NCG060182_2023 DMR_20230419

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 0 1 8 2 Person Collecting Samples: Yin-Pong George CHANG,P E
Facility Name: Pilgrim's Pride Corporation,Marshville Processing Plant Laboratory Name: K&W Laboratories
Facility County: Union Laboratory Cert. No.: 559
Discharge during this period: n Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions for any benchmark exceedances?❑ Yes ❑■ No
If so,which Tier(I, II,or III)?
Part A:Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in (Red)
Parameter t
Code Parameter Outfall#1 Outfall Outfall Outfall Outfall
N/A Receiving Stream Class Salem Creek
N/A Date Sample Collected MM/DD/YYYY 04/07/2023
46529 24-Hour Rainfall in inches 1.35
00556 Oil&Grease in mg/L(30i <5.3
C0530 TSS in mg/L(100 or 50*) 5.4
00400 pH in standard units(6.0-9.0) 7.4
31616 Fecal Coliform per 100 nil of 3 650
freshwater(1000)
61211 Enterococci per 100 ml of saltwater
(500)
00340 Chemical Oxygen Demand in mg/L 26
(120)
Part B:Vehicle& Equipment Maintenance Areas—Benchmarks in(Red)
Parameter Parameter Outfall Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY
00552 Non-Polar Oil&Grease in mg/I(15)
NCOIL New Motor/Hydraulic Oil Usage in
gal/month
Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HOW),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.
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 Deteg ed Authorized Individual Date

K & W Laboratories Results Report
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Midland,North Carolina 28107
Tel[phone] Fax[phone] I
Client: Pilgrims Pride Corp. Date: 17-Apr-23
PO Box 668 Order ID: 23040708
Marshville,NC 28103
Project: Marshville Stormwater Collect Date: 4/7/2023
Location: Outfall#001 Collect Time: 10:45:00 AM
REPORTING ANALYSIS
SAMPLE# PARAMETER RESULT UNITS METHOD LIMIT DATE
23040708-01 COD 26 mg/L SM5220D 10 4/14/2023
23040708-01 Fecal Collform 3650 colony/100m1 SM9222D(MF) 1 4R/2023
23040708-01 Oi1&Grease <5.3 mg/L EPA1664B 5.3 4/13/2023
23040708-01 pH 7.4 units SM4500H+B 0.1 4R/2023
23040708-01 TSS 5.4 mg/L SM2540D 2.5 4/11/2023
pH analysis initiated more than 15 minutes after sample collection.
NC Certification: 559 SC Certification: 99051
Certified Bye
wit
raK ska/Lab Director

K & W Laboratories Tel: [phone]
1121 Hwy 24/27 W Midland,NC Fax:[phone] Chain of Custody Record
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Address: PO Box 668
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