NCG060182 DMR SW (23)

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SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted `7 - 9 ^/�r
CERTIFICATE OF COVERAGE NO. NCG066 I
FACILITY NAME - : / v 1'4, S
COUNTY U4 110 Aj 11
PERSON COLLECJ�ING SAMPLES
LABORATORY/Cltkl�obhCa g rjC S Lab Cert. # -'S'!�?
Part A: Stormwater Benchmarks and Monitoring Results
Environn( - >1tal Plan
SAMPLE COLLECTION YEAR XeQ /:5;*—
FACILITY ACTIVITIES INCLUDE (check all that apply):
�Wprocess meats ❑ use animal fats/byproducts
DISCHARGING TO SALTWATERS? DYES /VNO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 22Y32ror No discharge this period
Outfall'No. SampleaCollected,'
mo/dd/yr
TSS, pH; COD,
mg/,L, , •Standard units mg/L
Oil:and'Grea'se,, FecaIl. Coliforml,,; Eh, terocogdi', ;
_ mg/L,. ` Colonies per 100.,inl;- ,` Coloniesper 100" -ml=
Benchmark -
100 or, 504 -Within 6.-0' :,120-.
30 1000 500
M-40 9
C
1 Only applies to facilities that use/process meats.
ZThe 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? ❑ yes ❑ no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
(if es complete Part B)
Outfall No. Sample Collected, -Oil•and,Grease,"
mo/dd/,yr mg/L
TSS,pH,
mg/L
'Standard unit's
New Motor Oil Usage,
Annualaverage.gal/mo' "
Benchmark - 30
"' 100 or'SO4
"6.0:-9:0
-
1 Only applies to facilities that use/process meats.
ZThe 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.
Z \Environmental\Industrial\PP-Pilgrim's Pride\PPNC-North Carolina\PPNC01-Marshville\PPNC01-02 SPILL PLANS\2013 Monitoring Form 2

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 SECT ON B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDE CE OR THE SAME PARAMETER AT ANYONE OUTFALL? YE O ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES NO ❑
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 f'in'es and imprisonment for knowing violations."
(Signature of Permittee)
(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
Z \Environmental\Ind sud su Rial\PP-Pilgrim's Pride\PPNC-North Carolina\PPNCOI-Marshville\PPNCOI-02 SPILL PLANS\2013 Monitory g Form 2