NCG060384_2022 DMR_20221003

NCDEQ Division of Energy, Mineral and Land Resources
5tormwater Discharge Monitoring Report (DMR) Form for NCGO60000
Food and Kindred
Click here for instructions
Complete, sign, scan and submit the DMR via the 5tormwater 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. NCG060384
Person Collecting Samples: John Haffner
Facility Name: Mondelez Global, LLC - Greensboro
Laboratory Name: Pace Analytical
Facility County: Guliford
Laboratory Cert. No.:5342
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? ❑ Yes U No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deti.nc.Roy/Forms/SW-DMR Q Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
parameter
Outfall001
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
WS-1V
N/A
Date Sample Collected MM/DD/YYYY
09/10/2022
46529
24-Hour Rainfall In inches
1
C0530
TSS in mg/L (100 orSD*)
918
pH in standard units (6.0--9.0 FW,
00400
6.8 — 8,5 SW)
734
Fecal Coliform per 100 ml of
31616
freshwater (if required) (1000)
N/A
Enterococcl per 100 ml of saltwater
61211
(if required) (500)
N/A
Chemical Oxygen Demand in mg/L
00340
(12.0)
23 1J
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
N/ A
00552
Non -Polar Oil & Grease in mg/L (15)
Non Detect
* 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): *J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
"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, includift the possibilityof fines and Imprisonment for knowing violations."
Signature of Permiteee or'Delegated Authorized Individual
[e-mail]
Email Address
Date
630-890-8844
Phone Number