NCG060382_Monitoring Report_20211129

RECEIVED
NCDEQ Division of Energy, Mineral and Land Resources VOY 29 2021
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000 LLh, -UEMLh
Food and Kindred enU Quahty Section
Nlooresv Ile Regional Office
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMUR Regional Office.
Certificate of Coverage No. NCG06 0382
Person Collecting Samples: Thomas Owens
Facility Name: Mountaire Farms Inc- Statesville Feed Mill
LaboratoryName: Statesville Analytical
Facility County: Iredell
Laboratory Cert. No.: 440
Discharge during this period: ©
Yes
[]No
(if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ® Yes ❑ No
If so, which Tier (I, II, or III)? III
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ❑Yes El No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall 02
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
10/28/2021
46529
24-Hour Rainfall in Inches
>S"
C0530
TSS in mg/L (100 or 50')
59.33
PH in standard units (6.0-9.0 FW,
00400
6.8-8.5SW)
7.43
Fecal Coliform per 1D0 ml of
31616
freshwater (if required) (1000)
Enterococci per 100 ml of saltwater
61211
(if required) (500)
Chemical Oxygen Demand In mg/L
00340
(120)
230
Additional parameters for outfalis in drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in gal/month
00552
1 Non -Polar Oil & Grease in mg/L (15)
• Outfalls to Outstanding Resource Waters (ORW), High Quallty Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional): October 2021
"I certify by my signature below, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel property gather and evaluate the information submitted. Based on my
Inquiry of the person or persons who manage the system, or those persons directly responsible forgathering the information, the information
submitted is, tothe best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false information, inclyding the possibility of fines and imprisonment for knowing violations."
Permittee or Delegated Authorized Individual
Email Address
Date
Phone Number

RECEIVED
NCDEQ Division of Energy, Mineral and Land Resources NOV 2 9 2021
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000 ,-,.R [)LMLfi
Food and Kindred "rind Quality Section
.oresviile Regional Office
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mall the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NOG06 0382
Person Collecting Samples: Thomas Owens
Facility Name: Mountaire Farms Inc -Statesville Feed Mill
Laboratory Name: Statesville Analytical
Facility County: Iredell
I Laboratory Cert. No.: "0
Discharge during this period:
® Yes ❑
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ® Yes []No
If so, which Tier (I, II, or III)? III
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ❑ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall 02
Outfall
Outfall
Outfall
Outfall
Cade
N/A
Receiving Stream Gass
C
N/A
Date Sample Collected MM/DD/YYYY
10/28/2021
46529
24-Hour Rainfall in inches
>3"
C0530
TSs in mg/L (100 or 50•)
59.33
00400
PH in standard units (6.0-9.0 FW,
7.43
6.8-8.5SW)
Fecal Col'dorm per 100 ml of
31616
freshwater (if required) (1000)
Enterococcl per 100 ml of saltwater
61211
d required) (500)
Chemical Oxygen Demand in mg/L
00340
(120)
230
Additional parameters for outfalls In drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New Motor/Hydraullc Oil
NG)IL
Usage in gal/month
D0552
Non -Polar Oil & Grease in mg/L (15)
• Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saitwater)
Notes (optional): October 2021
"I certify by my signature below, under penalty of law, that this document and all attachments were prepared under my direction or supervision In
accordance with a system designed to assure that qualified personnel property 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, inclNding the possibility of fines and Imprisonment for knowing violations."
Pennittee or Delegated Authorized Individual
Emag Address
/i j tH
Date
Phone Number