NCG060007_2022 DMR_20220112

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. NCG06p 000
Person Collecting Samples: ,
Facility Name: o('c,
Laboratory Name: AAP_Ir
Facility County: 0 - ,J
Laboratory Cert. No.: ) 65
Discharge during this period: Oyes ❑ No {if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes o
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via httpsaledocs.de9.nc.gov/l prmslSW-DMR ❑ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
N/A Receiving Stream Class
2
3
N/A
Date Sample Collected MM/DD/YYYY
t 3 - 2 Z
1 - '3 - 2 -L-
46529
24-Hour Rainfall in inches
t , R
1.9
C0530
TSS in mg/L (100 or 50*)
00400
pH in standard units (6.0-9.0 FW,
6.8 — 8.5 SW)
,
31616
Fecal Coliform per 100 ml of
)
Li
freshwater (if required) (1000)
oQ
61211
Enterococci per 100 ml of saltwater
(if required) (500)
00340
Chemical Oxygen Demand in mg/L
I
J
j120)
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
NCOIL I Estimated New Motor/Hydraulic Oil
I Usage in gal/month
00552 1 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
I (Freshwater) (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, accurate, and complete. I am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee Or IOelegated Authorized Individual
a ,,S
Email Address
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Phone Number

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Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Aip'Igo
s
Contact: Tina Williams ReportDate: 1/11/2022
Client: Doroda Foods
P.O. Box 1436
Reidsville, NC 27320 Date Sample Rcvd: 1/3/2022
Meritech Work Order # 01032102 Sample: Outfall #3 Grab 1/3/22
Parameters Result Ana_i_LsI5 DateReporting limit Method
COD
<15 mg/L
1/6/22
15 mg/L
EPA 410.4
Total Suspended Solids
4 mg/L
1/4/22
2.5 mg/L
SM 2540 D
Fecal Coliform
24 col/100 ml
1/3/22
1 col/100 ml
SM 9222 D
PH
7.9 S.U.
1/3/22
1.0 -14.0 S.U.
SM 4500-HB
I hereby certify that I have reviewed and approve these data.
Laboratory Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

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Meritech, Inc.
Environmental Laboratory
Laboratory Certification No.165
Contact: Tina Williams
Client: Doroda Foods
P.O. Box 1436
Reidsville, NC 27320
Report Date: 1/11/2022
Date Sample Rcvd: 1/3/2022
Meritech Work Order # 01032101 Sample: OutfaIl #1 Grab
1/3/22
Parameters
Result
Analysis Date
Reparng Limit
Method
COD
19 mg/L
1/6/22
15 mg/L
EPA 410.4
Total Suspended Solids
17 mg/L
1/4/22
2.5 mg/L
SM 2540 D
Fecal Coliform
1,210 col/100 ml
1/3/22
1 col/100 ml
SM 9222 D
pH
8.3 S.U.
1/3/22
1.0 -14.0 S.U.
SM 4500-HB
I hereby cert(& that I have reviewed and approve these data. ----V 41-'41
Laborata r7' Representative
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

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