NCG060007_2022 DMR_20230111

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. NCGO6 0t 0 V Person Collecting Samples: ;fir . tAj-.\ \, 14vvns
Facility Name: GAC„... %-c-)0,AS L Le__ Laboratory Name: 'mt2c•\-ek%
Facility County: oCN._-,,- ►‘.,,• J Laboratory Cert. No.: 1 (05
Discharge during this period: PEP(e-s ❑ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑ No
If so,which Tier(I,II,or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.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 I 3
N/A Date Sample Collected MM/DD/YYYY 1 I_ (( •22 I I- )i-2t
46529 24-Hour Rainfall in inches , 53 D- , S "Z,
C0530 TSS in mg/L(100 or 50*) I '1 5 Li f
00400 68in8t5SW) units(6.0-9.0 FW, ,�
Fecal Coliform per 100 ml of / ( �C•j�J _ _
31616 freshwater(if required)(1000) ' ) '1 5 3 9 op
61211 Enterococci per 100 ml of saltwater
—
(if required)(500) —
00340 Chemical Oxygen Demand in mg/L C_,
(120) 'S
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 1
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 benchmark 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,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."
aU.a).u, r- "1-11f . y• Il -2q- 202-
Signature of Permittee or Delegt Auth rized Individual Date
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Email Address Phone Number

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Meritech, Inc.
Environmental Laboratory
Ali Laboratory Certification No. 165
MAW ,
Contact: Tina Williams Report Date: 11/18/2022
Client: Doroda Foods
P.O.Box 1436
Reidsville,NC 27320 Date Sample Rcvd: 11/11/2022
Meritech Work Order# 11112204 Sample: Stormwater 1 Grab 11/11/22
Parameters Result Analysis Date Reporting Limit Method
COD 387 mg/L 11/15/22 15 mg/L EPA 410.4
Total Suspended Solids 175 mg/L 11/14/22 2.5 mg/L SM 2540 D
Ammonia,Nitrogen 0.4 mg/L 11/15/22 0.1 mg/L EPA 350.1
Oil &Grease(HEM) <5,0 mg/L 11/14/22 5.0 mg/L EPA 1664B
Fecal Coliform 6,455 CFU/100 ml 11/11/22 9 CFU/100 ml SM 9222 D
pH 6.9 S.U. 11/11/22 1.0-14.0 S.U. SM 4500-HB
Temperature 18.5 °C 11/11/22 - SM 2550 B
/ ��I hereby certify that I have reviewed and approve these data. if/ �i,�iC.�
Lal orata_v Representative
642 Tamco Road,Reidsville,North Carolina 27320
tel.[phone] fax.[phone]

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Meritech, Inc.
Environmental Laboratory
k
Laboratory Certification No. 165
1111.1 . . ,
Contact: Tina Williams Report Date: 11/18/2022
Client: Doroda Foods
P.Q.Box 1436
Reidsville,NC 27320 Date Sample Rcvd: 11/11/2022
Meritech Work Order# 11112204 Sample: Stormwater 1 Grab 11/11/22
Parameters Result Analysis Date Reporting Limit Method
COD 387 mg/L 11/15/22 15 mg/L EPA 410.4
Total Suspended Solids 175 mg/L 11/14/22 2.5 mg/L SM 2540 D
Ammonia,Nitrogen 0.4 mg/L 11/15/22 0.1 mg/L EPA 350.1
Oil &Grease(HEM) <5,0 mg/L 11/14/22 5.0 mg/L EPA 1664B
Fecal Coliform 6,455 CFU/100 ml 11/11/22 9 CFU/100 ml SM 9222 D
pH 6.9 S.U. 11/11/22 1.0-14.0 S.U. SM 4500-HB
Temperature 18.5 °C 11/11/22 - SM 2550 B
and approve these data.
I hereby certify that I have reviewed pp (/
La oratory Representative
642 Tamco Road,Reidsville,North Carolina 27320
tel.[phone] fax.[phone]

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