NCG060382_MONITORING INFO_20190516

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V Cc,
DOC TYPE
❑HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ 2 DI°I Os (* / (/
YYYYMMDD

.a�:EYi � OPEM7En ..
May 8, 2019
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
RECEIVED
MAY 18 2019
DWR SECTILm
ON
Enclosed please find the Discharge Monitoring Report required by the storm water general permit at our
Statesville Breeder Feed Mill. The DMR reflects the month of April 2019. There has been significant
progress with results, with COD being the only parameter slightly over the benchmark value. We will
continue to monitor and improve operations as needed.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
aj2�
Austin Pajda
Environmental Manager
Cc: Tanya Rogers -Vickers (Mountaire) TAVI
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by haw well we service our internal and external customers"

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 05/08/2019
CERTIFICATE OF COVERAGE NO. NCG060382
FACILITY NAME Statesville Breeder Feed Mill
COUNTY iredell
PERSON COLLECTING SAMPLES
LABORATORY —Statesville Analytical— Lab Cert. # _440
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats N use animal fats/byproducts
DISCHARGING TO SALTWATERS? []YES NNO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall Z 1.0" or MNo discharge this period3
Outfali No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Collforml,
Colonies per 100 ml
Enterococcil,
Colonies er 100 ml
Benchmark
-
100 or 50"
Within 6.0 — 9.0
120
30
1000
500
02
04/05/2019
42
7.33
134
<5.43
3 Only applies to facilities that use/process meats.
2 The 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 N no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
" Outfall No.
Sample Collected,
mo/dd/ r
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark'-`
-
30
100 or 504
6.0 — 9.0
1 Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
b 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.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑
REGIONAL OFFICE CONTACT NAME: James Moore
-Mail an orlainal and one copy of this DMR, includina all "No Discharge" reports, within 30_days of receipt of the lob results for at end of
monitorina period In the case o "No Dischar e" 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."
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: httpa/portal,ncdenr.org/weblwa/ws/sulnpdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

_�Kefl . orexnran .
April 16, 2019
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCGO60382
To who it may concern,
RECRI E
MAY 0 3 2019
GEN 1+iA _ FILES
DtAiR S rC 1110N
Enclosed {Tease find the Discharge Monitoring Report required by the storm water general permit at our
Statesville Breeder Feed Mill. The DMR reflects March 2019. Facility personnel were unable to obtain a
sample for a representative storm event within the month due to the timing of rain events. A qualitative
monitoring report is not attached as no sample -was taken.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
a g
�*�
Austin Pa
Environmental Manager
Cc: Tanya Rogers -Vickers (MountaireylV46
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by how well we service our internal and external customers„

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 03/25/2019
CERTIFICATE OF COVERAGE NO. NCGO60382
FACILITY NAME Statesville Breeder Feed Mill
COUNTY Iredell
PERSON COLLECTING SAMPLES
LABORATORY —Statesville Analytical_ Lab Cert. # _440
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
FACILITY ACTIVITIES INCLUDE (check all that apply):
11 Use/process meats ® use animal fats/byproducts
DISCHARGING TO SALTWATERS? AYES ®NO
PLEASE REMEMBER TO SIGN ON THE REVERSE —)
Total event rainfall z N/A_ or 0No discharge this period3
" Outfall No.
',Sample Collected,_.,
. mo/dd/yr, -:.
T5S, ' '
: mg/L'. ' .
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Collforrril, , . ,
Colonles per 100 mi.
Enterococd" .
Colonies -per 100 ml
;Benchmark
iDO'or50°.
Within
120
30
1000,.
5W
02
Unable to
obtain a
representative
sample
1 Only applies to facilities that use/process meats.
The 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.
'See 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 > SS gal of new motor oil/month.
Outfall No:� ,
Sample.Collected, `
mo/dd/yr,,
OII and Grease,
mg/L
TSS,
mg/L
pFf,
Standard units
New Motor Oil Usage,' '
Annual average gal/mo .
Benchmark
-
30
100 or SW
6.0 — 9.0
1 Only applies to facilities that use/process meats,
z The 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.
°See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART If SECTION B.
• 2 EXCEEDANCES IN A 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 MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑
REGIONAL OFFICE CONTACT NAME: James Moore
Mall an original and one c92y of this DMR Including all "No Discharge" reports, within 30 days of receipt of the lab results jor at end o
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."
(Signature of Permittee)
Z{/�--
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/webLwq/ws/su/npdessw#tab-4
SWU-249 I-ast Revised: October 18, 2012
Page 2 of 2

IMA
AYA
.
�
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out rhisform, pimse visit, http'.11*Ml.rtW=.oWweblwglw;-,isty/npdessw#tab4
Permit No.: NICJ 1 J 1 f J I J or Certificate of Coverage No.: N/c(Gd 016J 0/ 3 / S/ 2/
Facility Nazi: i e Fmrs- stdMMIle scaeerr Feed fr
City; 1t p
irtspectar: fiT�S �i
Date of Inspectiou:
Tune of h mpec ion:
go -
Total Event motion (m+ts):
No. _ 704978-3055
Was this a Repmentwive Sturin Event? (See information below) Yes ❑ No
Please check your permu to verify if Qualitative Monitonag must be performed durvig a reprrsentarive
storm event (requirements vary).
A "Regmentative Storm Event" Ls a storm event that measures greater than 0.1 inches of rainfall and that
is preoodtsd by at Least 72 hours (3 days) in whdch no sto m event measuring great" than 0.1 inches has
occurred A single storm event may contain up to 10 consecutive hours of no precipitatiorL
By this signatwre, I =d4 th, this report is accurate and complete to the best of my lmawietige:
of Pcamittec OT
L Qutfail
Outfall No. OW Sw=wre (Pape, ffiu:k etc.) Pie -- -
Receiving Stream,: Third r;rrmk
Describe the indmrial acuvit= that occur within the outfail dramage area
Tnwk trarmpm aban. retwie CuefM qggM mamtx , and feed
2 Cakes: Describe the color of dq dissr PM basic cot (red, brovm, b1m etc.) and tint
(light, medium, dark) as ors:
3. Odor; Describe any disfw odors that the may have (Le., smells smirgly of oil, weak
chlorine odor, cm.)-.
PaW 1 of 2
SWUM 20IM613

4. Clarity: Choose the number which bcst describes the clarity of the discharge, where I is clear
and 5 is very cloudy
102 3 4 5
& Ong Sates: Choose the number wtuch best deambes the amount of floating solids m the
stoimwatea discbmge, where l is no solids and 5 is the smrace covered with $oa3ing solids:
I C)2 3 4 5
6. SuspeadW Shucks: Choose the a nor which best d bes the amoum of suspended solids is
the swmwather discharge, Where I is no solids and 5 is a ly muddy:
l (D 3 4 5
7. is there any foam m the no mwater discharge? Yes (No
& Is there an eng sheen in the sw mwater discharge? Yes ONo
9. is them evidence of eroalon or depoition at the outfall? Yes S
10. Other OhvMW lamrstars of Stormwater Pbil>af w:
List and descnbe
Noft- Low dWrky, high ham, an d/or the greseam of foam, 08 shin, or ernffmmddepesl� may
he h2fficativei of paw exposnre. Thee candftions w&YaW fmllm9r invesfigadmL
t?w2of2
SWUM-20120613

March 25, 2019
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
_mNtQ � 01ERATEb .
D
APR 02 20
ce-40 F.,
is
I / "tA1 �t"FS
ra,�l
Enclosed please find the Discharge Monitoring Report and Qualitative Monitoring Report required by
the storm water general permit at our Statesville Breeder Feed Mill. The DMR reflects February 2019.
COD and TSS for February's sampling event tested at 413 mg/L and 127 mg/L respectively. Mountaire is
continuing to investigate and improve operations at the Statesville Feed Mill. Stone around the corn
transfer leg has been placed which, we believe, should improve overall COD. Mountaire will re-evaluate
current storm water practices during the next sampling event.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
Austin Pajda
Environmental Manager
Cc: Tanya Rogers -Vickers (Mountaire)-o-1
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by how well we service our internal and external customers„

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG0160000
Date submitted: 03/25/2019
CERTIFICATE OF COVERAGE NO. NCG060382 SAMPLE COLLECTION YEAR 2019
FACILITY NAME Statesville Breeder Feed Mill FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredeil ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? [—]YES ®NO
LABORATORY Statesville Analytical_ Lab Cert. # 440
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall ? 0.47"_ or ❑ No discharge this period'
Outfall No.
Sample Collected,
-mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
oil and Grease,
mg/L
Fecal Coliform',
Colonies er 100 ml
Enterococcil,
Colonies per 100 ml
Benchmark
-
100 or SW
Within 6.0 — 9.0
120
30
1000
Soo
02
02/19/19
127
6.8
413
14
N/A
N/A
i 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.
45ee 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 0 no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
-
1 Only applies to facilities that use/process meats.
2 The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at Ary outfalls, you must still submit this discharge monitoring report with a checkmark here.
45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if ves• complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART 8 MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
+ 2 EXCEEDANCES IN A 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 MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ®NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑
REGIONAL OFFICE CONTACT NAME: James Moore
Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 days of recei t of the lab results or at end of
monitorina 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."
i
(Signature of Permittee) (Date)
Additional copies of this farm may be downloaded at: http://"portal,ncdenr,org/web/wq/wsZsu/ng�essw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

Stormwatel Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidrurar o ijtuuxg out ibis form, lsIarae visiX htty_Lki. de ,oWaveblwc f�vv�Tsulnpdcssw#Fab
Permit No-_ NICJ I 1 1 1 1 1 1 or Certificate of Coverage No._ NCP f318I 0/ 3 / 8/ 21
Facility Nam • Fma W
County: t Phone No_ 70-873-3055
lnspemr. 6,44,J We,-O'_ - -
Date of bsperxicsn-
- me of mwec tiew
Toisl Evan Preoa Cox < /N C�' y 7 rn !
Was this a Rive Starm EvenO (See irifi i(m below) R Yes ❑ No
P[mse dwx* yarn pennd to verify if Qnahtmve Momwrmg must be p+erfarmwd &rang a reprew=we
ADM eVeM (rEqUirMe7aX vary) -
A Storm Event" is a storm event that weasum greater ftn U mcbes of rainfall and that
n preamkA by at imgt 72 hours (3 days) in which no stm event measuring greater than 0.1 inches has
oocmard- A sib storm cvcm may contain up to 10 ovnseculive trams of no predg�
By This(that this report is wxurata artd Cmviete to the best of my bxwdedge:
or )
L Oat&H Deseripsti=
OutfaH No- Om Strwwre (papa, ditch. etc-) Fte
Rcc wing strew Third (>aek
Descri-ba the mdmmmal acuities that occur witbin the outiaH drainage areas
French vehide fer kxh SmM ri =ftn nae—arid teen � ..
Z Calm ,-be the color of tie &dmjXe.ttsb'tg basic coksrs {rod, hen, bltm, e#c) and twt
R+_!A4 mmiman, dam) as _ _jfK4a&mAd
3 odbr: Dot s m-be any distinct odors ttt the edge mar have- Cf-e_, --A shy of cry, weak
odor, ems): 11 /D0 C _ fwpzic�
Page I of 2
•z�.. .,,

4. Cbrlty: Choose the number w13ch best descril es the clarity of the disclmrgc, whrrc I is clear
and S is very clmdy-
102 3 4 5
S. Fkating SoI C bom Cite number why !test demnibes the amount of floating solids is tie
swrmwater &%dmrge, wh= I is no solids mad 5 is the sudaee covered with floating solids:
1 0 3 4 5
6. Susxnded S CbDm the number which best describes the awotmt of suspended solids in
the Swwmvrater discharge, when I is no solids and 5 is extremely muddy:
i (D 3 4 5
7. Is tyre any farm m the Awmwatei dischae? Yes No
& Is dnere an all sbam in de starmwate r ds ? Yes
9. Is t=w evidence of eresim or deposdam at the as ffiffl? Yes No
1Q 01h9w ©bviasus Ids of Sturmwater PGRBtk D:
List and d=crib e
Note: low charily, higb so Huh andAD r the presmm of famm, an shn, or era%ionl z=y
be eve of puRalawd exposair. 1hCSC COUCTIUM wariraitt f6rihM ilITCMIgHfUIEL
Page 2 of
SWLLM 2DI2%13

Analytical Results
Mourrtaire Farms
4M ToyiUWMe Fitly
S"esvdle. NC 28625
Receive Dam: OMU2019
Reported: 031=20ig
For.
Gonunents-
STATESVILLE
~` ANALYTICAL
Sample ParnmeUw
Sample in
Result
Unit Wedw d Ana*"d Analyst
1902Z5-1 z-0I OM=W QrjW t
[3emaxrd
OF2
413
nlg& HAO1D 03KD12Q19 C.L
190225-11-01 Off and Grease
OF2
14.O
mgli_ "165CRAWO 03AT 2019 Cl
190225-11-01 TSS
OF2
127
rang g°G"D`'s 9319112019 WC
Rey s1SROVed.
9
Denim Myers
NC Cent SM.
NCOW Ced 237755,
EPA
PO BOX 229 ■ SUtsvfflE„ MC ZBW - 7D4/872/4W
Page 1 d3

February 13, 2019
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
Enclosed please find the Discharge Monitoring Report and Qualitative Monitoring Report required by
the storm water general permit at our Statesville Breeder Feed Mill. The DMR reflects January 2019.
Results from the most recent sampling event have indicated tremendous efforts towards meeting
benchmark limits since the December 2018 sampling event. COD and TSS for January's sampling event
tested at 127 mg/L and 115 mg/L respectively. As an additional effort towards meeting the benchmarks,
gravel was placed on the dirt drive for truck traffic which ultimately leads to the catch basin network.
We are hopeful that this effort will result in both parameters meeting benchmark limits during the next
sampling event -
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
("Z
Austin Pa a
Environmental Manager
Cc: Tanya Rogers -Vickers (Mountaire)��
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by haw well we service our internal and external customers"

r
SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 02/12/2019
CERTIFICATE OF COVERAGE NO. NCGO60382 SAMPLE COLLECTION YEAR 2019
FACILITY NAME Statesville Breeder Feed Mill FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredell ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? [-]YES ®NO
LABORATORY_Statesvilie Analytical_ Lab Cert. if _440
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall 2 0.17" or ❑ No discharge this period'
Outfall Nab
fi'Sam Ie,Collecfed, ,
P
ma/,dd/,yr
FSs,
mg/L
H
PJI
Standard units
"D,'011�and
Grease,
mglL
Fecal C'oliform�;�f
rolonies per 100 ml
Enteracocch �"
Colonfiesiper}100m1
J9enchmark'
ff100 or 502
KW- Ith 6T0,?=-9:0j
jXjWf20 ,
_93.0
WMGNNWA
lff,,W45001'
02
01/29/19
lis
7.0
127
6.1
N/A
N/A
1 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 outfalis. 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.
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.
Outfall No.
sample Cnlle'c ed,
m_ o/,dd/,yr
011 and Grease,
mg/LNL
ss
JMTW,§Z*S*ta'ndVXrunIt5rd
" '� '
New,Motors oil",Usage ;
An' nua veyra a alp/ o .
[Benchmark
a
3a
it30�or�50'
,6'0, `90
�„` ;;
1 Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at gny 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.
(if yes, complete Part B)
S W U-249
Last Revised: October 18, 2012
Pagel of 2

*FOR PART A AND PART B MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ® NO []
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ® NO ❑
REGIONAL OFFICE CONTACT NAME: James Moore
Mail an on inal and one capy of this DMR including all "No Dischar e" reports, within 30 da s of receipt of the lab results or at end o
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."
(Signature of Permittee)
(Date)
Additional copies of this form may be downloaded at: http://portal.ncde_nr.org/webl�+�/ws/suLnpdessw#tab-4
SW i 1-249
Last Revised: October 19, 2012
Page 2 of 2

A
RCKHR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring,.Report
For guidance on filling out (Wpm please visit: ht pgh ggW cdenr.org/we6/wgia'slsulnedessw*ah-4
Permit No.: NIC/ ! / / / / / / or Certificate of Coverage No.: YC G! O ! 6! O 3 181 2/
Facility Name: luOUMMre Fames• SUMsvft Breeder Feed Min
County. Iredell Phone No. 704978-3055
lmspector.s
Date of Inspection: 1- _ q - 11 -
Time of inspection: ZT
Total Event Precipitation (inches). :� I ti i( -ak
Was this a Representative Storm Event? (See information below) R Yes ❑ No
Please check your permit to verify if Qualitative Monftoriicg must be performed &tnng a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event that. measures greater. than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
Occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify dAs report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. 0Q2 Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Third Creek
Describe the industrial activities that occur within she omtfaii drainage area:
Ttudc transportation, vehide fueling, garage maintenance. and feed badinelreceMag
2. Color:.. escribe:the cdlor.of thf discharge :basic colors (red, brown, blue, etc.) and tint
J (light, medium, dark) as descriptors: j�� �M MOEN
3. Odor: Describe any distinct odors that the discharge may have (Le., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best dcscriiies the clarity of the discharge, where l is clear
and 5 is very cloudy:
i 2 (3D. ; 4 5
5. Floating Solids: Choose ttie nurn6dt which best describes the amount of floating solids in the
stormwater discharge, where l is no solids and 5 is the surface covered with floating solids:
l D2 3 4 5
6. Suspended Solids: Choose the number which hest describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy
1 [ 2 ) 3 4 S
7. Is there any foam in the storrnwater discharge? Yes No
& Is there an oil -sheen in the stormwater discharge? Yes eo
9. Is there evidence of erosion or deposition at -the outfall? Yes NNo
10. Other Obvious indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
be indicative of pollutant expdsure.. These combdons warrant further invesdption.
Page 2 of 2
SWLJ-242-201206 B

Date: - w Nq Analyst:
pH Meter Calibration
pH Buffe
pH Reading
Q
4
7
•© Z
10
F _C-i
pH 7 check
7

Analytical Results STATESVILLE
ANALYTICAL
Mountaire Farms
4085 Tayiorsville Hwy
Statesville, NC 28625
Receive Date: 01/29C2019
Reported: 02/06/2019
For.
Comments:
Sample Number Parameter Sample ID Result Unit Method Analy� Analyst
190129-25-01 , •Chemical,Oxygep , _ OF2 127 rttg/L ""''�O fl2l0120i9.:CG
be-�46cf
190129-26-01 Off and Grease OF2 6.08 mg/L EPAIS"RftB 02RWO19 CI_
190129-25-01 TSS OF2 115 mg/L o-7D1' 02/012019 1MC
Reslly submitted,
Dena Myers
NC Cer# #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 - Statesville, NC 28687 • 704/872/4697
Faye 1 of 3

ant:
STATKSV EAt'IAi"CAL
L22 Caws WW - P.O.Ow 229
WnWhe, NC 21697
Addmm,
2Z
r
(704) 072469T
Cwp of
Custody Record
ntut Pella Phone N FAX#
POO Raqutapionod by. m
keD-IT!
0�6r1
iera6Ot i,
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15�rs�"�alwttod fnrm�ly
,MM
I
i
I:lalinquishad by:
'
TlmQl-4QOpmjq Vale Ll=f! �"�f
9ampied lty:
Received by:
'� t. --
Time am, ale J� l�!
Transported by,
k
Rellnqulahed by:
I
Tlrtte am. pm Data —J—J
Holding times met:
Received by:
Camel ft building
q1•
'
Time am, pm Date
,
cot nplleace work:�
Time begin am, pm Data ___/ J _
Noit•cantpiiwm wank:
Time endpm Date
~
'
_am,
Lno
Coffr"tn: 9amploe:T"'
pwwntl On Ike;
hem limn«
e?:
ilme bepin am, pm pate _ _hl
Time end am, pm Date
"s
+notate:
0o
N
N
x
0
a

Condition of Receipt
J
Sample Nwnber 190129-25-01 Terrip on Arrivat 3.2
pH on Anival: <2 Parameter Schedule: 00 and Grease
Hydrochloric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: TSSS
Received on foe
pH on Arrival: <2 Parameter Schedule: Cbemical Oxygen Dennand
Sulfuric Acid Received on tee
Chemicals in containers, lab
PO Box 228 - Statesville, NC 2M7 . 704/872/4S7
Page 2 013

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 12/17/2018
CERTIFICATE OF COVERAGE NO. NCGO60382 SAMPLE COLLECTION YEAR 2018
FACILITY NAME Statesville Breeder Feed Mill REC�^� VED FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredell ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES JAN 0 3 �Q1� DISCHARGING TO SALTWATERS? ❑YES ®NO
LABORATORY —Statesville Analytical_ Lab Cert. # _440CENTRAL FILES
DWR SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
Total event rainfall z 0.28" or ❑ No discharge this period'
Outfall No.
=
'Sample Collected,
mo/dd/yr
'TSS,
mg/L' " "'.
� ._ pH;
:. Standard units:
COD,
mg/L
Oil'and,Grease;
rrtg/L`
; Fecal.Coliforml,
:'Colonles:per 100 nl
Enterococci';
Colonies per 100 mi '
Benchmark..
-:. ,:
100 ar 504..,
'•Within 6.0-9.0. ;
120
:..: 30
` 1000
500
02
11/23/18
29
7.1
59
7.4
N/A
N/A
' 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 as 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.
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.
Outfall No.
f, `Sample Collected;
mo/dd/,yr .,
Oil and Grease,
`mg/L
TSS,
mg/L-
pH, '
Standard units:':
New; Motor Oil Usage,
Annual average gal/mo ;
Benchmark : _
- .:
30.
- 100 or 504 .
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 aM 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.
(ifyes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
+ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitorina 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
11
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."
(Signature of Permittee)
1Z-17_4
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SW U-249
Last Revised: October 18, 2012
Page 2 of 2

F WA
MCDEHR
F Stormwatelr Discharge OutfaU (SDO)
Qualitative Monitoring:;Report
For guidance on filling out this form, please visit: bW:/lportal.nedenr.orgtweh wctlwn/sulrpdessw#tab-4
Permit No.: NICI I_I l / l !—I or Certificate of Coverage No.: NJUW 0 16l 0l 3 l s ! 21
Facility Name: Moantaire F statesWle Breeder Feed MID
County: Iredell Phone No. 704-978-3055
Inspector., ;
Date of Inspection: /p
Time of Inspection:
Total Event Precipitation (inches):
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed durr & a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greater=than 0.1 inches of rainfall and that
is prmeded by at least 72 hours (3 clays) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation_
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Pe,4ttee or
1. Outfali Descxipgop:
Outfall No. 002 Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Third Creek
Describe the industrial activities that occur within the outfall drainage area:
--_ Truck transportation_vehide fueling, garage maintenanm, and fed loading recei
2. Color: 9Describe the color of, the discharge using basic:colors.(red, brown; blue, etc:) and tint
(light, medium, dark) as descriptors:
3. Odor. Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, wean
chlorine odor, etc.): /iN& 0,91 r:;(ZGf
Page 1 of 2
SWU-242-ZD 120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where l is clear
and 5 is very cloudy:
1 (92 3_,,4 5
5. Floating Solids: Choose the number ivhicb best describes the amount of floating solids in the
stormwater discharge, where l is no solids and 5 is the surface covered with floating solids:
1Q 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy
1 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an'oi7 sheen in the storinwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes No'
14. Other Obvious Indicators of Stormwater Pollution: -
List and describe
Note: Low clarity, high solids, and/or the presence of foam, ot3 sheen, or erosion/deposition may
be indicative of.pollutaat exposure. These conditions warrortt further investigation.
Page 2 of 2
SWU-242-20120613

LTMA
Ran
Stormwater Discharge Outfall (SDO)
Qualitative Monitoruzg Report
For guidance on filling out this farm, please visit: htW.-14Mg.ncdenr.ordweWa/wsfsu/nudessw#tab4
Permit No.: or Certificate of Coverage No.: N�ClGI 16 / 13 ! 1?I
Facility Name: Mot UM Farm&- ftleaWle Breeder Feed Mil
County: IredeU Phone No. 704-978-3055 .
Inspector.
Date of inspection:
Time of fnspec ion:
Total Event Precipitation (inches): - 4 / %NCB
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Moniror hg mW be performed during a representative
storm everts (requirements vary).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
is Preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, f certify that this report is accurate and complete to the best of my lmowledge:
(Signature of PegOttee or
1. QutM Description:
Outfall No, 002 Structure (pipe, ditch etc.) pine
Receiving Stream: Third Creek
Describe the industrial activities that occur within the outfail drainage area:
Tnlck transportation, vehicle fuelirN, garage maintenance. and feed loadinalreceiving_
2. Collor: ;Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, clam) as descriptors: 41
3. Odor. Describe any distinct odors that the `discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
swu_242-2A120613

4. Clarity: Choose the cumber which best describes the clarity of the discharge, where i is clear
and 5 is very cloudy.
1 f2 3 4 5
5. Floating Solids; Choose the number which best describes 6e ammtmt of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
10 2 3 4 5
6. Suspended Solids. Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where l is no solids and 5 is exft=ly muddy:
l 6 3 4 5
7. U there any foam in the stormwater discharge? Yes No
8. Is there an o17 sheen in the sturmwater discharge? Yes
4. Is there evidence of erosion'er depadtion at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and desmbe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/depasMan may
be lndWatiae df pollutant exp6sam- T6,ese contdibhons warrant ftnr#hetr favestigathm.
Page 2 of 2
SWU-242-20120613

January 22, 2019
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
RECEI .E:D
FED o 2019
DI R sECTIO�v
Enclosed please find the Discharge Monitoring Report and Qualitative Monitoring Report required by
the storm water general permit at our Statesville Breeder Feed Mill. The DMR reflects December 2018.
The results from this sampling event have caused the site to exceed benchmark parameters four times
since sampling began in October of 2017. We believe sampling results for TSS and COD were negatively
impacted by a scale project that began late November of 2018 and finished the first week in January
2019. The settling tank was cleaned out after the project finished and showed an accumulation of solids.
We believe the timing and amount of precipitation and loading of construction material to this settling
tank has caused elevated results. With construction of the scale complete and tank cleanout post
construction, the Statesville Feed Mill site is awaiting a representative rain event to reassess sampling
results to determine the next course of action.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
Austin Pajda
Environmental Manager
Cc: Tanya Rogers -Vickers (Mountaire)-( V-4
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We treasure quality by how well the service our internal and external customers"

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 01/22/2019
CERTIFICATE OF COVERAGE NO, NCG060382
FACILITY NAME Statesville Breeder Feed Mill
COUNTY Iredell
PERSON COLLECTING SAMPLES
LABORATORY —Statesville Analytical_ Lab Cert. # _440
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ® use animal fats/byproducts
DISCHARGING TO SALTWATERS? DYES ®NO
PLEASE REMEMBER TO SIGN ON THE REVERSE •4
Total event rainfall z 0.97" or ❑ No discharge this period3
Outfall No. r
Sample Collected;,
mo/dd/yr .
TSS, -�
mg/L' -
pH;
.standard units.
:COD,
"mg/L
Oil and Grease,
mg/L .
Fecal Collfornti�,` ;
Colonies per.100 m4
Enterocnccil,° ,, a
Colonies per 100 mi.
Benchmark ', ,
lOQ`or 501.:'
': Within 6A-9.4
120
30
1000
500'
02
12/20/18
1384
7.1
531
9.1
N/A
N/A
1 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 2ny 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ® no
Part 8: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall-No.
`
Sample Collected,
Rmo/dd/yr� '` ,
" '°. "OIl and :Grease,`
mg/L. ;
= TSS'
mg%L
pH; .'
standard units
New. Motor Oil Usage,.' ,
Annual average gal/mo , ,
Benchiriark:.
30 . .:,.
200 or-50`:.
6.0 — 9A
_
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
9 For 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,
(if yes. complete Part B)
SWU-249 Last Revised: October 18, 2012
Page] of 2

*FOR PART A AND PART B MONITORING RESULTS:
* A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B,
+ 2 EXCEEDANCES IN A 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 MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO[-1
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 for at end of
monitoring period in the case of "No Discharge" repogs) 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."
(Signature of Permittee)
1-2
(Date)
Additional copies of this form may be downloaded at: http://Rortal.ncdenr,org/weblwq/ws/su/npdessw#tab-4
SWU-249
Last Revised: October 18, 2012
Page 2 of 2

4,
NCDENR
Stormwater DiDischargeOutfall (SDO)
Qualitative Monitoring; 4ppqd,,
For guidance onfiffing out this form, please vish.-
or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0I3 1812/
Facility Name: MOuntan Farnis- SMBreeder Feed MM
County! ITedell PhoneNo,- 704-978-3055.
Inspector:
Date of Inspection: -2.v
Time of Inspection:
Total Event Precipitation (inches): - -i . . / 1A, - ",/
Was this a Representative Storm Event? (See infbrmadn below) aYes F No,
Piease check your permit to verify if QuaLifarive Monitoriftg must be.performed !during; a representative
storm event (requiremeras vary).
A "Representative Storm Evenfl is a storm event that measuresgreater-than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
of Perpis or Designee)
1. Outfall. Description:
Ou&4 No.. 002 Structure (pipe, ditchetc.). Pipe
Receiving Stream: Third Creek
Describe the mdusaW activities that occur within the outfall drainage area:.
Truck transportation, vehicle fueling, garage maintenance, an hnd 1oad'OgLO=wyjn!j3._
2. Color;, -Describe the,color.of the dischpmingbas:ic colors,(red,,brown, blue, etc.) and tint
(light, medium, dark) as descriptors; Z/7
3. Odor- Describe any distinct odors that the discharge may have (Le., smeDs strongly of oil, weak
chlorine odor, etc.): fffL/ IC 0-- �Ioev�
Page I of 2
S1WU-24220UD613

-: xa
4. Clarity: Choose the number which best �de_ k ibA the clarity of the discharge, Where I is clear
and 5 is very cloudy:
1 2 ' , 4 5
5. Floating Solids: Choase the number wti cb best'desdibes #lie-amoum of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
10 2 l 3 4 5
h. Suspended Solids: Choose the nu nber which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
10 04 5
7. Is there any foam in ft storurwater discharge? Yes No
$. 'h there an oil sheeniii the stoi"ater'discliarge? Yes
9. ' U:thereevidenceof erosion ur deposition at the autfall? ' Yes No
Ia. Other Obvious indicators of Stormwater Pollution:
List and describe
1t i
Note: Lone clarity, (nigh solids, alnWor the presence of foam, oil sheen, or erosion/deposition may
be indiativa of.poUntant expagare. Them csn&tions warrant further- in t1dii.
Page 2 of 2
swt-242-20120613

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Date: JZlzozlAnalyst:-ys�
pH Meter Calibration
pH Buffer pH Reading
4
7"
io
pH 7 check

• Q g E M! U
1 i c°slt }'r`lrtiw olicAwll
October 24, 2018
Division of Water quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
Enclosed please find the Discharge Monitoring Reportand Qualitative Monitoring Report required by
the storm water general permit at our Statesville Breeder Feed Mill. The DMR reflects September 2018.
During this sampling event, the Feed Mill Manager (sampler) noted a large volume of water in the catch
basin where Outfal[ 2 is located. This catch basin was collecting water from both the street and the Feed
Mill property. We believe that the sample obtained reflecting an elevated TSS and COD was directly
affected by this additional loading from the street. We will further evaluate and determine any
additional actions needed during the next sampling event.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
Austin Pajda
Environmental Manager
Cc: Tanya Rogers -Vickers (Mountaire) 100
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by how well we service our internal and external customers"

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 09/26/2018
CERTIFICATE OF COVERAGE NO. NCG060382 RECEI EPMPLE COLLECTION YEAR 2018
FACILITY NAME Statesville Breeder Feed Mill R C V CILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredell NOV 0 5 2018 ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? DYES ®NO
LABORATORY Statesville Analytical_ Lab Cert. # _440 CENTRAL FILES
SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE -�
Part A: Stormwater Benchmarks and Monitoring Results
Total event rain/'all z 1" or ❑ No discharge this period3
Outfall No. `
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliforml,
Colonies per 100 ml
Enterococcl',
Colonies per 100 ml
.Benchmark
100 or.SO°.
Within 6.0 —9.0
120
30
1000
Soo
02
09/26/18
875
7.0
199
9.8
N/A
N/A
' 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 is 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.
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 > S5 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
'011 and Grease,
mg/L
TSS,
mg/L.
pH,
Standard units
New Motor Oil Usage,
Annual average gat/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
1 Only applies to facilities that use/process meats.
'The 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.
'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if Les, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
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:
"1 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."
(Signature of Permittee)
/u - �3-�8
(Date)
Additional copies of this form may be downloaded at: http:lZportal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

� OR
Stormwater Discharge Outfall (SDO)
Qualitative �Monuitoring. Report _
For guidance on filling out this form, please visit_ hupyLEgni,nQdcx�2Mbyc Lw—qhwslsnlnRdoe2w ab-4
Pertrut No.: JG 1j I �J 1 1 or Certificate of Coverage No.: Nj— g1 OSim
Facility Name: Mountslfe Farms StffMSVMe eceeaer Fear MM
County, Iredell Phoae No. .744978-3055
Inspector: — eeQ
Date of Inspmtion: 9. .2
Time of Inspection.
Total Event Precipitation (inches): /. /�✓�}�
Was this a Representative Sum Event7 (See information below) [P�es ❑ No
Please check your permit to verify if Qualitative Monitoring muse be performed during. a representative
storm evert (requirements vary).
A "Representative Storm Event" is a storm event that rrteasiues; greater -than 0- l inches, of rainfall and that
is preceded by at least 72 hours (3 clays) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive flours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
e
(Sign of Permi, or Designee) _
1, outran ll>es Poon:
Outfall No. 002 Structure (pipe, ditch, etc.) Pipe
Receiving Stream Third Creek
Descnbe the industrial activities that occur -within the outfall-drainage area:
Truck transportation, vehicle fueiina• garage maintenance, end feed loadings ceiving - —
2, Color. Describe Fite color of the diwharge.usin :basic-colors.(t�; brown; blues etc:) and tint
(light, medium, dark) as descriptors: �/ � -- - --
3. Odor, Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weals
chlorine odor, etc.): A%f i fsvto
Page t of 2
SWU 242-2012%13

�1=
4. Clarity: Choose the number which best de bcs;the clarity of the e, where 1 is clear
and 5 is very cloudy: discttarg
1 2-1" 3 4 5
5. Floating Solids: Choose 'ti& iiuffibei ovlg cli hest lscr bes the:,aar&a mt of floating solids in the
stormwater discharge, when I is no solids and 5 is the surface covered with floating solids:
6. - Sugwnded Solids: Choose the number which best describes the amount of suspended solids'ui
the stormwater discharge, where i is no solids and 5 is extremely muddy:
1 2C) 3 - 4 5
7. Is there any foam in the su=water discharge? Yes No
8. Is there an 6 sheen'ia the stoh-nvi aiei'discii&ge? Yes
% Is thereevidence bf eiosibn or. deposition at�thc outfall? ' ` - Yes'
10. Other Obvious In icators of 5tormwater Pollution:
Yj
List and describe
i
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erasionldeposition may
be hAcative'of poilu#ant exposure:: These conditions wiri-ant Part invesfigation '
SW-242-20I M13
Page 2 of 2

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Wafter Quality General Permit No, NCG060000
IZEDate C! btbd:11/07/2018
CERTIFICATE OF COVERAGE NO. NCG060382 SAMPLE COLLECTION YEAR 2018
FACILITY NAME Statesville Breeder Feed Mill NOV 2 0 Z014ACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredeil CENTRAL FILES ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES IDWR SFCTIOtOISCHARGING TO SALTWATERS? []YES ®NO
LAB ORATORY_StatesviIle Analytical_ Lab Cert. # �440
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE —)
Total event rainfall N/A or ❑ No discharge this period
Outfall No.
Sample Collected,
mo/dd/yr' '
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliforml;
Colonies per 100 ml
Enterococci',
-Colonies per 100 ml
Benchmark
-
100 or 50"
Within 6.0 ' 9.0
120
30
1000
Soo
02
Unable to obtain
sample.
N/A
N/A
1 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? ❑ yes ® no
Part B: Vehicle Maintenance Area Monitoring Results, only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
ma/dd/yr, ,
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor.0il Usage,, .
Annual average gal/mo`
; 9enchmark,
30
100 or 504
6.0 — 9.0
-
' Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at pny 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.
(if es, complete Part Bj
SWU-249 Last Revised: October 18, 2012
Page l of 2

Is
*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• 2 EXCEEDANCES IN A 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 MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO
REGIONAL OFFICE CONTACT NAME:
Mail an orI inal and one copy of this DMR Including all "No Discharge" reports, within 30 days of receipt of the lab results or at end o
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."
(Signature of Permittee)
1-- 1_.1.
(Date)
Additional copies of this form may be downloaded at: http:/Iportal.ncdenr.org/web/wq/ws/su/Ppdessw#tab-4
SW U-249
Last Revised: October 19, 2412
Page 2 of 2

OVA-
Stormwater Discharge Outfall (SDO)
Qualitative. Monitoring Report
For guidance on filling oza dais form, please visit.- t %R;%wtal ;nc d=-orVsu/n ess sip 4
Permit No.: NLCIJ-4-4-j—J_L I or Certificate of coverage No.: NIGGi 0 / 61 01 S i 8121
Facility Name: Ww t we l Omr- stafsye ate, Feed W
Phone -.No. 704-578-3055
l'nspect,ar:
Date of inspection:
Time of Inspection:
Total Event Fiecipitation (inches): A1A
Was this a Representative Storm Event? (See information below) ❑ Yes
Wig
E DES Or
Please check your permit to vet ify if ?ualitcttive Martitor ng-must be per during.a. representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event that measums greater4m 0.I iinehes� of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0,1 inches has
occurred. A single storm event may contain up to 10 consecutive hour's of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
of PernA or Designee)
L Ouffall Description:
Outfall No. 002 Structure (pipe, ditch, etc_) Ripe -
Receiving Stream: Third Creels
Describe the industrial activities that occur within the outfall drainage area:
Truck transportation, vehicle fuefing, garage maintenance, and ft2d loadi remMna.
I CtF pr:;Mescn'be the.color;of the discharge uskg basic colors (red, brown,-hhie;etc ).and tint
(light= medium, dark) as descriptors:
3. Odour: Describe any distinct
chlorine odor, etc.):
that the discharge may have (i.e.. smells strongly of oil, weak
Page t of 2
SWU-242-WI20613

4. Clarity: Choose the number which best cleserit>e's the clarity of the discharge, where 1 is clear
and 5 is very cloedy:
1 2r _ ,3y •4 S � N-
5. Floating Solids: Choose the nu nber which best describes the amount of floating solids in the
starmwater discharge, where 1 is no solids and 5 is the surface covered with floatatg solids:
1 2 3 4 5 A
G. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy: j
1 2 3 4 5 !r A
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the storinwater dis&aig0 [� Yes No
II
9. Is there evidence of erosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution -
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may
be indicative 6f-polluuint exposure. These conditions warrantfnrther investigation.
Page 2 of 2
SWU-242-2}I20613

me�tiv . ore�r�n __
September 26, 2018
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
RECEIVED
OCT 03 1018
r�EN7-R.,41� i=1L Es
Enclosed please find the Discharge Monitoring Report and Qualitative Monitoring Report required by
the storm water general permit at our Statesville Breeder Feed Mill. The DMR reflects August 2018.
A sample was not able to be taken for the month of August. We will obtain a sample per the Tier II
requirements during the next qualifying rain event during staffed hours_ To assist with obtaining a
representative sample, the Statesville Breeder Feed Mill purchased and will operate/maintain an
approved pH meter. This will allow for samples to be taken after lab hours without exceeding the hold
time for pH.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
ad
Austin Paj da
Environmental Manager
Cc: Tanya Rogers -Vickers (Mountaire) `_-
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by lww well we service our internal and external customers"

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 09/26/2018
CERTIFICATE OF COVERAGE NO. NCGO60382 SAMPLE COLLECTION YEAR 2018
FACILITY NAME Statesville Breeder Feed Mill FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredell ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERSiT DYES ®NO
LABORATORY —Statesville Analytical_ Lab Cert. # _440
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall N/A or ❑ No discharge this period
Outfall No.
Sample.Collected;
mo/dd/yr
TSS,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform',
Colonies per 100 ml
Enterococcl',.
Colonies per 100 ml
Benchmark
-
100 or 50'
within 6.0 — 9.0
120
30
1000
Soo
02
No Sample
N/A
N/A
' Only applies to facilities that use/process meats.
' The total precipitation must be recorded using data from an on -site rain gauge.
s For 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes N no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
outfall No.
Sample Collected,
mo/dd/yr;
Oil and Grease,.
TSS,
mg/L
pH,
Standard units
New Motor Oil usage,
Annual average gal/mo
Benchmark
-
30 '>
100 or 504
6.0 — 9.0
-
' Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
8 For 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.
(if yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
+ A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
2 EXCEEDANCErS IN A 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 MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
_Mail an original and one copy of this [AMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for 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."
(Signature of Permittee)
(Date)
Additional copies of this form may be downloaded at: httP://Qortal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

MCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring_Re-oort
For guidance on fitting out this farm, please visit: httv111_rtcderrr_or�laeb/wgfwslsulnndessatab-
Permit No.: NICi / 1_f 1^f�l�C or Certificate of Coverage No.: N/CfGf E3 f 642f 3 f 8# 2I
Faclfity Name: Mountaire Fames- atatez�ANe awede< Fead M'il
County, plredell r _ _Phone No., 704-978-3055:
Inspector.-
Date of Inspection:
Time of Inspection:
q �res�fiye' Eve' Web nab�
Total Event Precipitation (inches): W 6e 0�s e -gip f 1m14
t.0
of fain N "to
Was this a Representative Storm Event? (See information below) ❑ Yes ❑ No '
Please cheek your permit to verify if Qualitative Monitorii g must be performed during a representative
storm event (requirements vary}.
A "Representative Storm Event" is a storm event that measures ttc:r.tha ti 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event meanuintr greater than 0.1 inches has
occurrad. A simple sa= event may contain up to 10 consecutive hates of no precipitation.
By this signatu 1 certify twt this report is accurate and complete to the best of my knowledge:
1. Unifa_ li' Description:
0, tfall No. 0112 Strutxur_e (pipe. ditch, etc.) pf
Receiving Stream Ttvrd Creek .
Describe the industrial activities, that occur within the outfaU drainage area
Truck trarisportation, vehicle fueling. garage maWenance arnf feed toadine rreceiying. _ ..
2. Color: Pescrz'be the color of the dischuge ttsk basic colors (red, brown.. blue, etc) and bent
(limit, inf iimn, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e-, smells strongly of oil, weak -
chlorine odor, etc.): WA
Page 1 of 2
swu-U2-201206 t a

4. Clarity: Choose the number which bens ilesqibes ,the clarity of the discharge, where 1 is clear
and 5 is very cloudy: `
t 2 3 _'. � 4 5
5. Floating, Solids: Chooselbii nambet cvtiitls best describes the aino>iat of floating solids in the
stonriwater discharge, where I is no solids and 5 is the smface covered with floating solids:
1 2 3 4 5 MIA `
f,, Suspended Sands: Choose the number which best describes the anmunt of sided solids is
the stormwster discbmTe, where 1 is no solids and 5 is extremely muddy:
I 2 3 4 3
7.
8.
Is there any foam in the stormwater discharge?
Yes No
Is theme atoif Sheen iia the stonmwafer &dharge? Yes Na
9 Is there eviden5ci of ei6dad!bt deposition at the outfali? Yes No
lQ C Cher Obvious indicators of Stormwater PoRutlon:
List and describe
Note: Law clarlty, high solids, andfor the presence of foam, oil sheen, or erosioafdeposition may
lie indicaiive og.pollnt.snt-exp6mwe.;.These coaditions wa&au luither investigation.
Page Z of 2
SWU-242-20t2Q613

�pED ► D�ElfU7£n .
August 2, 2018
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
_
R E C, �— Y
Raleigh, NC 27699-1617
AUG C
RE: Permit No. NCG060382 CEN i RA(.
fit-'r�rFr
To who it may concern,
Enclosed please find the Discharge Monitoring Report required by the storm water general permit at our
Statesville Breeder Feed Mill. The DMR reflects July 2018.
As noted in our 11 half 2018 submittal, Mountaire stated we would begin conducting monthly
monitoring and sampling required by Tier II requirements until additional analyses are obtained. A
sample was not able to be taken for the month of July due to sample results from the previous
monitoring period being received in the middle of the reporting month. Because of this, a qualifying rain
event was not captured. We will obtain a sample per the Tier II requirements during the next qualifying
rain event during staffed hours.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
Austin Pajda
Environmental Manager
Cc: Tanya Rogers -Vickers (Mountaire)—ow
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by how well we service our internal and external customers"

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 08/2/2018
CERTIFICATE OF COVERAGE NO. NCG060382
FACILITY NAME Statesville Breeder Feed Mill
COUNTY Iredell
PERSON COLLECTING SAMPLES
LABORATORY —Statesville Analytical_ Lab Cert. # _440
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2018
FACILITY ACTIVITIES INCLUDE (check all that apply):
❑ use/process meats ® use animal fats/byproducts
DISCHARGING TO SALTWATER$? ❑YES ®NO
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfoii' N/A or ❑ No discharge this period'
Outfall No. ,
Sample Collected;.,
mo/dd/*r
TSS,
mg/L .'.
pH;
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliform',
Colonies per 100 ml
Enteiococci',
Colonies per 100 ml
Benchmark
-
100 or 504
Within 6.0 — 9.0
120
30
1000
500
02
No Sample
N/A
N/A
1 Only applies to facilities that use/process meats.
'The 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.
"See 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.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6.0 — 9.0
-
I Only applies to facilities that use/process meats.
'The 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.
'See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(if yes, complete Part B)
S W U-249 Last Revised: October 18, 2012
Page I of 2

*FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCFS IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION a.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
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 afl "No Discharge" reports, within 30 days of receipt of the lab results (or at end of
monitoriM_ 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."
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/suLnpdessw##tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

CC-DENR
Stormwater Discharge Outfall (SDO)
QuAitatave,Monitoring Report
For guidance on filling out this form, please visit:l�tp;�Fpor[al.ncdenr.wc�fwslsu/w#ta� 4
Permit No.: N/C{! 1 1! 1 ! I or Certificate of Coverage No.: N_IQ/g ©I 61 0I 31$12I
Facility Name: MourrWe Fmm9- stmbn+rmc Breeder Feed MM
County.
}redeH phffn
IhSpector: =j
Date of Inspection:
Time of Inspection:
No., 704-97"055
ZZ
Total Event Precipitation (inches): /VDT
p �r.�.► Fat at-, ly
Was this a Representative Storm Event? (See information below) ❑ Yes ❑ No
Please check your permit to verIVY if Qualitative Mortltorii g roust be perfz?rmed clrsring a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event thata zeasures_greatet.than•(1.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occusrrd. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. OatfaU Description:
Outfall No. 002 Structure (pipe, ditch, etc.) „ piu
Receiving Stream Third Creek
Describe the industrial activities that occur within the outfall drainage area:
Truck transportation, vehicle fueling, garage maintenance, and f ge loagpng(m, wing.
2. Coior:.Describe the color of the discharge using basic colors (red, brown; blue, etc:) and tint
(light. medium, dark) as descriptors:
3. Odor. Describe any distinct odors that the discharge may have (Le-, smells strongly of oil, weak
c121orine odor, etc.):
Page 1 of 2
SW[7-242-2.0120613
%r

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where l is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which hest describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the. stormwater discharge? Yes No
S. Is there an oil sheen in the stormwater discharge? Yes No
9. is these evidence of eroslou or deposition at the outfall?
10. Other Obvious indicators of Stormwater Pollution. -
List and describe
Yes No
Note: Low clarity, high solidss and/or the presence of foam, oil sheen, or erosion/deposition may
be indicative of polttant exposum. These conditions warrant further investigation.
Page 2 of 2
scars-24Z-20124613

FFDEHR
Stormwater Discharge Outfall (SDO)
Qualitative_ Monitoring_ Report
For guidance on filling out this form, please visit: htm:mortal.ncdenr.orglweblwgtn&,;u/�¢essv�#tab-4
Permit No.; �i/G / / 1_l I I I or Certificate of Coverage No.: NIGG/ 0 /� 0/ 3 ] 8 / 2/
Facility Name: Mmftke Firms- StawsAW $rewer Feed m-a
County. lrecleli . Phone No. 704-978-3055
Inspector: A
Date of Inspection: .... L.L. Ar
Time of Inspection;
Total Event Precipitation (incites): AI0 54nPZZ 4 L !/
Was this a Representative Sturm Event? (See information below) ❑ Yes ❑ No
Please check your permit to verify if Qualitative Monitoring rust be performed during a representative
storm event (requirements vary).
A "Representative Storm Event" is a storm event that measures greapq.than 0.1 inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Perminee or Designee)
L Outtall Description:
Outfall No. 002 Structure (pipe, ditch, etc.) Pipe _
Receiving Stream: Third Creek
Describe the industrial activities that occur within the outfall drainage area:
Truck transportation, vehide fueling, garage maintenanoe, and feed loading/receiving
2. Wor:. Describe the color, cf.the dischargeusing.basic colors (red, brown_ ;blue, etc:) and tint
(light, medium, dark) as descriptors:
3. Odor. Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page I of 2
SWU-242-20120613

4. Clarity: Choose the number which besi describes. the clarity of the discharge, where I is clear
and 5 is very cloudy.
1 2 3 4 5
5. Floating Solids: Choose the nen�ber which best describes the arizount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where i is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
& Is there an o0 sheen in the stormwater discharge? Yes No
9. Is there evidence of erosion or deposition at the outfall?
10. Other Obvious Indicators of Stortawater Polludon:
List and describe
Yes No
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposi6on may
he indicative of pollutairt exposure. These conditions warrant further investigation.
Page 2 of 2
Swi1-242-20120613

1
r,EV a __1-7Z£n
July 12, 2018
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
RECEIVE[)
JUL 2 4 20
CENTRAL FILES
DV►!R SECTION
Enclosed please find the Discharge Monitoring Report required by the storm water general permit at our
Statesville Breeder Feed Mill. The DMR reflects the first half of the 2018 reporting year.
Please take note that our facility received coverage under this permit on June 13, 2017; however, due to
a storm water construction project, Outfall 2 did not come online until December 2017. We obtained a
sample during the first rain event on December 8, 2017 to ensure a sample was taken during the
monitoring period which resulted in two exceedances. This sample set obtained on June 27, 2018
resulted in exceedances for the same parameters. We will begin conducting monthly monitoring and
sampling required by Tier Two requirements until additional analyses are obtained.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
Austin Pajda
Environmental Manager
Cc: Tanya Rogers -Vickers (Mountaire) 'TMCNI
Beth Sise (Mountaire)
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by how well we service our internal and external customers"

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted: 07/12/2018
CERTIFICATE OF COVERAGE NO. NCGO60382 SAMPLE COLLECTION YEAR 2018
FACILITY NAME Statesville Breeder Feed Mill FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredell ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? []YES ®NO
LABORATORY —Statesville Analytical_ Lab Cert. # _440
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall Z 0.16 or ❑ No discharge this period'
-Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L_Standard
pH,
units
COD,
mgjL
Oil and -Grease,
rng/L
Fecal Coliforml,
Colonies per 100 mi '
Enterococcll,
Colonles,per 100 ml
'Benchmark
-
100 or SO' .
,Within 6.0 — 9.0
120
30
1000
500
02
06/27/2018
102
6.42
262
<10.2
N/A
N/A
Only applies to facilities that use/process meats.
z The total precipitation must be recorded using data from an on -site rain gauge.
For 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.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes E no
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr:
OII'and Grease,
mg/l
TSS,
mg/L
pH,:
"Standard units
New Motor.011' Usage,
Annual average gal/mo.
9ench'mark .,..
30
100 or 504
6.0 — 9.0
-
I 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.
"See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
(ifyes, complete Part B)
SWU-249 Last Revitied: October 18, 2012
Page 1 of 2

*FOR PART A AND PART 9 MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B,
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO
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 for 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 S16N 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."
(Signature of Perm
-7j r
(Date)
Additional copies of this form may he downloaded at: httplhortal.ncdenr.ore/w_ebLwg/wsfsu/njjdessw#tab-4
SW U-249
Last Revised: October 18, 2012
Page 2 of 2

Energy. Mineral
and Land Resources
ENVIRONMENTAL QUALITY
United Parcel Service, Inc.
Attn: Vincent Mollo
2008 Fay Street
Durham, NC 27704
ROY COOPER
Governor
MICHAEL S. REGAN
Sccrelary•
�J L' WILLIAM E. VINSON, JR.
3 Zola Interim Director
February 15, 2018
Subject: COMPLIANCE EVALUATION INSPECTION
United Parcel Service
Durham Facility, Certificate of Coverage-NCG080382
NPDES Stormwater General Permit-NCG080000
Durham County
Mr. Mollo:
On February 14, 2018, a site inspection was conducted for the UPS -Durham facility located at the Fay
Street Facility, Durham County, North Carolina. A copy of the Compliance Inspection Report is enclosed
for your review. Vincent Mollo was present during the inspection and his time and assistance is greatly
appreciated. The site visit and file review revealed that the subject facility is covered by NPDES
Stormwater General Permit-NCG080000, Certificate of Coverage-080382. Permit coverage authorizes the
discharge of stormwater from the facility to receiving waters designated as Ellerbe Creek, a Class WS-
IV;NSW waterbody in the Neuse River Basin.
As a result of the inspection, the facility was found to be in compliance with the conditions of the
NCG080382 permit. Please refer to the enclosed Compliance Inspection Report for additional comments
and observations made during the inspection.
Please be advised that violations of the NPDES Stormwater General Permit are subject to a civil
penalty assessment of up to $25,000 per day for each violation. If you or your staff has any questions,
comments, or needs assistance with understanding any aspect of your permit, please contact me at (919)
791-4200 or by e-mail at [e-mail].
State of North Carolina I Environmental Quality I Energy, Mineral, and Land Resources
Raleigh Regional Office 1 1628 Mail Service Center I Raleigh, NC 27609
919 791 4200

- r s
January 12, 2018
Page 2 of 2
Sincerely,
4�
Thad Valentine
Senior Environmental Specialist
Cc Central Stormwater Permitting Program Files
RRO — Land Quality Section, Stormwater Files-NCG080382

Compliance Inspection Report
Permit: NCG080382 Effective: 1111£117 Expiration: 10131/18 owner: United Parcel Service Inc
SOC: Effective: Expiration: Facility: United Parcel Service -Durham
County: Durham 2008 Fay St
Region: Raleigh
Durham NC 27704
Contact Person: Tony McNeill Title: Phone: 910`790-7425
Directions to Facility:
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On -Site Representative(s):
Related Permits:
Inspection Date: 02/14/2018 Entry Time: 10:OOAM Exit Time: 12:OOPM
Primary Inspector. Thaddeus W Valentine Phone:
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Transportation wlVehicle Maintenance/Petroleum Bulk/Oil Water Separator Stormwater Discharge COC
Facility Status: Compliant ❑ Not Compliant
Question Areas:
Storm Water
(See attachment summary)
Page: 1

I
Permit: NCGO80382 Owner . Facility: United Parcel Service Inc
Inspection Date: 02114/2018 Inspection Type: Campiiance Evaluation Reason for Visit Routine
Inspection Summary:
A Very well put together plan with datailed monitoring and maintenance documentation. We recommend developing a
stratagy for stabilizing the inlet area and filtering the accumulated runoff from the parking lot.
Page: 2

pemltt• NCGO80382 owner - Facility: United Parcel Service Inc
Inspection hate: Q211412018 Inspection Type : Compliance Evaluation Reason for Visift Routine
Stormwater Pollution Prevention Plan
Yes No NA NE
Roes the site have a Stormwater Poilufion Prevention Plan?
E ❑ ❑ ❑
# Does the Plan include a General Location (USGS) map?
■ ❑ ❑ ❑
# Does the Plan include a "Narrative Description of Practices"?
0 ❑ ❑ ❑
# Does the Plan include a detailed site map including outfall locations and drainage areas?
0 ❑ ❑ ❑
# Dces the Plan include a list of significant spills occurring during the past 3 years?
E ❑ ❑ ❑
# Has the facility evaluated feasible altema5ves to current practices?
0 ❑ ❑ ❑
# Does the facility provide all necessary secondary containment?
0 ❑ ❑ ❑
# Does the Plan include a BMP summary?
0 ❑ ❑ ❑
# Does the Plan include a Spill Prevention and Response Plan (SPRP)?
0 ❑ ❑ ❑
# Does the Plan include a Preventative Maintenance and Good Housekeeping Plan?
E ❑ ❑ ❑
# Does the facility provide and document Employee Training?
■ ❑ ❑ ❑
# Does the Plan include a list of Responsible Party(s)?
E ❑ ❑ ❑
# Is the Plan reviewed and updated annually?
N ❑ ❑ ❑
# Does the Plan include a Stormwater Facility Inspection Program?
E ❑ ❑ ❑
Has the Storrnwater Pollution Prevention Plan been implemented?
0 ❑ ❑ ❑
Comment: All required documents were made available and orderly. Exceptionally
well out together and
maintained plan
gualitative Monkodniq Yes No NA NE
Has the facility conducted its Qualitative Monitoring semi-annually? E ❑ ❑ ❑
Comment: Provided
Analytical Monitoring
Yes No NA NE
Has the facility conducted its Analytical monitoring? El 1:10 0
# Has the facility conducted its Analytical monitoring from Vehicle Maintenance areas? 0 ❑ ❑ ❑
Comment: Analytical data was in order with no exceedances of teh benchmark
Permit and Qutfalls
Yes No NA NE
# Is a copy of the Permit and the Certificate of Coverage available at the site? E ❑ ❑ ❑
# Were all outfalls observed during the inspection? M ❑ ❑ ❑
# 1f the facility has representative outfall status, is it properly documented by the Division? ❑ ❑ N ❑
# Has the facility evaluated all illicit (non stormwater) discharges? 0 ❑ ❑ ❑
Comment: All outfalls were observed. Two corr gated pipes were found to be draining the parking lot on the
West side of the parking lot that need stabilizing.
Page: 3

-.raE4 • orelG7En
January 8, 2018
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
RECEIVED
JAN 2 5 2018
CENTRAL FILES
Enclosed please find the Discharge Monitoring Report required by th6 T�a gneral permit at our
Statesville Breeder Feed Mill. The DMR reflects the second half of the 2017 reporting year.
Please take note that our facility received coverage under this permit on June 13, 2017; however, due to
a storm water construction project, Outfall 2 did not come online until December 2017. We obtained a
sample during the first rain event on December 8, 2017 to ensure a sample was taken during the
monitoring period. We believe the exceedances in this DMR submission are the cause of construction
debris on site from the completion of the Storm Water Improvement Project (dirt on site, etc). This may
be further investigated by obtaining an additional sample in the first half of 2018.
If you have any questions, please feel free to contact me at 302-934-3070.
Thank you,
Austin Pajda
Environmental Compliance Coordinator
Cc: John Wren (Mountaire)
Beth Sise (Mountaire)('
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by how well we service our internal and external customers"

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG0600DO
Date submitted: 01/08/2018
CERTIFICATE OF COVERAGE NO. NCG060382 SAMPLE COLLECTION YEAR 2017
FACILITY NAME Statesville Breeder Feed Mill FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredell ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? ❑YES ®NO
LABORATORY —Statesville Analytical_ Lab Cert. #,440
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event roinfall ' 0.53 or ❑ No discharge this period3
Outfall.No.,.
'Sample Collected,',
' -� TSS,
mg/L
pH,
Standard units..
Cob,
mg/L
Oil and Grease,
mg/L
Fecal Coliform',
'Colonies per 100 ml
.,Enterococcil,
Colonies -per 160 ml
Benchmark
-
160 or SO4
Within 6.0-9.0
120
30
1000
. 500
02
12/08/2017
528
6.5
148
19
>6000
' Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
' 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 SS 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.
Outfall No.-
Sample Collected,
mo/dd/yr"
Oil and Grease,
mg/L
TSS, ..
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or SW
610 — 9.0
' Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
a 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.
(i.f yes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PART B MONITORING RESULTS:
* A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
* 2 EXCEEDANCES 1N A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B.
* TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES []NO[]
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 o f receipt of the lab results ror at end of
inonitorin erlod In the case o "No Dischar e" re arts to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
YOU MUST SIGN TH6 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."
j V V r
VV� LLL�
[Signature of Perm
S-/1�5 -
(Da ej
Additional copies of this form may be downloaded at: http://13ortal.ncdenr.org/web/+nip/ws/su/nodessw#tab-4
SWU-249 Last Revised: October 18, 2B12
Page 2 of 2

p R 1 ,�j'M
145
Mb-u`n�aire-)
fresh Yorrn C.,Itick�en ej
October 31, 2017
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Permit No. NCG060382
To who it may concern,
RECEIVED
NOV 0 9 20V
CENTRAL FILES
DWR SECTION
Enclosed please find the Discharge Monitoring Report required by the stormwater general permit at our
Statesville Breeder Feed Mill. The DMR reflects the second half of the year for the general permit which
is set to expire on October 31, 2017.
Please take note that our facility received coverage under this permit on June 13, 2017; however, due to
a storm water construction project, a representative sample of facility conditions was not able to be
taken. We are anticipating to obtain a sample for the second half of 2017 in the months of November
and December as construction for this project is now complete.
I hope that you find the attached submittal satisfactory to meet the permit requirement. If you have any
questions, please feel free to contact me at 302-934-3070.
Thank you,
Austin X-
Environmental Compliance Coordinator
Cc: John Wren (Mountaire)
Beth Sise (Mountaire) Z;6
John Jacobs (Mountaire)
Mountaire Farms Inc.
"We measure quality by how well we service our internal and external customers"

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted:10/31/2017
CERTIFICATE OF COVERAGE NO. NCGO60382 SAMPLE COLLECTION YEAR 2017
FACILITY NAME Statesville Breeder Feed Mill FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY Iredeli ❑ use/process meats ® use animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? []YES ®NO
LABORATORY Lab Cert. #
Part A: Stormwater Benchmarks and Monitoring Results
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Total event rainfall z or ❑ No discharge this period3
Outfall No.
Sample Collected,
mo/dd/yr
TSS,
mg/L
pH,
Standard units.
COD,
mg/L
oil and Grease,
mg/L
Fecal Coiiforml,
Colonles,per.100 ml
Enterocbccil,
. Colonies per 100 ml
Benchmark
- ...
100 or 504
Within 6.0 — 9.0
120
30
1000.
Soo
02
Unable to obtain
refer to
cover letter.
1 Only applies to facilities that use/process meats.
2 The 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.
"See 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.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/MD
Benchmark
-
30 •
100 or 504
6.0 — 9.0
-
1 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.
(ifyes, complete Part B)
SWU-249 Last Revised: October 18, 2012
Page 1 of 2

*FOR PART A AND PANT 13 MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A 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 MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ NO ❑
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
monitoring period in the case of "No Discharge" report5j 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."
iw
(Signature of PerrQttee)
� /az/ 2
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4
S W U-249
Last Revised: October 18, 2012
Page 2 of 2

Central Files APS — SWP
6/1312017
Permit Number NCG060382
Permit Tracking Slip
Program Category
Status Project Type
NPDES SW
In review New Project
Permit Type
Version Permit Classification
Food/TobaccolSoaps/Cosmetics/Pubtic Warehousing Stiormwater Discharge COC
COC
Primary Revlewwr
Permit Contod Affiliation
jolie.ventaloro
Coastal SWRuIs
Permitted Flow
Faciltty
Facility Name
Maiorffllrwr
Regfon
Mountaire Fauns - Statesville Breeder Feed MW
Minor
Mooresville
Location Address
Coup
2206 W Front St
Iredell
Facility Contact Affiliation
Statesville NC 28687
John Jacobs
2206 W Front St
Owner
Statesville
NC 28687
Owner Name Owner Type
Mountaire Fars Inc Nan -Government
0ar Affillatlon
Mark Chranowski
Dir Ops Processing Sr of
PO Box 1320
DatesfEvents Millsboro DE 19966132
Scheduled
Orlg Issue App Received Draft Inittatod Issuance
5r1312017
Public Notice Issue
(ait3)201"7
E Expiratton
b 1 2olt�I °�3�
JZ01-7
Regulated Activities
Requested lReceived Events
Food and kindred products manufaclWre
RO staff report received
6112/17
RO staff report requested
9i26117
Outfall 001
Waterbody Name Stroamindex Number Current Ctass Subbasin
Third Creek {Third Creek WS No. 37) 12.10&20-4 C 03-07-06

Kra
Energy, Mineral
and Land Resources
ENVIRONMENTAL QUALITY
June 13, 2017
Mr. Jimmy Paulakuhn
Vice President of Live Operations
Mountaire Farms, -Inc.
P.O. Box 1320
Millsboro, DE 19066
ROY COOPER
Governor
MICHAEL S. REGAN
secretary
TRACY DAVIS
Dfrecior
Subject: General Permit No. NCG060000
Mountaire Farms — Statesville Breeder Feed Mill
COC No. NCG060382
Iredell County
Dear Mr. Paulakuhn:
In accordance with your application for a discharge permit received on May 23, 2017, we are
forwarding herewith the subject certificate of coverage (COC) to discharge under the subject state —
NPDES general permit. This permit is issued pursuant to the requirements of North Carolina General
Statute 143-215.1 and the Memorandum of Agreement between North Carolina and the US
Environmental Protection Agency dated October 15, 2007 (or as subsequently amended).
Please take notice that this certificate of coverage is not transferable except upon approval of the
Division of Energy, Mineral and Land Resources. The Division of Energy, Mineral and Land
Resources may require modification or revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Energy, Mineral and Land Resources, the Coastal Area Management Act, or any other
federal or local government permit that may be required.
Please note that the attached permit expires on October 31, 2017. Your COC will be automatically
renewed to cover the full 5 year term of the soon to be reissued permit. In the interim you must abide
by the terms of the expiring permit. You can review the proposed general permit changes once they
are posted at: http:lidea_nc.gQylabout./divisions,/energy-mineral-land-resourcesleve
State of North Carolina I Environmental Quality I Energy, Mineral and Land Resourm
1612 Mail Service Canter 1 512 North Salisbury StreN I Raleigh, NC 27699-1612
919 707 9200 T

If you have any questions concerning this permit, please contact Julie Ventaloro at telephone number
[phone] or by email [e-mail]_.
Sincerely,
for Tracy E. Davis, P.E., CPM, Director
Division of Energy, Mineral and Land Resources
cc: Mooresville Regional Office, Zahid Khan
Central Files
Stormwater Permitting Program Files
Sett of Nw6 Cuohn I &=== l Qoa&y 1 Ea:W. Mnad udLu d Rmmm
1612 hM Same Oogs 1 512 Note Satiny Salta 18ah06 AC 16M16U
919 707 9M T

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF ENERGY, MINERAL AND LAND RESOURCES
GENERAL PERMIT NO. NCG060000
CERTIFICATE OF COVERAGE No. NCG060382
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful
standards and regulations promulgated and adopted by the North Carolina Environmental
Management Commission, and the Federal Water Pollution Control Act, as amended,
Mountaire Farms, Inc.
is hereby authorized to discharge stormwater from a facility located at
Mountaire Farms — Statesville Breeder Feed Mill
2206 West Front Street
Statesville
Iredell County
to receiving waters designated as UT to Third Creek, a class C water in the Yadkin -Pee Dee
River Basin, in accordance with the effluent limitations, monitoring requirements, and other
conditions set forth in Parts I, II, 11I, and IV of General Permit No. NCG060000 as attached.
This certificate of coverage shall become effective June 13, 2017.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day June 13, 2017.
for Tracy E. Davis, P.E., CPM
Director, Division of Energy, Mineral and Land Resources
By the Authority of the Environmental Management Commission

Division of Energy, Mineral and Land Resources
e;A"L7VC11 Land Quality Section��..� N
INational Pollutant Discharge Elimination System
j C - D- NCG060000 81
r,_-9 .El YID N. .F. Heypur.C[s
NOTICE OF INTENT
FOR AGENCY USE ONLY
Date Received
Year
Month
m
Ceruficaw of covmw-
NCG0
k m
P , Ass'hied to
nr
National Pollutant Discharge Elimination System application for coverage under General Permit
NCGO60000:
STORMWATER DISCHARGES associated with activities classified as:
J
SIC (Standard Industrial Classification) 20 Food and Kindred Products
SIC 21 Tobacco Products
SIC 283 Drugs
SIC 284 Soaps, Detergents, & Cleaning Preparations; Perfumes, Cosmetics, & Other Toilet Preparations
SIC 422 Public Warehousing and Storage (except 4226)
For questions, please contact the DEMLR Regional Office for your area. See page 4.
Do Not use this NOl for renewals.
(Please print or type)
1) Mailing address of owner/operator (address to which all permit correspondence will be mailed):
Name Mountaire Farms Inc.
Street Address Po Box 1320
City Malsbwo State atr ZIP Code 199"
Telephone No. 302 934-3070 Fax: [phone]
2) Location of facility producing discharge:
Facility Name Mountaire Farms -Statesville Breeder Feed Mill
Facility Contact John Jacobs
Facility Address 2206 West Front Street
Facility City Statesville State NC ZIP Code 28687
Facility County iredetl
Telephone No. 704 978-3055 Fax:
Email pacobsGmountaire.com
3) Physical Location Information:
Please provide a narrative description of how to get to the facility (use street names, state road numbers, and
distance and direction from a roadway intersection). From 1-40, take exit to take NC-90 EIUS-64E. In two tenths
of a mile, turn left on to State Rd 1359. In one half of a mile, the feed mill swill be on the left at address 2206 W Front St.
(A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.)
4) Latitude 350 47' 24.6372" N Longitude 80* 55' 34.248" W (deg, min, sec) 35.7 ?00 1/
O t/ '
5) This NPDES Permit Application applies to which of the following: q "`/ 6 J
❑ New or Proposed Facility
X Existing
Date operation is to begin
SW U-221
Page 7 of 4
Last revised 6/24114

NCG060000 N.O.I.
6) Standard Industrial Classification:
Provide the 4-digit Standard Industrial Classification code (SIC code) that describes the primary industrial
activity at this facility.
SIC code: 2 0 4 8
7) Activities
a) Provide a brief narrative description of the types of industrial activities and products manufactured
at this facility: Feed is produced for chicken
b) Check all activities occurring at this facility:
❑ use or process meats 25 use or process animal fats/byproducts
8) Discharge points / Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 2
What is the name of the body or bodies of water (creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Third Creek
Receiving water classification: c
Is this a 303(d) listed stream? NO Has a TMDL been approved for this watershed? NIA
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e_g. City of Raleigh municipal storm sewer). NIA
9) Does this facility have any other NPDES permits?
X No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
10) Does this facility have any Non -Discharge permits (ex: recycle permit)?
X No
❑ Yes
If yes, list the permit numbers for all current Non -Discharge permits for this facility:
11) Does this facility employ any best management practices for stormwater control?
❑ No
X Yes (Show any structural BMPs on the site diagram.)
If yes, please briefly describe: Routine sweepings and catch basin cleanings.
12) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
R Yes
If yes, when was it implemented? May 1, 2017
13) Are vehicle maintenance activities occurring at this facility?
XNo ❑Yes
Page 2of4
SW U-221 Last revised 6124114

NCG060000 N.O.I.
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
D( No ❑ Yes
b) Is this facility a Small Quantity Generator (less than 1000 kg. of hazardous waste generated per month) of
hazardous waste?
XINo ❑Yes
c) Is this facility a Large Quantity Generator (1000 kg. or more of hazardous waste generated per month) of
hazardous waste?
3K No ❑ Yes
d) Is hazardous waste stored in the 100-year flood plain?
R No ❑ Yes If yes, include information to demonstrate protection from flooding.
e) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stared:
Where is material stored:
How many disposal shipments per year:
Name of transport 1 disposal vendor:
Vendor address:
15) Certification:
North Carolina General Statute 143-215.6E (i) provides that:
Any person who knowingly makes any false statement. representation, or certification in any application, record, report,
plan, or other document filed or required to be maintained under this Article or a rule implementing this Artide: or who
knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or
who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be
operated or maintained under this Article or rules of the Commission implementing this Article shall be guilty of a Class 2
misdemeanor which may include a fine not to exceed ten thousand dollars ($10,000).
I hereby request coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete,A nd/accurate.
Printed Name of Person Igni g: Vr% Mot*'�ct4� � r�
Title: j :.rr -_'v P4 k t a. L L.� If I c,-C- res i, t- e F�� G a/ Q
sk17
(Date Signed)
This Notice of Intent must be accompanied by a check or money order for $100.00, made payable to:
NCDENR. Do not send the check or money order separately.
Page 3 of 4
SWU-221 Last revised 6/24114

NCG060000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
SZ Check for $100 made payable to NCDENR. Must be included with this application (not sent separately).
iZ This completed application and all supporting documents.
if A site diagram showing, at a minimum, (existing or proposed):
(a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls
corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored,
loaded, and unloaded, (f) impervious areas, (g) site property lines.
Ed Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map.
Mail the entire package to:
Stormwater Permitting Unit Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee coverage under the General Permit.
For questions, please contact the DEMLR Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office ......
[phone]
Fayetteville Office...
[phone]
Mooresville Office...
[phone]
Raleigh Office _.......
[phone]
Washington Office...
[phone]
Wilmington Office ...
[phone]
Winston-Salem ...... [phone]
Central Office .........(919)
807-6300
Page 4 of 4
SW U-221 Last revised 6/24114

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May 1, 2017
Stormwater Permitting Unit Program
Division of Energy, Mineral and Land Resources
1612 Mail Service Center
Raleigh, North Carolina 27669-1612
To whom it may concern:
#4 114
sT o�Al �32ar D
O,g4f�q E*D
RpER41, G
Please find the attached Notice of Intent application for coverage under General Permit
NCG060000 for the Mountaire Farms Statesville Breeder Feed Mill. The application, check made
payable to NCDENR for $100, site diagram, and USGS quad sheet with the facility's location are
all included within this submittal.
Should you have any questions, please feel free to contact me at 302-934-3070.
Sincerely,
Austin Pajda
Environmental Compliance Coordinator
CC: John Wren (Mountaire Farms'
Beth Sise (Mountaire Farms
Mountaire Farms
"We measure quality by how well we service our internal and external customers"

170
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