HomeMy WebLinkAboutNCG060382_Monitoring Report_20220401NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
Click here for instructions
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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 0382
Person Collecting Samples: Thomas Owens
Facility Name: Mountaire Farms Inc - Statesville Feed Mill
LaboratoryName: Statesville Analytical
Facility County: Iredell
Laboratory Cert. No.: 440
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? ❑X Yes ❑ No
If so, which Tier (I, II, or III)? III
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ® Yes ❑ No
Date Uploaded: 03/30/2022
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall 02
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
02/03/2022
46529
24-Hour Rainfall in inches
1
C0530
TSS in mg/L (100 or 50*)
206
00400
PH in standard units (6.0 —9.0 FW,
6.8 — 8.5 5W
7.07
31616
Fecal Coliform per 100 ml of
freshwater (if required) 1000
61211
Enterococci per 100 ml ofsaltwater
(if required) 5o0
00340
Chemical Oxygen Demand in mg/L
q03
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
Non -Polar Oil & Grease in mg/L (15)
vuLa w vuuwnuu,g nesource waters tUnw3, Hign 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 3.00 mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional): Feb 2022
"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,i Ciuding-t ssibility of fines and imprisonment for knowing violations."
i"
Sign re of Perrot' t e or Delegated Authorized Individual Date
Email dress Phone Number
NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
Click here for instructions
�di r'o
O'y
0
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 0382
Person Collecting Samples: Thomas Owens
Facility Name: Mountaire Farms Inc - Statesville Feed Mill
Laboratory Name: Statesville Analytical
Facility County: Iredell
Laboratory Cert. No.: 440
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? Q Yes [:]No
If so, which Tier (I, II, or III)? III
A copy of this DMR has been uploaded electronically via https://edocs.deci.nc.gov/Forms/SW-DMR ® Yes [-]No
Date Uploaded: 03/30/2022
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Renrhmnrkc in 1D ,A%
Parameter
Code
Parameter
Outfall 02
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
02/03/2022
46529
24-Hour Rainfall in inches
1
C0530
TSS in mg/L (100 or 50*)
206
00400
pH in standard units (G.0-9.0 FW,
6.8 - 8.5 SW)7.07
31616
Fecal Coliform per 100 ml of
freshwater (if required) loon
Enterococci per 100 ml ofsaltwater
(f required) s0040
L00361211
Chemical Oxygen Demand in mg/L
1
403
T
(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
Non -Polar Oil & Grease in mg/L (15)
n 4.,11
-- - - ...•. 115 11—VU-C VVULUlb JUMV), nigh Quanrywaters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 rng/L. All other water classifications have a benchmark of mo mg/L
FVV (Freshwater) SW (Saitwater)
Notes (optional): Feb 2022
"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 informs ' n i c nr ssibility of fines and imprisonment for knowing violations."
22
Sign re of PerW9 a or Delegated Authorized Individual Date
Email dress Phone Number