r response actions this sample period for any benchmark exceedances? IYes Q No
If so, which Tier (I, II, or I[[)? III
A copy of this DMR has been uploaded elect onically via https://edocs.deg.nc.gov/Forms/SW-DMR Flyes E]No
Date Uploaded:
Analytical Monitoring Requiremerits for
with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall01
Outfall02
Outfall03
Outfall
Outfall
N/A
Receiving Stream Classt
C;Sw
C;Sw
C;Sw
N/A
Date Sample Collected
MM/DD/
YYY
46529
24-Hour Rainfall in inc'
es
C0530
TSS in mg/L (100 or 5
*)
00400
pH in standard units (
.0— 9.0 F1
V,
6.8 — 8.5 SW)
00556
Oil & Grease in mg/L {
0)
31fi16
Fecal Coliform per 1001
ml of
freshwater (if required)
(1000)
Enterococci per 100 ml of saltw I
er
61211
(if required) (500) �
00340
Chemical Oxygen Demand in mg
L
(120) I
Additional parameters far 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
910
00552
Non -Polar Oil & Greas4 in mg/L (
5)
w WuLaranu,ng rcesource waters turf I, rngn ctuautywaters (HQWJ, Trout waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 5o mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional): October2021
"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 jssure 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 possibil�tyoffinesland imprisonment for knowing violations."
Signature of Permittee or Delegateld Authorised Individual
[e-mail]
Email Address
Date
910-359-5515
Phone Number