NCG060174 DMR SW (5)

Environd ital Plan
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina_ Division of Water Quality General Permit No. NCG060000
Date submitted 0. I _01 b (� I Zo i (a)
CERTIFICATE OF COVERAGE N • CGfiE d _ SAMPLE COLLECTION YEAR 20I Io
FACILITY NAME i�l',4riK1S � � � TYACTIVITIES1NCLUDE (check all that apply):
COUNTY �..� ,use/process meats ❑ use animal fats/byproducts
PERSON COLLECTING SAMPLES MAY 2 3 4916CHARGING TO SALTWATERS? DYES NNO
LABORATORY Lab Cert. # r��,-�� r ,
®WR SECTION FILES
CTION
Part A: Stormwater Benchmarks and Monitoring Results
Outfall No. Sample Collected; ` TSS, pH, COD,
mo/dd/yr mg/L Standard units me/L
Benchmark
100 or 50" . Within 6.0 — 9.0 120
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rair
Oil and Grease,
mg/L'
30
Fecal Coliform',
Colonies per 100 ml
1000
this
Colonies per 100 ml
500
Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?E] yes D no (if yes complete Part B)
Part B: Vehicle Maintenance Area Monitoring Results: only for fac lities averaging > 55 gal of new motor oil/month.
Outfall No. Sample Collected, Oil and Grease, "TSS,
pH, New Motor Oil Usage,
mo/dd/yr mg/L mg/L Standard units Annual average gal/mo
Benchmark - 30 100 or 504 6.0-9.0 _
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on-site rain gauge.
aFor sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Z:\Environmental\Industrial\PP-Pdgrim'sPnde\PPNC-North Carolina\PPNC04-Sanford Fresh Plant\PPNC04-01SPILL\2013

Environmental Plan
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCES INA ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR IVIOAE BENCHMARK EXCEEDENCE `FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES Dfgo ElDLtt-(a[(
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES 2 NO ❑ F"'` " "'" "' "``'"`75 orF t�C-(-ab2r
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring
period in the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, 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."
JLI'a- P<
(Signature of Permittee)
i ( � Zo I&
(Date)
Additional copies of this form may be downloaded at:.http://portal.ncdenr.org/web/wq/­ws/­su/­npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Mnnitnrirru Fnrm 9Z:\Environmental\Industrial\PP-Pligrim'sPride\PPNC-NorthCarohna\PPNC04-Sanford Fresh Plant\PPNC04-01SPILL\2013