NCG060349_2021 DMR_20220104

Washington Regional Office
Attn: David May
943 Washington Square Mall
Washington, NC 27889
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
i
- l
Stephen Richards
828-925-0572 — Cell
252-795-0830 — Office

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (D Vil,) Form for IM00060000
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 Silverthorn
Facility Name: Flagstone Foods - Ann's House of Nuts
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? QYes 0 No
If so, which Tier (I, ll, or III)?
A copy of this DMR has been uploaded electronically via https:Hedocs.deg.nc.gov/Forms/SW-DMR Yes [] No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
FW
FW
FW
FW
N/A
Date Sample Collected MM/DD/YYYY
10/28/21
10/28/21
10/28/21
10/28/21
46529
24-Hour Rainfall in inches
.5
.5
.5
.5
C0530
TSS in mg/L (100 or 50*)
7.9
10
2.5
<2.5
00400
pH in standard units (6.0 — 9.0 FW,
6.9
6.7
6.7
6.6
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)
00340
C 2em ical Oxygen Demand in mg/L
39
96
<20
<20
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 benchmarl<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 system, or those persons directly responsible for gathering the information, the information
submitted is, to the best of my knowledge and belief, true crate, and complete. I am aware that there are significant penalties for submitting
false inform inclu�i�g the possibilit ,of fines and imprisonm nt for knowing violations."
12 z
Signature of Permlttee a egate Authorize Individual Date
r' C n -�
Email A dress Phone Number

Environment 1, Incorporated
P.O. BOX 7085,114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
FLAGSTONE FOODS LLC STORMWATER
ATTN: RICKY COOKE
113 SW RAILROAD STREET #70
ROBERSONVILLE, NC 27871
ID#: 72
DATE COLLECTED: 10/28/21
DATE REPORTED : 11/08/21
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)
6.9
6.7
6.7
6.6
10/29/21
DNS 4500HB-11
COD, mg/l
39
96
< 20
< 20
11/05/21
HMM H8000-79
Total Suspended Residue, mg/l
7.9
10
2.5
< 2.5
11/0V21
DNS 2540D-15
TPH (1664B), mg/1
< 5.0
< 5.0
< 5.0
< 5.0
11/02/21
HMM EPA1664B

Cnviravnental
Quality
Stormwater Discharge Outfall (SAD®)
Qualitative Monitoring Report
For guiduttee on filling out this form, please visit https:Hdcq.ne.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/ / / l l l 1 / or Certificate of Coverage No.: N/C/Gk) /G 61
Facility Name: %���, s' �, P_ %"co o�s
County: _ �'Ji� �`i. Phone No.
Inspector: /vP
Date of Inspection 1) - /
Time of Inspection:
i
Total Event Precipitation (inches): ya,
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:
Peruittee or Designee)
1. Outfall Description:
Outfall No. I Structure (pipe, ditch, etc.): ,9,
Receiving Stream:
Describe the industrial activifies that occur within the outfall drainage area:
�� n� i'✓t c s{ v cQ heG.-v
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2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:;
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): AO rQ , <- -1,' e L c-- 7� M o -
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 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 6 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 3 4 5
7. Is there any foam in the stormwater discharge? o Yes V No.
8. Is there an oil sheen in the stormwater discharge? oYes 9 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.
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Etndronmental
Qcrallty
Stormwater ]Discharge Outfall (SD®)
Qualitative Monitoring Deport
For guidance on filling out this form, please visit littps:Hdcq.ne.gov/about/divisions/energy-inineral-land-resources/
npdes-stortnwater-gps
Permit No.: N_/C/ / / / / / / / or Certificate of Coverage No,: N/C/G/6/ G� `, 3q / /
Facility Name: _ — — —
County: Phone No. a 5 - -7.Ls
Inspector:)��
Date of Inspection:
Time of Inspection: /e� ,, 0 (-/ p n-
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 knowledge:
(Signature GYIermittee or Designee)
1. Outfall Description:
Outfall No, Structure (pipe, ditch, etc.): ,oi_ .�� CO J 6, �,(,2 -S�rl,L.," JV'ek r'„\,
Receiving Stream:
A•oc,,.,,r` t.e-
Describe the industrial activi't'es that occur within the outfall drainage area: P�� 2}—
�� /
Page 1 of 2
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2. Color; Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors;
3. Odor.- Describe any distinct odors that the discharge may have (i.e,, smells strongly of oil, weak
chlorine odor, etc.): jlv
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
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:
lJ 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� 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? cUYes V No.
9. Is there evidence of erosion or deposition at the outfall? o Yes V 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

fnvirolunental
Qualfty
Stormwater Discharge Outfall (SIB®)
Qualitative Monitoring Report
For guidance on filling out this form, please visit https:Hdeq.iic.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No,: N_/C/ / / / / /, / / or Certificate of Coverage No.: N/C/G/0/6A3/a/.y /•9/
Facility Name:
County: Phone No. �.S -��} �6 O O
Inspector:,`c.�
Date of Inspection: /0 U
Time of Inspection: /D y / 0
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 DENILR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.): 5"Icu t.,zl C Q
Receiving Stream:-
PC4
Describe the industrial activities that occur within the outfall drainage/ area:
.S i',,-RP V/tin C� lk,19- cC v'%a'�r T / o !L ) t2(0t9V,
Page 1 of 2
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2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc,) and tint
(light, medium, dark) as descriptors: C/ e" k, '/ /� h-1 {
3. Odor: Describe any distinct odors that the discharge may have (ix., smells strongly of oil, weals
chlorine odor, etc.): /y'D 'Q ,s/-' -/ n&
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
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 1 is no solids and 5 is extremely muddy:
C1 2 3 4 5
7. Is there any foam in the stormwater discharge? o Yes No.
S. 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 V 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
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit littps:Hdcq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/ / / / / / / / or Certificate of Coverage No.: N/C/GO ,�g o
Facility Name: �r
County; Phone No.
Inspector:
Date of Inspection; i0 �•y 1
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 lcmowledge:
Permittee or Designee)
1. Outfall Description:
Outfall No. Structure (pipe, ditch, etc.): �p -e
Receiving Stream:
r/a,w�,r-,A
Describe the industrial activities hat occur within the outfall drainage area: {'wtrrf�-
Page 1 of 2
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2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C/�c,-r /—,44�-
3. Odor: Describe any distinct odors that the discharge may have (Le., smells strongly of oil, weak
chlorine odor, etc.): Na r( s f oSo w
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
(l 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:
Cl? 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 2 3 4 5
7. Is there any foam in the stormwater discharge? o Yes o�P No.
8.
9.
Is there an oil sheen in the stormwater discharge? oyes ® No. _
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