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HomeMy WebLinkAboutNCG060022_MONITORING INFO_20141013STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V UC2 O QUO DOC TYPE 0 HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ 9 b 1 y I o I'1 YYYYMMDD O Tyson April 15, 2019 Department of Environment and Natural Resources Division of Water Quality, Central Files 1617 Mail Service Center Raleigh, NC 27699 -1617 RE: Tier Two Monthly Discharge Report Tyson Farms, Inc. Monroe, Union County, North Carolina General Permit Number: NCG06000 Dear Sir/Madam: , Per the requirements of General Permit No. NCG060000, enclosed are two copies of the monthly discharge report for outfall #007. Outfall #7, which is the discharge from the on property stormwater pit, was above the COD and TSS benchmarks for two consecutive sampling periods placing this location in Tier Two. Monthly sampling for COD and TSS is being conducted at outfall #7. If you have any questions, please contact me at (704) 296-4959 or via email at chris.harrington@tyson.com. Sincerely, ChOisHarrington, CHMM Complex Environmental Manager Tyson Farms, Inc. Monroe, NC Complex 233 S. Secrest Ave., Monroe NC 28112 (704) 296-490o Fax: (704) 296-4904 www.tysortfoods.com STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000 CERTIFICATE OF COVERAGE NO. NCG06 0 0 2 3 FACILITY NAME Tyson Farms, Inc. COUNTY Union PERSON COLLECTING SAMPLES Chris Harrington LABORATORY PAR tabs Lab Cert. # 20 Part A: Stormwater Benchmarks and Monitoring Results Date submitted REIVED APR 2 4 Z019 qO00N YEAR 2019 QWPP RIOD i❑ Jan -June ❑ July -Dec or 0 Monthly' AAaISC�� (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ❑Other FACILITY ACTIVITIES INCLUDE (check all that apply): ■❑ use/process meats a use animal fats/byproducts PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall Z or 0 No discharge this period3 Outfa111Vo. Sample Date Sam Collected, ma/dd/yr TSS, mg/L pH, Standard units COD, mg/L 0i1 and Grease, mg/L -Fecal Coliform; Colonies per 100 ml Enterococd, Colonies per.100 ml Benchmark _ _ _. _ - 100 or SW Within 6.0 — 9.0 120 30 10001 5001 Parameter -Code -. ......... ... C0530 00400 00340 005S6 31616 61211 007 no flow no flow no now no flow no flow no flow no flow 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 aM outfalls. You must still submit this discharge monitoring report with a checkmark here. 45ee General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies, 'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? NO yes ❑ no Permit Date: 11/1/2018-05/31/2021 (ifyes, complete Part 8) SWU-244, Last Revised 11/5/2018 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfali No. Oate=Sample Collected (m6/dd/yrj 24-hour rainfall amount, Inchesz New Motor Oil or Hydraulic Oil Usage Non -Polar O&G/Total Petroleum Hydrocarbons Total Suspended Solids Benchmarks - - - 15 mg/L 100 mg/L or 50 mg/O Parameter Code - 46529 NCOIL 00552 C0530 Footnotes from Part A also apply to Part B *FOR PART A AND PART B MONITORING RESULTS: + A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCE£DANCES 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 0 IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES []NO[] REGIONAL OFFICE CONTACT NAME: Mail an original copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonrp4t for knowing violations." Date Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018 Page 2of2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Resources General Permit No. NCGO60000 Date submitted 1-25-2019 CERTIFICATE OF COVERAGE NO. NCG060 0 2 2 FACILITY NAME Tyson Farms COUNTY Iredell PERSON COLLECTING SAMPLES Kevin Haynes LABORATORY Par Labs Lab Cert. # 20 Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2018 RECF IVED JAN 81 2019 ;L FILES OWR SECTION FACILITY ACTIVITIES INCLUDE (check all that apply): ❑� use/process meats X use animal fats/byproducts DISCHARGING TO SALTWATERS? DYES ■❑NO PLEASE REMEMBER TO SIGN ON THE REVERSE --> Total event rainfall 2 or D No discharge this period3 ' Oiitfali Nod "Sample!Gollected, 31'11�S; 'i t rk I ,p pH, i ra,r Standardlunits "" CO",se, + Iv m L m.rrrm,��,, :i� g/L Fecal"Califor"m , „Iu'arrusurtrrirr�mg/1 Calonlesi er 100jm1 1WE16R66 ocI� .Colonies� er,,iDD;'mI. SW-101 Did not meet reporting criteria SW-301 Did not meet reporting criteria SW-401 Did not most reporting criteria SW-501 Did not meet reporting criteria ' 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 and! 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 0 no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. 6 `6utfalliNo' ti11� �� ii � i� r Sample'Collected;!? t10... hma%dd/, Ir,� t�li 1}OII'anif Grease, (l.. mmgl TSS, h:rnB/L , r A , :S andaHil nits. New,Matar°O#I'llsage;` %! Annual aye age gla#%rtio�,l �8en"cli`ma"rk4iiP�llll�f,'1�Il�filff��f�1��tN�=llld��l��fi!illflll i�f!#I"�i?�C��3Q i'QO.,or�50 '� ('�l�t=:�x�'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. (1yes, complete Part B) SWU-249 Last Revised: October 18, 2012 Page 1 of 2 *FOR PARTA 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 11 SECTION S. • 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 for at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Resources Attn: DWR 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-,_Nouctrig the possibility of fines and imprisonment for knowing violations." ature -2�l'f (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/weblwg/ws/­`sulnr)dessw#tab-4 SWU-249 Last Revised: October 18, 2012 Page 2 of 2 O Tyson July 24, 2018 RECEIVED JUL 31 2018 CENTRAL FILES N.C. Division of Water Quality DWR SECTION Attn: Central Files 1617 Mail Service Center, Raleigh, NC 27699-1617 Dear Sir or Madam: Enclosed are 2 copies or the required storm water sampling for the outfalls covered by General Permit No. NCG060000 — Tyson Farms NCG060022 Please contact me if you have any questions at 704-546-2602 ext. 232. Reg rds, Kevin Haynes — Environmental Manager, Tyson Farms — Harmony, NC Tyson Foods, Inc. RVAF- Harmony 5o1 Sheffield Road, liarniom, NC 28634 Soo-568-9607 704-546-2602 Fax:479-717-0353 -'%'-.tysonfoods.com 9 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted ^ 7-49i4-/ G CERTIFICATE OF COVERAGE NO. NCG06 FACILITY NAME .s. '✓ COUNTY / PERSON COLLECTING SAMPLES 15tVIA )Lrle"� LABORATORY_ NJA _ Lab Cert. # N Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR o30/ y FACILITY ACTIVITIES INCLUDE (ch k all that apply): se/process meats se animal fats/byproducts DISCHARGING TO SALTWATER ? []YES [2rNO !LEAz—C R21A EMi3ER �rD S1�,NI ONE 4 t'11E Total event rainfoli2 or I Ato discharge this period3 Outfail No. Sw- rfC l Sample Collected, mo/dd/yr TSS, PH, ` mg/L Standard units I COD, mg/L Oil and Grease, � mg/L Fecal Colifor Colonies per 100 ml Enterococci Colonies per 100 mi Benchmark - 100 or 50' j Within 6.0 — 9.0 120 30 j 1000 500 DID AJ& MtRZJS(" A P02 1 - I i j 1 Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. `See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark �aapplplies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes Sao Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. OutfalE No. Sample Collected, Oil and Grease, 755, pH, i New Motor Oil Usage, mo/dd/yr rng/L ms/L Standard units Annua[ average gal/m.o Benchmark I - i 30 j 100 or 5o` 6.0 — 9.0 Only aoDlies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an. on -site rain: gauge. 3 i discharge r i still I this discharge i --i 'or sampling periods with no discharge at any outialls, you• must, sti sub:mii this discharge monitoring report wits, a C:�eckmark here. r i } i, a e: ' n}t' o See Gene. a. Permit next, able 3, icenti"yir:g Yee especially ser,sitiv� rec_'�vi�.g Water c:assir:catier�s where the more protec.iv� benchmark applies. (if yes, complete Part B) SW a-2=9 "FOR PART A AND PART B MONiT©RiNG RESULTS: • A BENGHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PER -MIT PART II SECT101\1 R. 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUT FALL TRIGGER TIER 2 REQUIREMENTS, SEE ?ERMIT ?ART li SECTION Ia- TIER 3: HAS YOUR FACILI T Y HAD 4 OR MORE BENCHMARK EXCEEDENCES Fq�^THE SAME PARAMETER AT ANY ONE OUT FALL? YES 'E] NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [—]NO IA•? REGIONAL OFFICE CONTACT NAME: /& Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 days of recei t ot the fob results or at end o monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central i:iles 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 these 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 c dingthe possibility of fines and imprisonment for knowing violations." (Signature of Perm (Date) Additional copies of this form may be downloaded at: nttq:�` ortai.ncdenr.�r�/� e� o :rs; su!^wessrita SWU-249 Las! Revised: C per 18, 2012 Pabe oil 7 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted %' i'g _ CERTIFICATE OF COVERAGE NO. NCG06 SAMPLE COLLECTION YEAR —D 1 2 FACILITY NAME TvSb In Ri mz FACILITYACTIVITIES CTIVITIES INCLUDE (che is all that apply): COUNTY _� 1�� .� ��se/process meats se animal fats/byproducts PERSON COLLECTING SAMPLES '1_W n ftG��lF?� LABORATORY N) A Lab Cert. # Part A: Stormwater Benchmarks and Monitoring Results .=HEASE R=:Y'=,�elc� WO SIGG i ON TA R V_R�� Total event rainfall z or o discharge this period Outfall No. Sample Collected, i mo/dd/yr TSS, i pH, mg/L Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Fnterococcil, Colonies per 100 ml l Benchmark l; 100 or 504 Within 6.0 — 9.0 120 30 1000 500 i I 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. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? 11 yes 4;o (ifyes, complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, I Oil and Grease, mo/dd/yr ; mg/L TSS, mg/L pH, New Motor Oil Usage, Standard units Annual average gal/mo Benchmark - 30 100 or Be 6.0 -- 9.0 ; - 1 I I i t un y appuea LU WLJHL es LnaL use/pi OCESS MleaLa. 2The total precipitation must be recorded using data from an on -site rain gauge. I For sampling periods wit# no disc:-harge at env outfalls, you must stili submit this discharge monitoring report with a checkmark here. 'See Gererai Permit text, Table 3, identifying the espedaiiy sensitive receiving water classifications where the more protective benchmark applies =FOR PART A AND PART 3 MONITORING RESULTS: • A BENCHMIARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS. 5EE PERMIT PART li SECT!ON S. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTF-ALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART I! SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES F R --, `E SAME PARAMETER AT ANY ONE OUT FALL? YES 'Ell NO.,rS,,T IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO l REGIONAL OFFICE CONTACT NAME: Mail an original and one cony 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 DischaLge" reports) to: Division of Water Qu2-iity Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699--1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "l 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 qualirried personnel properly gather and evaluate the information submitted. Based on my inquiry of the r person or persons who manage the system, orthose 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 informationsytiOudipg the possibility of fines and imprisonment for knowing violations." (Date) Additional copies of this form may be downloaded at::tt tiorrai.r;�c2:; orar'v�eo/l:u `:�lsls l N Ss r stab-'— swJ-1^9 Last Revised: C ')er 18. 2 0 12 Pave 2 of-2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted -7 A4- iB CERTIFICATE OF COVERAGE NO NCG066 Q ; ? SAMPLE COLLECTION YEAR Ja12 FACILITY NAME l FACILITY. ACTIVITIES INCLUDE (check all that apply): COUNTY use/process meats mouse animal fats/byproducts PERSON COLLECTING SAMPLES •O DISCHARGING TO SALTWATERS. MYES [:]NO LABORATORY NIP Lab Cert. # Part A: Storrnwater Benchmarks and Monitoring Results PL EASE REZMEM1P-E:R TG SIGN ON THE REVEcRS Total event rainfall or I6o discharge this period Outfall No. �; _ Sample Collected, TSS, moJdd/yr ! mgJL pH, Standard units COD, mg/L Oil and Grease, —I—Coll mg/L Coliform , Colonies per 100 ml Enterococci`, Colonies per 100 ml Benchmark I 100 or 50` Within 6.0 — 9.0 120 30 1 1000 500 I i inn sa ij6; inl ' { I i 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. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oif per month? ❑ yes 2!�o Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, i Oil and Grease, T55, ? pH, New Motor oil usage, mo/dd/yr I mg/L I mg/L Standard units Annua[ average gal/mo j Benchmark 30 i 100 or 5e i 6.0 — 9.0 i - i I I I (ify es, complete Part B) Uniy appues to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 r r r i €I ill - n' e m i r+ i For sampling periods with no discharge at a^:v o.��a. s, you must still submi:.�,;s a�scharg,. �t.on.toring repo.: with a check:�ar< Here. nor 'n ` T h l r '�r , i•. .1w n a See Gene ai . er, ..it text, able 3, tdentiFying t. e esaec:a 3y se, sitive receivi ng water -,iris,-:cat,o:,s where the mo, e protective benchmark applies. SW -?_; 'FOR PART A AND ?ART B MONITORING RESULTS: A BENCHMARK EXCEEDAMCE RIGGERS TIER 1 REQUIREMENTS. SEE PERMIT ?ART it SECT ION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL T RIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART li SECTION S, • i IER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO THE SAME PARAMETER AT ANYONE OUT FALL? YES I ND IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ 1VQ' REGIONAL OFFICE CONTACT NAME: 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 o monitorinq12eriod in the case of "No Discha[ge" reports) to: DIVislon of `A/2ter 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 responsibie for gathering the information, the information submitted is, to the best of my kngwledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting False information, !,DeXdiinthe possibility of fines and imprisonment for knowing violations." 7 (Date) Additional copies of this form may be downloaded at: SW'U-249 Last Revised: C ')er 18. 201 P a 2 c - of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCGO60000 Date submitted-7-94-i" CERTIFICATE OF COVJRAGf NO. NCGD6�� SAMPLE COLLECTION YEAR at) FACILITY NAME / V50n FO('M5FACILITY CTIVITIES INCLUDE (ch ck all that apply): COUNTI use/process meats se animal is/byproducts PERSON COLLECTING SAMPLES DISC ARGING TO SALTWATER ? [YES�No LABORATORY NIA Lab Cert. i* N Part A: Stormwater Benchmarks and Monitoring Results P L..ACE REz':17- N,311-R -3TO SIGk' CAI` T, 1ZE ilrL ERrL Total event rainfall z or F)(o discharge this period3 Outfall No. 6U - Sample Collected, TSS, pH, mo/dd/yr mg/L Standard units COD, i mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Enterococci-,� Colonies per 100 ml Benchmark 100 or 50' I Within 5.0-9.0 I 120 30 1 100a 500 I � ' DD-j N X.j I I f Only applies to facilities that use/process meats. z i he 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. aSee 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 Part B: Vehicle Maintenance Area Monitoring Results. only for facilities averaging > 55 gal of new motor oil/month. ':. Outfall No. i i Sample Collected, i oil and Grease, TSS, ma/dd/yr mg/L mg/L pH, New Motor Oil Usage, i Standard units ; Annual average gal/mo Benchmark - I 30 I 100 or 50` i 5.0 — 9.0 , 1 I 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 o�tfalls, you must still submit this discharge monitoring report with a checkmark here. `See General Permit text, Table 3, identisying the espec ally sensitive receiving water dassificatie^s where the more protective benchmark applies. (if yes, complete Part B) SWU-2) *FOR PART A AND PART B MONITORING RESULT S: A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERM<T PART it SECTION 3_ e 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUT FALL TRIGGER TIER 2 REWREMENTS. SEE PERMIT ?ART it SECTION • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO �iE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO 1lll���� REGIONAL OFFICE CONTACT NAME: Mail an on inni and one copy of this DMR including all "No Dischor e" reports, within 30 days of receipt of the lab results or at end o monitorinipe_riod in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mad 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 k owledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,g the possibility of fines and imprisonment for knowing violations." 7.21 (Date) Additional copies of this form may be downloaded at: l i _llviia{.�C72 1f.3rI'lticwyJG�."JSISU�^�u�5�'h' awl SWU-2?9 LastRevised: C )e- 18, 20 i 2 P`� 1L 2 --` 2 0 Tyson January 19, 2018 N.C. Division of Water Quality Attn: Central Files 1617 Mail Service Center, Raleigh, NC 27699-1617 Dear Sir or Madam: Enclosed are 2 copies or the required storm water sampling for the outfalls covered by General Permit No. NCG060000 — Tyson Farms NCG060022 Please contact me if you have any questions at 704-546-2602 ext. 232. Regards, 4 � � Kevin Haynes — Environmental Manager, Tyson Farms — Harmony, NC R.EeENED jo 2 4 24MB E)WR SECTION Tyson Foods, Inc. RVAF -Harmony 501 Sheffield Road, Harmony, NC 28634 800-568-9607 704-546-2602 Fax:479-717-0353 www.tysonfoods.com SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted i- Iq-1 $ CERTIFICATE OF COVERAGE NO. NCG06 D j_,�,� FACILITY NAME Mn RAC[n� COUNTY _.jgLj)1 �1 PERSON COLLECTING SAMPLES �f ' LABORATORY l_a Lab Cert. # Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR <X)II FACILITY ACTIVITIES INCLUDE (chqck all that apply): use/process meats a anim�Wois/byproducts DISCHARGING TO SALTWATE ? ❑YES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2 or o discharge this period3 Outfall No. u! Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Colifor , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 504 Within 6.0 — 9.0 120 30 1000 500 ) INJ CO 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 pl�e 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 50 6.0 — 9.0 - 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 anv outfalls, you must still summit 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 S) SWU-249 Last Revised: October 18, 2012 *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 • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO E SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO 1F YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ No REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this D_MR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to:^� Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "i certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, iD*&g the possibility of fines and imprisonment for knowing violations." Z19.18 (Date) Additional copies of this form may be downloaded at: http:///portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4/web/wq/ws/su/npdessw#tab-4 SWU-249( Last Revised: C 'qer 18, 2012 Pale 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 17 t q- 13 CERTIFICATE OF COVERAGE NOS.NCG06D_.L a-rL SAMPLE COLLECTION YEAR Jill _ FACILITY NAME : nn 1-' "CMS_ _ FACILITY ACTIVITIES INCLUDE c ck all that apply): COUNTY dP- Ll se/process meats use animal is/byproducts PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? []YES LABORATORY. tJ1 '• _ Lab Cert. # —�T PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results Total event rainfall2 or o 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 ColifortW, Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50° Within 6.0 — 9.0 120 30 1000 500 1 Only appiies 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 M 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 50 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. °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-2=19 last Rev;sed: October 18, 2012 'FOR PART A AND PART B MONITORING RESULTS: 0 A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART li SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART Il SECTIONNBB • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR E SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO,p� 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 monitorinq 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,;Poiding the possibility of fines and imprisonment for knowing violations." Fe of Permrttee) J-1518 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/`sujnpdessw#tab-4 SWU-249 Last Revised: ( er ]8, 2Q12 )Page 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG06000_0_ Date submitted _ 1-IQ I3 CERTIFICATE OF COVERAGE NO. NCGor,0_D_ ,& FACILITY NAME TV-'V)n Pkf M--, COUNTY 1 94 PERSON COLLECTING MPLES 4<PV1V LABORATORY Lab Cert. # Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR FACILITY CTIVITIES INCLUDE (ct5rl all that apply): 'se/process meats a animal f s/byproducts DISCEI RGING TO SALTWATER ? ❑YES 0 PLEASE REMEMBER TO SIGN ON THE REVERSE 3 Total event rainfall 2 or DrNo 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 Colifor , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 1000 Soo 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 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 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 50 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. 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 13) SWU-249 Last Revised: October 18, 2012 *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Il SECTION B. 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION . TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES F ' Of HE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO)z 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 receiptqf the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,j;oudingithe possibility of fines and imprisonment for knowing violations." i re of Permitteej 11q-1 V (Date) Additional copies of this form may be downloaded at: http://i2ortai.ncdenr.org/web/wo/ws/suZnRdessw##tab-4 SWU-249( Last Revised: C er 18, 2012 )Pa,,e 2 of 2 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 1-1"—) CERTIFICATE OF COVERAGE NO. NCG06.L Q _.a FACILITY NAME �V `L-nn 1rVL'� COUNTY PERSON COLLECTING AMPLES 9EiD]3aQyV--S I LABORATORY Lab Cert. # Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR D) FACILITY,ACTIVITIES INCLUDE Lchqck all that apply): �guse/process meats Cajuse animal is/byproducts DISC ARGING TO SALTWATER ? ❑YES ONO PLEASE REMEMBER TO SIGN ON THE REVERSE -) Total event rainfall a or Ywo discharge this period3 Outfall No. 1 p Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal ColiformI, Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 1000 Soo l Only appiies 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 air 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/rno Benchmark - 30 100 or 50 6.0 — 9.0 - Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 4See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (ff yes, complete Part B) S W U-2Y9 Last Revised: October 18. 2012 *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEE DANCE 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 • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR^E 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: T �� Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 ij 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, in `g th f 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/su/npdessw#tab-4 SWU-249( Last Revised: f ❑er 18, 2012 Page 2 of 2 0 Tyson July 26, 2017 N.C. Division of Water Quality "r-N i r(AL FILES Attn. Central Files 9WR SECUM 1617 Mail Service Center, Raleigh, NC 27699-1617 Dear Sir or Madam: Enclosed are 2 copies or the required storm water sampling for the outfalls covered by General Permit No. NCG060000 — Tyson Farms NCG060022 Please contact me if you have any questions at 704-546-2602 ext. 232. Rega ds, KevinHaynes— Environmental Manager, Tyson Farms — Harmony, NC Tyson Foods, Inc. RVAF - Harmony 501 Sheffield Road, Harmony, NC 28634 800-568-9607 704-546-2602 Fax:479-717-0353 r+ww.tysonfoods.com SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG06_10,a,,'L SAMPLE COLLECTION YEAR oil FACILITY NAME ! w df S FACILITY ACTIVITIES INCLUDE (ch k all that apply): COUNTY use/process meats use anima! is/byproducts PERSON COLLEgNG SAMPLES ,4S DISC ARGING TO SALTWATE S? ❑YES 0 LABORATORY M f b ` Lab Cert. # C30^ Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE --) Total event roinfall z1 � 0, 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 Enterococcil, Colonies per 100 ml Benchmark - 100 or 50 Within 6.0 — 9.0 120 30 1000 500 M jcg 4,61 3- 1 Only appiies 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;Rno 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 Osage, Annual average gal/mo Benchmark - 30 100 or 50 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 gny 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 T act P"';... I- 19 1l111) *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 SECTI N q. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR HE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NOew REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30_days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information,"�ing the possibility of fines and imprisonment for knowing violations." re of �7-a 7 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/nodessw#tab-4 S W U-249 f Last Revised: C 'per 18, 2012 Pane ? oi' 2 AM p F70MPT•ACCLJ F7ATE•RELIABLF_ L.ABOIZATORIES, INC 1VWW[ ARLABS.C)\1 REPORT OF ANALYSES Attn: KEVIN HAYNES TYSON FOODS -HARMONY PO BOX 158 501 SHEFFILED ROAD HARMONY, NC 28634- PROJECT NAME: JUN 17 DATE: 07/13/17 SAMPLE NUMBER- 128062 SAMPLE ID- TYH SW-101 SAMPLE MATRIX- WW DATE SAMPLED- 06/23/17 TIME SAMPLED- 0530 DATE RECEIVED- 06/23/17 SAMPLER- KH RECEIVED BY- DJ TIME RECEIVED- 1035 DELIVERED BY- CM TYPE SAMPLE- Grab Page 1 Of 1 ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS pH VALUE SM 450OH-B 06/23/17 0530 KH 7.82 units CHEM.OXY.DEMAND EPA 410.4 06/26/17 0805 CT 2,210 mg/L DECAL COLIFORM SM 9222 D 06/23/17 1130 RE 8.20 col/100mLs OIL & GREASE EPA 1664 06/26/17 1445 CT 58.9 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 06/26/17 0320 DJ 170 mg/L LABORATORY DIRECTOR--- r Ro. Rox 411483 • Charlotte. NCB 28241-1483 I'limic: 47044 588-8333 • I=tip: (704) 588-8335 P I A�l , t PROMPT •ACOURATE •RCLrr.aL-C I,A.B0R.A'1"ORI1:S, INC: Shipping: 2217 Graham Park Drive Charlotte, NC 28273 CHAW OF CUSTODY PAR Laboratories, Inc Phone (704) 588-8333 Fax (704)588.8335 Mailing: PO Box 411483 Charlotte, NC 28241-1483 It is essential that aEl information be recorded on th;s Chain of Custody 7acumenl for acceptance by PAR Laboratories, Inc and the North Carolina Departrnent of EnvironmentHl antl Natural Resources Company Name (billing) j Comments/ Special Instructions Tyson Foods (Harmony)-- Ad�'ress ' _ 501 Sheffield Road_____ pH = City, State ii zip code — Harmony, NC_28634 Point of Contact 4 Telephone Number -- --- -- — — Kevin Haynes 704-546-2602 Ext. 232 Sample jj Taken By: PRINTED NAME 1C.V1 O �ifqyNt':� SIGNATURfx i Q r ARE SAMPLES FOR STATE or EPA REPORTING? YES X NO "Sample Type: ow ww GWMW rtw Soil other �5t'l Sample Temp at time of sampling: _ ° C Sample Temp upon receipt: ° C "Field Preserved: Yes X No Teflon Liner/Zero Headspace: Yes No n!a X Client Sample I.D. (Sample Location ! Number) Comp Grab Present I Set up Date/Time Collection Dalerrime Analyses Requested STORMWATR aW t X < 4° C`; r•+:� = 3� �' �+3- )�'17 = —� — SS x I M 50 ;== _ 3 �z � r OD X H2SO, ;. ;^ y �`= � 17 10(L Et GREASE I — X -< 4'''= -�� -rT IPECAC COLiFORM dell quished rJatarTime i ed bwater t lme , (A*4" 9. R ' inqui d b eta e � Receiv d by: ' DatElTime - G=Composite G=Grab Dl=t]rirtkintqWater VNN=U4fastewater GLVMW=Groundwa er Monitoring Well HVY=Hazardous waste SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG06_ _(2 a A SAMPLE COLLECTION YEAR az)1 FACILITY NAME rm5 FACILITY ACTIVITIES INCLUDE (ch ck all that apply): COUNTY i'P Q use/process meats use animal is/byproducts PERSON COLLECT G SAMPLES U+ 0 DISCH RGING TO SALTWATER ? []YES N0 LABORATORY G( L66�, Lab Cert. # Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER T O SIGN ON THE REVERSE 4 Total event roinf7/12 •�� 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 Coliform , Colonies per 100 ml Enterocacci , Colonies per 100 ml Benchmark 100 or 50" Within 6.0 — 9.0 120 30 1000 500 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, 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 50 6.0 — 9.0 - 1 Only applies to facilities that use/process meats. TThe 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 i 9�r IQ ')AI *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 Il SECTION/ . • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FO 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 al! "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 ir 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 o my wledge and belief, true, accurate, and complete. l am aware that there are significant penalties for submitting false information�g the possibility of fines and imprisonment for knowing violations.' (Signature ,�7-7(loa (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.or /web/wq/ws/su/g/web/wq/ws /n�dessw#tab-4#tab-4 SWU-249. I Last Revised: C 'ier 18, 2012 Page 2 of 2 v PRuMPT• A CCLI RATE• RE L I AS LE LABORATORIES, INC %V 1V 1V.1'A R LA EIS.CO M REPORT OF ANALYSES Attn: KEVIN HAYNES TYSON FOODS -HARMONY PO BOX 158 501 SHEFFILED ROAD HARMONY, NC 28634- PROJECT NAME: JUN 17 DATE: 07/13/17 SAMPLE NUMBER- 128063 SAMPLE ID-- TYH SW-301 SAMPLE MATRIX- WW DATE SAMPLED- 06/23/17 TIME SAMPLED- 0450 DATE RECEIVED- 06/23/17 SAMPLER- HH RECEIVED BY- DJ TIME RECEIVED- 1035 DELIVERED BY- CM TYPE SAMPLE- Grab Page 1 of 1 ANALYSIS ANALYSTS METHOD DATE TIME BY RESULT UNITS pH VALUE SM 450OH-B 06/23/17 0450 KH 7.66 units CHEM.OXY.DEMAND EPA 410.4 06/26/17 0805 CT 81 mg/L FECAL COLIFORM SM 9222 D 06/23/17 1130 RE 11.48 col/100mLs OIL & GREASE EPA 1664 06/26/17 1445 CT < 6.6 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 06/26/17 0820 DJ 57 mg/L LABORATORY DIRECTOR 11.0. 13ux =11 148i; • C'lt irlt)tte. NC28241-i483 l'hatitc: (704) 588-8333 • Fax: (704) 588-8333 &T, PROMPT- A r,0UR ATE• REL. I A OLE LABOIZA1'01U L S, INC: CHAIN OF CUSTODY PAR Laboratories, Inc Phone (704) 588-8333 Fax (704) 588-8335 Shipping: Mailing: 2217 Graham Park Drive PO Box 411483 Charlotte, NC 28273 Chartotte, IBC 28241-1483 It is essential thai all wofmatier, ."(. r8corccj or. ;hi> Chair: of Cuslo4y dxumerd fDr acceptance by PAR t.aboral7ies. tnc and the Borth Carolina Depar c-rit of Environmental and Natural Resources. Company Name (billing) Comments/ Special Instructions Tyson Foods (Harmony) — _— — Address 501 Sheffield Road — pH - f G City, State Er zip code Harmony, IJC 28634 Point of Contact Ec Telephone Number Kevin Haynes 704-546-2602 Ext. Z37 Sample Taken Sy: PRINTED NAMEKCYIPJ 1 INCS SIGNATURE ARE SAMPLES FOR STATE or EPA REPORTING? YES X NO 'Sample Type: ow Ww GWMW Hw Soil Other Sample Temp at time of sampling: ° C Sample Temp upon receipt: _ ° C "Field Preserved: Yes X No Teflon Liner/Zero Headspace: Yes No n1a X Bent Sample I.D. Set Up Collection II nab ses (Sample Location 1 Number) Comp Grab l Presery Date/Time Daterrime Requested STORMWATER X < q° c £_s:; ;; . G �•3 -3Gi� IT55 IAT� X H1so� «� _ •,; �i r �_ 3 �c P -- COD - _ L4:Jf' -— X HZSO, t L`'4 O blL Ft GREASE . `'-'v X < 4° C ' `.� ' ". 93 --X1 i FECAL COLIFORM Oaf �C _. i C=Composite G=Grab DVV=0rinVing Water W'> =Wastewater G4VMW=Gro DaielAlme Well H'-N=Hazardous Waste OSf SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG06D ` 9 C� SAMPLE COLLECTION YEAR & FACILITY NAME FACILITY ACTIVITIES INCLUDE (ch ck all that apply): COUNTY {`� use/process meats use animal fats/byproducts PERSON COLLECTINGSAMPLES i` P� DISCH RGING TO SALTWATER ? ❑YES �NO LABORATORY U� _�-(�b5 Lab Cert. # - Part A: 5tormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall z1, Q(� or []No discharge this period3 Outfall No. $ _ uo I Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coiiform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or 50 Within 6.0— 9.0 120 30 1000 Soo D ' 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 anv 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 V�o 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 50 6.0 -- 9.0 - 1 Only applies to facilities that use/process meats. 2The totai 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. (if vet complete Part B) S YY U-249 1 ncr R-4-4- C)'t-k - IQ 'M 1 7 *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 SECTI(RN. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES ITHE 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 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 informatior6.Wu4ng the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) 17 e�, q (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.crg/web/wg/wsZsu!npdessw#ftab-4 S W U-249 f Last Revised: C 'per 18, 2012 ?asie 2 of' 2 pROMPT• A CCU RATE- RELIABLE LABORATORIES, INC NVww t'AlZLAllS.00J%l REPORT OF ANALYSES Attn: KEVIN HAYNES TYSON FOODS --HARMONY PO BOX 158 501 SHEFFILED ROAD HARMONY, NC 28634- PROJECT NAME: JUN 17 DATE: 07/13/17 SAMPLE NUMBER- 128064 SAMPLE ID- TYH SW-401 SAMPLE MATRIX-- WW DATE SAMPLED- 06/23/17 TIME SAMPLED- 0625 DATE RECEIVED- 06/23/17 SAMPLER- KH RECEIVED BY- DJ TIME RECEIVED- 1035 DELIVERED BY- CM TYPE SAMPLE-- Grab Page 1 of 1 ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS pH VALUE SM 450OH-B 06/23/17 0625 KH 7.82 units CHEM.OXY.DEMAND EPA 410.4 06/26/17 0805 CT 1,063 mg/L FECAL COLIFORM SM 9222 D 06/23/17 1130 RE 9.84 col/100mLs OIL & GREASE EPA 1664 06/26/17 1445 CT 15 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 06/26/17 0820 DJ 162 mg/L LABORATORY DIRECTOR R0, lion 41 1483 • Chadoitc, NC 282 41-1483 1'hoac: (704) 58N-S333 • Fav (704) 588-8335. r�RphA p7•oCCIJRATi_• RLLiAULC L.A.I30ItA".I'QRIES, INC CHAIN OF CUSTODY PAR Laboratories, Inc Phone (704) 588-8333 Fax(704) 588-8335 Shipping: Mailing: 2217 Graham Park Drive PO Sox 411483 Charlotte, NC 28273 Charlotte, NC 28241-1483 It is esseniial that all ,nformaticn on th;s Chair, 4i Cusicdr .1,0c :ment for acoeolar,Ce by PAR Laboratories. Inc and the North Carolina DepaC,rrenl of Env,rcnmentat and Natarai R, sS=ces. Company Name (billing) Comments/ Special Instructions Tyson Foods (Harmony) /Address 501 Sheffield Road pH = 1. City, State t3 zip code Harmony, NC 28634 Point of Contact It Telep,)one Number Kevin Haynes 704-546-2602 Ext. 232 Sample - Taken By: PRINTED NAME i LLVt�- )-)o,tI, o - SIGNATURE rtr�• x E� ARE SAMPLES FOR STATE or EPA REPORTING? YES X NO Sample Type: aw _ —_ vvVv .aC' GwMw iiW — — -- Soil other Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C "Field Preserved: Yes X No Teflon Liner/Zero Headspace: Yes No n/a X Client Sample I.D. Set Up Collection natyses (Sample Location 1 Number) Comp Grab Pieserv. DatelTime Date[Time equested — STQRMWATER — — X < 40 c�,`$< <] — € SS t X H,SO, Y1; � f L9.3 l }COD -- i XTH 50 �_ �� SOIL Et GREASE 24 •., f' ter'+ X 4° C x 'FECAL COLI FORM i € I i', I I r ' C=Compcsite itc ring Wetl HW=Hazardous Waste It i SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted CERTIFICATE OF COVERAGE NO. NCG06D DA SAMPLE COLLECTION YEAR a� FACILITY NAME vas p rat FACILITYACTIVITIES INCLUDE (check all that apply): COUNTY )Y ede U use/process meats use animal is/byproducts PERSON COLLECT G S MPLES Q DISC ARGING TO SALTWATER ? ❑YES�NO LABORATORY ttkj Mb_--) Lab Cert. # Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall Z) - 0 (2 or ❑ No discharge this period' Outfall No. 5 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 Enterococcil, Colonies per 100 ml Benchmark - 100,or 504 Within 6.0-9.0 120 30 1000 Sao 7 Z 1 Only appiies 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 a___y 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? ❑ yesY� o 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 50 6.0 — 9.0 - 2 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 T act P_v ;'_A. 14 '1nII *FOR PART A AND PART B MONITORING RESULTS: 0 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 SECTIO . TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEFDENCES FO THE SAME PARAMETER AT ANYONE OUTFALL? YES ❑ N 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 DischamE" reports, within 30 days of receiptof 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 27699-161.7 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, yWirlg the possibility of fines and imprisonment for knowing violations." re of Perin �zCO (Date) Additional copies of this form may be downloaded at: http://portai.ncdenr.org/web/wc,/ws/su/nQdessw#tab-4 S W U-249 , Lase Revised: C 'per 18, 2012 Paae 2 o[2 Am F jz PROMPT. A CCU RAT E-RELJA RLE LABOKATORIES, INC %VWNV_PARLABS.00.N] REPORT OF ANALYSES Attn: KEVIN HAYNES TYSON FOODS -HARMONY PC BOX 158 501 SHE_:ILFD ROAD HARMONY, NC 28634- PROJECT NAME: JUN 17 DATE: 07/13/17 SAMPLE NUMBER- 128063 SAMPLE ID- TYH SW-501 SAMPLE MATRIX- WW DATE SAMPLED- 06/23/17 TIME SAMPLED- 0535 DATE RECEIVED- 06/23/17 SAMPLER- KH RECEIVED BY- DJ TIME RECEIVED- 1035 DELIVERED BY-- CM TYPE SAMPLE- Grab Page 1 of 1 ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS pH VALUE SM 450OH-B 06/23/17 0535 KH 7.74 units CHEM.OXY.DEMAND EPA 410.4 06/26/17 0805 CT 163 mg/L FECAL COLIFORM SM 9222 D 06/23/17 1130 RE 8.20 col/100mLs OIL & GREASE EPA 1664 06/26/17 1445 CT < 6.6 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 06/26/17 0820 DJ 716 mg/L LABORATORY DIRECTOR -- --..- 11.0. 13t)x 411483 • Charlotte, NC 28241-1483 Phone: (704) 598-8333 • l-su: (704) 588-8335 0k CHAIN OF CUSTODY PAR Laboratories, Inc F3JAM PRO M PT, G GCIJRA-rE• RCL I AD LE Phone (704) 58$•8333 LABOR-A'1'ORIES, INC Fax (704) 588.8335 Shipping: Mailing: 2217 Graham Park Drive PO Box 411483 Charlotte, NC 28273 Charlotte, NC 28241-1483 It is esssmial Mat aff informas;on €- ra20:Ced on ;hs Chair. of Custod -jcc--mer.; f:,r acceptance ty PAR Laboratories, Inc and The Norlh Carolina Departmcnf of Envorcr.mennI and tti'at::ral Resaueces Company Name (billing) I Comments/ Suecial Instructions n Foods (Harmony) Address 501 Sheffield Road City, State h zip code Harmony, IJC 28634 Point of Contact it Telephone lium:;cr Kevin Haynes 704-546-2602 Ext. 732 Sample j Taken By: PRINTED NAME �C-YINLNyN� pH= 77`7 SIGNATORY A l ii"'7" ARE SAMPLES FOR STATE or EPA REPORTING,? YES X NO "Sample Type: ow ww ,X-f--%WlVlW HW Soil Other SjA,! Sample Temp at time of sampling: ° C Sample Temp upon receipt: q C "Field Preserved: Yes X No Teflon Liner/Zero Headspace: Yes No nla X ^lien Sample I.D. I Set up Collection nalyses (Sample Location i Number) Comp Grab I Preseiv. Daterrime Date/TimeRequested — ___ STORM WAT R w - .5-c[ � X I < 4° c �-. �j �: CJ t .� —_ — SS --- - --- X I HzSO.SOIL =dam COD Et GREASE X ` 4° C Ir:1 7 . FECAL COLIFORM E i r�eu Isneq ay' L)aier I rn•re ec ea oy alet I Irne by- a e I Receivlerd by: IF DalelFime C=Ccmposite =Grab W=Drinking Water WW=Wastewater CWVMW-Groundwa er rvlonitohrg Well HW=Hazardous Waste Rain began : 07:03 AM 2-15-17 Rain Guage @ 0.01 .0711 AM Grab sample = # 3 outfall : 0730 AM Rain at end of storm event : .21 inches Rain stopped at 08:19 2-15-17 Sampling Point # 3 : Drainage Area = 1.0 Q = CIA I = .21 in. C = 1.0 Q = .009 mg RECEIVED MAR 0 6 2011 CENTRAL FILES DWR SECTION STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC D b O C30 or Certificate of Coverage Number: NCG . O n FACILITY NAME tqLl,� !2�� PERSON COLLECTI G SAMPLE(' CERTIFIED LABORATORV(S) Lab #;L-Q Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: a O f I (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) i I COUNTY RECEI �J E)HONE NO. (a MAR 0 0 Z011 (SIGNATURE OF OR DESIGNEE) By this signature, I certify that this report is accurate CENTRAL HLEScomplete to the best of my knowledge. DWR SECTION B�Outfall �_� ]Date it' dSample ,� 2r4Vy Collected n nV ;To[al=�� we - . _ I low; r, .. ?ll h��r "J s r,� r '� ti:� 7S; „'. 't r l S F Q? Y t ! M MG, c `' � _ ' °� xt" w -f a �. _ :'i �- D1 — —/ vc� • S Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no (if yes, complete Part B) Part B: Vehicle Maintenance Activitv Monitoring Requirements ONEi i i 1477 �r ' `. 1 . i 116.i I., .IJ i. " a�� Fonn SWU-246-051100 Page i of 2 STORM EVENT CHARACTERISTICS: Date Total Event Precipitation (inches): a.2/ Event Duration (hours). , D19 (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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 sbility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) Form SWU-246-051100 Page 2 of 2 PLL PRO MPT•Arr- JRATE•R ELi A BLE LABORATOR)rES, INC WWWPARLABS.0011 REPORT OF ANALYSES Attn: MIKE CAMPBELL TYSON FOODS -HARMONY PO BOX 138 501 SHEFFILED ROAD HARMONY, NC 28634- PROJECT NAME: FEB 17 DATE: 02/22/17 SAMPLE NUMBER- 126639 SAMPLE ID- TYH STORMWATER SAMPLE MATRIX- WW DATE SAMPLED- 02/15/17 TIME SAMPLED- 0730 DATE RECEIVED- 02/17/17 SAMPLER- MC RECEIVED BY- DJ TIME RECEIVED- 1120 DELIVERED BY- CM TYPE SAMPLE- Grab Page 1 of 1 ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS pH VALUE SM 450OH-B 02/15/17 0730 MC 6,41 units CHEM.OXY.DEMAND EPA 410.4 02/20/17 0750 CT 55 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 02/20/17 0810 DJ 7.5 mg/L LABORATORY DIRECTOR F r P.O. Box 411483 • Charlotte, NC 28241-1483 Phone: (704)588-8333 • Fax: (704)588-8335 L RTORIES, INC. CHAIN OF CUSTODY PAR Laboratories, Inc Phone (704) 588-8333 Fax (704) 588-8335 Shipping: Mailing: 2217 Graham Park Drive PO Box 411483 Charlotte, NC 28273 Charlotte, NC 28241-1483 It is essential that all information recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North Carolina Department of Environmental and Natural Resources. Company Name (billing) Comments/Special Instructions TYSON FOODS ' Address 501 Sheffield Road 4 3 o City, State & Zip Code Harmony, NC 28634 Point of Contact & Telephone Number Mike Campbell 704-S46-2602 ext:236 Sample taken by: IS THIS FOR STATE or EPA REPORTING? YES _X_ NO 'Sample type: DW WW _ X_ GWMW HW Soil Other _SW Sample Temp upon receipt: �L °C Awr- "Preserved: Yes _X No Teflon Liner/ Zero Headspace: Yes — No _ NIA Client Sample I.D. Sample Location / Number) ( Temp Degree) Comp Grab Preserv. Set Up Date/Time Collection DatelTime Analyses Requested Stormwcter � � " 3 b X % O —1 1 TSS X H2504 Cod X Ph Relinqui h by: DatelTime Received by: DateiTime �£ nquis d yt) oD(atefrime, !� Reced by: DaleTime �7 r� /7� - r%% / !r� /� 1 / ?—iwJ.r D Z—t 7 —1 / C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitorin�fWell HW=Hazardous Waste " See Other Side /_ January 29,2008 John Lesley D.E.H.N.R. Division Of Water Quality 610 East Center Ave. Mooresville, N.C. 28115 Subject : Wash down spill at Stormwater # 101 Dear Mr. Lesley, F E $ 1 2008 NO DENR IRO DWO_Surface Woter Protedon This letter is in reference to our phone conversation on January 24, 2008.On said day we had experienced extremely cold temperatures causing the outlet pipe on Stormwater 4 101 to freeze. The plant personnel were washing down the parking lot and thus caused about 100 gallons of our treated effluent that they use to wash down with to spill to Hunting Creek. The problem was corrected and the system is back on line. Should you have any questions concerning the above , please do not hesitate to call me at 704-546-2602 ext 236. Sincerely, Mike Campbell ORC Tyson Foods Harmony, N.C. i STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC (2 D I b 0 0 0 or Certificate of Coverage Number: NCG Q OO A 2- FACILITY NAME PERSON COLLECTINGAMPLE(S) CERTIFIED LABORATORY(S) PaA- L allb # Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the satnpling results from the laboratory.) COUNTY PHONE NO. a (SIGNATURE OF PGRUT2TiE DESIGNEE) By this signature, I certify that this report is accurate complete to the best of my knowledge. Outfal l Date 50050 Dsn3 L. o D .3 4fi1 :rLL No. Sample Total nn q .collected Flow molddl r MG .{ hv -33-LS- D. 4640 7.0 7 37 Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no (if yes, complete Part 13) Part R- Vnhirle Maintenance Artivity Mnnitnrina Renuirements Outfall No. Date Sample Collected 50050 _ 00556 . _ 00530 ,. 00400: Total Flow Oil and Grease ., . Total "` Suspended -:, Solids - ;,pH-Niw Motor Oil U§age.. ma/ddl r MG m 1= . : , m I. 'unit , allmo'. b 1-7- -! 111 Q& - 40 -2, C. WaA -S`v i - A3 —iS Form SWU-246-051100 Page I of 2 ir STORM EVENT CHARACTERISTICS: Date 1.23-13, Total Event Precipitation (inches);. a Event Duration (hours). 4,42. . (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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 knowled an belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the Ali of fines and imprisonment for knowing violations." l _ C/'/� ig o e mittee) (Date) Form SWU-246-051100 Page 2 of 2 4r PLIR PROMPT- A CCU RATE -RE LIABLE LABORATORIES, INC WW W.PARLASS.0O3%1 REPORT OF ANALYSES Attn: MIKE CAMPBELL TYSON FOODS -HARMONY PO BOX 158 501 SHEFFILED ROAD HARMONY, NC 28634- PROJECT NAME: JAN 15 DATE: 02/02/15 SAMPLE NUMBER- 117464 SAMPLE ID- TYH STORMWATER #301 SAMPLE MATRIX- WW DATE SAMPLED- 01/23/15 TIME SAMPLED- 1135 DATE RECEIVED- 01/24/15 SAMPLER- MC RECEIVED BY- RE TIME RECEIVED- 1100 DELIVERED BY- MC TYPE SAMPLE- Grab Page 1 of 1 ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS pH VALUE SM 450OH-B 01/23/15 1135 MC 7.03 units CHEM.OXY.DEMAND EPA 410.4 02/02/15 0800 CT 37 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 01/26/15 0830 DJ 7 mg/L LABORATORY DIRECTOR P.O. Box 411483 • Charlotte, NC 28241-1483 Phone: (704) 588-8333 • Fax: (704) 588-8335 f*�'8R CHAIN OF CUSTODY TORIES. INC. PAR Laboratories, Inc Phone (704) 588-8333 Fax (704) 588-8335 Shipping: Mailing: 2217 Graham Park Drive PO Box 411483 Charlotte, NC 28273 Charlotte, NC 28241-1483 It is essential that alt information recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North Carolina Department of Environmental and Natural Resources, Company Name (billing) Address City, State & Zip Code TYSON FOODS 501 Sheffield Road Harmony, NC 28634 Point of Contact & Telephone Number Mike Campbell 704-546-2602 11 Comments/Special Instructions %010�. z 7. zi 3 Sample taken by: IS THIS FOR STATE or EPA REPORTING? YES ✓ NO "Sample type: DW WW _ GWMW HW Soil Other —SW— Sample Temp upon receipt: -- °C Preserved: Yes _�,/ No Teflon Liner/ Zero Headspace: Yes _ No _ NIA Client Sample i.D. Sample Location 1 Number) Comp Grab Preserv. Set Up Datelrime Collection Daternme Analyses Requested TORMWATER # 301 X H2SO4 coo X x PH %43 ncIwqulmlcu uy. � uate! I lme Keceived b y= batefrime ell quished by: Date rime Received by: Date rime C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste " See Other Side 2-9-2015 ATT : Central Files D_E.H.N.R. N.C. Division Of Water Quality 1617 Mail Service Center Raleigh ,N.C. 27699-1617 RECEIVED FEB 16 2015 CENTRAL FILES Subject : General Permit No. NCG 060000 DWR SECTION Tyson Foods NCG 060022 lredell County Dear Madam or Sir Enclosed are two copies of the required storm water sampling results for the outfall Har-301 covered under the above subject permit and certificate coverage. Please contact me at 704-546-2602 ext. 236, should you have any questions. Sincerely , zwx 67qfi� Mike Campbell ORC Tyson Foods Harmony, N.C. Rain began : 10:56 AM 1-23-15 Rain Guage @ 0.01 : 11:15 AM Grab sample = # 3 outfalI : 11:35 AM Rain at end of storm event : .93 inches Rain stopped at 16:27 PM 1-23-15 Sampling Point ## 3 : Drainage Area = 1.0 Q = CIA 1 = .93 in. C = 1.0 Q = 0.040 mg A�� NCDE !NR North Carolina Department of Environment and Natural Resources Pat McCrory Governor Mr. Gregg Wikstrom Tyson Farms, Inc. 501 Sheffield Road Harmony, NC 28634 Dear Mr. Wikstrorn: Donald R. van der Vaart Secretary July 16, 2015 RECEIVED JUL 2-0 2015. CENTRAL FILES DWR SECTION Subject: NPDES General Permit NCG060022 Tyson Farms, Inc. Formerly Tyson Poultry, Inc. Certificate of Coverage NCG060022 Iredell County Division personnel received your request to revise your stormwater permit Certificate of Coverage to accurately reflect your new company and/or facility name. Please find enclosed the revised Certificate of Coverage. The terms and conditions contained in the General Permit remain unchanged and in full effect. This revised Certificate of Coverage is issued under the requirements of North Carolina General Statutes 143-215.1 and the Memorandum of Agreement between North Carolina and the U.S. Environmental Protection Agency. If you have any questions or need further information, please contact the Stormwater Permitting Program at (919) 707-9220. Sincerely, for Tracy E. Davis, P.E., CPM, Director Division of Energy, Mineral and Land Resources cc: Mooresville Regional Office Stormwater Permitting Program Files Central Files Division of Energy, Mineral, and Land Resources Energy Section - Geological Survey Section - Land Quality Section 1612 Mail Service Center, Raleigh, North Carolina 27699-1612.919-707-92001 FAX: 919-715-8801 512 North Salisbury Street, Raleigh, North Carolina 27604 - Internet: http://Dortal.ncdenr.org/webllr/ An Equal Opportunity 1 Affirmative Action Employer — 50% Recycled 110% Post Consumer Paper STATE OF NORTH CAROLINA DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES DIVISION OF ENERGY, MINERAL, AND LAND RESOURCES GENERAL PERMIT NO. NCG060000 CERTIFICATE OF COVERAGE No. NCG060022 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, Tyson Farms, Inc. is hereby authorized to discharge stormwater from a facility located at: Tyson Farms, Inc. 501 Sheffield Road Harmony Iredell County to receiving waters designated as Hunting Creek, a class WS-III water in the Yadkin River Basin, in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III, and IV of General Permit No. NCG060000 as attached. This certificate of coverage shall become effective July 16, 2015. This Certificate of Coverage shall remain in effect for the duration of the General Permit. Signed this day July 16, 2015. for Tracy E. Davis, P.E., Director Division of Energy, Mineral, and Land Resources By the Authority of the Environmental Management Commission j r-e-da"- ►`�f24 �`� . Division of Energy, Mineral & Land Resources Land Quality Section/Stormwater Permitting �. National Pollutant Discharge Elimination System NCDENR E Rwiydr—N�MTu+��-Mb F�n PERMIT NAME/OWNERSHIP CHANGE FORM FOR AGENCY USE ONLY Date Recelved Year Month Day 1. Please enter the permit number for which the change is requested. NPDES Permit (or) Certificate of Coverage Ili G S 16 1 6 1 0 1 1 NT I G Gj 0 1 6 10 1 0 2 2 Il. Permit status prior to requested change. a. Permit issued to (company name): Tyson PoulqX, Inc. b. Person legally responsible for permit: Gregg Wikstrom First MI Last RECEIVED DENR-LAND QUALITY STORMWATER PERMITTING Facility name (discharge): d. Facility address: Plant Manager Title 501 Sheffield Road Permit Holder Mailing Address Harmony NC 28634 - City State Zip (704) 546-2602 (704) 546-5944 Phone Fax Tyson Poultry, Inc. 501 Sheffield Road Address Harmony NC 28634 City State Zip e. Facility contact person: Kevin Haynes (704) 546-2602 First l MI / Last Phone 111. Please provide the following for the requested change (revised permit). a. Request for change is a result of: ❑ Change in ownership of the facility ® Name change of the facility or owner If other please explain: Legal department has advised that it is critical that the proper legal entity appear on all permits and government correspondence. b. Permit issued to (company name): Tyson Farms_, Inc c. Person legally responsible for permit: Gregg_ Wikstrom First MI Last Plant Manager Title 501 Sheffield Road d. Facility name (discharge): e. Facility address: Permit Holder Mailing Address Harmony NC 28634_ City- State J Zip (704) 546-2602 gregg.wikstrom@tyson.com J� Phone E-mail Address Tyson Farms, Inc 501 Sheffield Road Address Harmony NC 28634 City State Zip f. Facility contact person: _ Kevin T Haynes First MI Last (704) 546-2602 kevin.haynes@tyson.com Phone E-mail Address Revised Jan. 27, 2014 NPDES PERMIT NAME/OWNERSHIP CHANGE FORM Page 2 of 2 IV. Permit contact information (if different from the person legally responsible for the permit) Permit contact: Kevin T Haynes First Ml Last EHS Manager Title 501 Sheffield Road Mailing Address Harmony NC 28634 CityV State) Zip (704) 546-2602 kevin.haynes@tyson.com Phone E-mail Address V. Will the permitted facility continue to conduct the same industrial activities conducted prior to this ownership or name change? ® Yes ❑ No (please explain) VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS ARE INCOMPLETE OR MISSING: ❑ This completed application is required for both name change and/or ownership change requests. ❑ Legal documentation of the transfer of ownership (such as relevant pages of a contract deed, or a bill of sale) is required for an ownership change request. Articles of incorporation are not sufficient for an ownership change. The certifications below must be completed and signed by both the permit holder prior to the change, and the new applicant in the case of an ownership change request. For a name change request, the signed Applicant's Certification is sufficient. PERMITTEE CERTIFICATION (Permit holder prior to ownership change): I, , attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application are not completed and that if all required supporting information is not included, this application package will be returned as incomplete. Signature APPLICANT CERTIFICATION Date I, Gregg Wikstrom„ attest that this application for a name/ownership change has been reviewed and is accurate and complete to the best of my knowledge. I understand that if all required parts of this application ar completed and that if all required supporting information is not included, this application package w' d as incomplete. Z 7_ Signature Date PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO: Division of Energy, Mineral and Land Resources Stormwater Permitting Program 1612 Mail Service Center Raleigh, North Carolina 27699-1612 Revised Jan. 27, 2014 0 6-1-16 ATT : Central Files D.E.H.N.R. N.C. Division Of Water Quality 1617 Mail Service Center Raleigh ,N.C. 27699-1617 RECENED 30 01 ZA r,EN'TRAL F-ILES DVIR SECTION Subject : General Permit No. NCG 060000 Tyson Foods NCG 060022 Iredell County Dear Madam or Sir Enclosed are two copies of the required storm water sampling results for the outfall Har-301 covered under the above subject permit and certificate coverage. Please contact me at 704-546-2602 ext. 236, should you have any questions. Sincerely , 7%�e &nf "-g Mike Campbell ORC Tyson Foods Harmony, N.C. Rain began : 07:10 AM 5-17-16 Rain Guage @ 0.01 : 0726 AM Grab sample = # 3 outfall : 0755 AM Rain at end of storm event : 1.17 inches Rain stopped at 1405 PM 5-17-16 Sampling Point # 3 : Drainage Area = 1.0 Q=CIA I = 1.17 in. C = 1.0 Q = .051 mg STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC G D 0 ©0 d or Certificate of Coverage Number: NCGG FACILITY NAME PERSON COLLECTEN AMPLE(S) CERTIFIED LABORATORV(S) an- ab # 2-D Lab ## Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: 2'0 (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the s mpling results from the laboratory.) COUNTY l PHONE N 76 e 2-. (SIGNATURE OF R DESIGNEE) By this signature, 1 certify that this report is accurate complete to the best of my knowledge. a&n .�i- :,� to . Yi< f ' ■�.n Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes (if yes, complete Part B) Part B: Vehicle Maintenance Ae ivity Monitoring Requirements Outfail ;� T . N, o Date' i Sam le 50450 _r TotalYPlow . 0OSS =,-Grease 160530!. 00400 pSuspended Oil Usage Ry. moldd/y` ;' CMG ` �m I ym" unity all'rno " - '302, u1 �.ta--- no Form SWU-246-051100 Page I of 2 STORM EVENT CHARACTERISTICS: Date S—/7—& " !, ! 7 Total Event Precipitation inches): Event Duration (hours): • �i S� A,uo. . (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): Mail Original and one copy to: Division of Water Quality Attn: Central files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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 minage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledg lief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including th off' i ' of fines and imprisonment for knowing violations." (Signature of Permittee) A pate) Form SWU-246-051100 Page 2 of 2 PA PROMPT•ACCLJRATE•RLLIAB1-E LABORATORIES, INC WWW.PARLABS.00:11 REPORT 0s ANALYSES Attn: MIKE CAMPBELL TYSON FOODS -HARMONY PO BOX 158 501 SHEFFILED ROAD HARMONY, NC 28634- PROJECT NAME: MAY 17 DATE: 05/23/16 SAMPLE NUMBER- 123343 SAMPLE ID- TYH STORMWATER #.f301 SAMPLE MATRIX- WW DATE SAMPLED- 03/17/16 TIME SAMPLED- C755 DATE RECEIVED- 05/17/16 SAMPLER- MC RECEIVED BY- RE TIME RECEIVED- 1235 DELIVERED BY- CM TYPE SAMPLE- Grab Page 1 of 1 ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS py VALUE SM 450OH-3 05/17/16 0755 MC 6.47 units CHEM.CXY.DEMAND EPA 410-4 05/23/16 0600 CT 85 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 05/23/16 0810 DJ 20 mg/L LABORATORY DIRECTOR P.O. Box 411483 • Charlotte, NC 28241-1483 Phone: (704) 588-8333 • Fax: (704) 588-8335 LR TORIES, INC. CHAIN OF CUSTODY PAR Laboratories, Inc Phone (704) 588-8333 Fax (704) 588-8335 Shipping: Mailing: 2217 Graham Park Drive PO Box 411483 Charlotte, NC 28273 Charlotte, NC 28241-1483 It is essential that all information recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North Carolina Department of Environmental and Natural Resources. Company Name (billing) Address TYSON FOODS 501 Sheffield Road Comments/Special Instructions City, State & Zip Code Harmony, NC 28634'� Point of Contact & Telephone Number Mike Campbell 704-546-2602 ext:236 Sample taken by: V IS THIS FOR STATE or EPA REPORTING? YES X_ NO *Sample type: DW WW _ X GWMW HW Soil —Other —SW — Sample Tem u on receipt: VA °C `* Preserved: es X No Teflon Liner/ Zero Headspace: Yes — No _ NIA Client Sample I.D. Sample Location / Number) ( Temp Degree) Comp Grab Preserv. Set Up Date/Time Collection DatefTime Analyses Requested Stormwater ,3b / X O Jj J Tr17 ' 1 TSS X H2SO4 d 75:E - Plp Cod X Ph = lo• 4 r] Relinquished by' Daterrime Received b : Datelrime e qui d by Dat� i a Re by: Daterrimg C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMVV=Groundwater Monitoring Well HW=Hazardous Waste " See Other Side STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC G o tv Dd e) 0 or SAMPLES COLLECTED DURING CALENDAR YEAR: -2 ej& Certificate of Coverage Number: NCG 'V n (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAMECOUNTY t!e-serf! PERSON COLLECTIN SAMPLE(S) � � V / D PHONE NO. 7,OVf s --2/04 2 CERTIFIED LABORATORY(S) ab # Lab # JAIL 2 3 2017 (SIGNATURE OF R DESIGNEE) By this signature, I certify that this report is accurate CENTRAL FILES complete to the best of my knowledge. Part A: Specific Monitoring Requirements DWR SECTION � 1 t-, z 4 HO 1 I I I .r 0 i 1! �1 • - � 1 �(.WA • 1 .. TZ 1�-.-�+ ?'`9.1 Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes —no (if yes, complete Part B) Part B: Vehicle Maintenance Activitv Monitorine Requirements Outfall' °� Dates 50050 .: 10036 -- 00530 0040' GNo ti " R, Sain nle ,; Col�pslcted,,` 1 otal Flow .... Oil and Total o. Suspended H p ' New Motor Oil Usage ,Crease S�-. ��V' l M-:E'rn 1 , t 1 y Solids . :.firms. �� F ,: �. .G m ► I.:rr W m .1 ,,. unit av 0 Form S W U-246-051 100 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date -"' Total Event Precipitation (inches): Event Duration (hours): (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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 ft�sihjity of fines and imprisonment for knowing violations." ignatu re . /. z 7. Zj; (Date) Form SWU-246-051100 Page 2 of 2 ATT : Central Files D.E.H.N.R. N.C. Division Of Water Quality 1617 Mail Service Center Raleigh ,N.C. 27699-1617 10-9-14 RECEIVED OCT 13 2014 CENTRAL FILES Subject : General Permit No. NCG 060000 DWR SECTION Tyson Farms NCG 060022 Iredell County Dear Madam or Sir Enclosed are two copies of the required storm water sampling results for the outfall Covered under the above subject permit and certificate coverage. Please contact me at 704-546-2602 ext. 236, should you have any questions. Sincerely , Mike Campbell ORC Tyson Foods Harmony, N.C. Rain began : 1405 PM 9-24-14 Rain Guage @ 0.01 : 1427 PM Grab sample = # 3 outfall : 1432 PM Rain at end of storm event: .14 inches Rain stopped at 1626 PM 9-24-14 Sampling Point # 3 : Drainage Area = 1.0 Q = CIA I = .14 in. C = 1.0 Q = .006 mg STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC lam' 0 (a 0 e0 0 Z> or Certificate of Coverage Number: NCG 0 4b 0 0-")- FACILITY NAME PERSON COLLECTI SAMPLE(S) 2� CERTIFIED LABORATORY(S) Q.L. ab # 0 Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR: d/ (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sa pling r salt fr the laboratory.) COUNTY PHONE NO. 70q S� G 2 0 '�-• 7rl (SIGNATURE OF OR DESIGNEE) By this signature, 1 certify that this report is accurate complete to the best of my knowledge. Outfall No. DateII Sample Collected I Div •♦ �� �sr i t Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, complete Part 13) Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected 50050 00556 00530 00400 Total Flow Oil and Grease . Total Suspended Solids pH New Motor Oil Usage mo/dd/ r MG m I mg/1 unit al/mo 49 G -'.� �#� iNErT$ o AA Form SWU-246-051100 - Page 1 of 2 STORM EVENT CHARACTERISTICS: Date tag- 14 Total Event Precipitation (inches): , Event Duration (hours): (if more than one stonn event was sampled) Hate Total Event Precipitation (inches): Event Duration (hours): Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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 sibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) Form SWU-246-05i100 Page 2 of 2 PRUMPT• A ECU RATE -RE LIABLE LABORATORIES, INC WWW.PARLABS.COM REPORT OF ANALYSES Attn: MIKE CAMPBELL TYSON FOODS -HARMONY PO BOX 158 501 SHEFFILED ROAD HARMONY, NC 28634- PROJECT NAME: SEP 14 DATE: 10/02/14 SAMPLE NUMBER- 116108 SAMPLE ID- TYH STORM #301 SAMPLE MATRIX- WW DATE SAMPLED- 09/24/14 TIME SAMPLED- 1444 DATE RECEIVED- 09/26/14 SAMPLER- MC RECEIVED BY- DJ TIME RECEIVED- 1155 DELIVERED BY- MC TYPE SAMPLE- Grab Page 1 of 1 ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS off VALUE SM 450OH-B 09/24/14 1444 MC 6.99 units CHEM.OXY_DEMAND EPA 410.4 09/29/14 0925 CT 10 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 09/29/14 0815 DJ 22 mg/L LABORATORY DIRECTOR P.O. Box 411483 • Charlotte, NC 28241-1483 Phone: (704) 588-8333 • Fax: (704) 588-8335 L RATORIES. INC. Shipping: 2217 Graham Park Drive Charlotte, NC 28273 CHAIN OF CUSTODY PAR Laboratories, Inc Phone (704) 588-8333 Fax (704) 588-8335 Mailing: PO Sox 411483 Charlotte, NC 28241-1483 It is essential that all information recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North Carolina Department of Environmental and Natural Resources. Company Name (billing) Address City, State & Zip Code 11e&1@I1I;10I+781.1 501 Sheffield Road Harmony, NC 28634 Point of Contact & Telephone Number Mike Campbell 704446-2602 Sample taken by: —IW, Comments/Special Instructions IS THIS FOR STATE or EPA REPORTING? YES X_ NO 'Sample type: DW WW _ _ GWMW HW Soil Other _SW X Sample Temp upon receipt: °C "Preserved: Yes _X_ No Teflon Liner/ Zero Headspace: Yes ! No _ NIA Bent Sample I.D. Sample Location I Number) Comp Grab Preserv. Set Up Daterrime Collection Datelrime Analyses Requested tormwater # 301 X H2SO4 C00 X i SS X / Ph (..4 9 Relinquished by:_ Datelrime Received by; boterrime by: Date ime Received by: Datelrime ' C=Composite G=Grab DW=prinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste —See Other Side 6-25-14 ATT: Central Files D.E.H.N.R. N.C. Division Of Water Quality 1617 Mail Service Center Raleigh ,N.C. 27699-1617 RECEIVED JUN 3 0 2014 CENTRAL FILES DWQ18QG Subject : General Permit No. NCG 060000 Tyson Farms NCG 060022 Iredell County Dear Madam or Sir Enclosed are two copies of the required storm water sampling results for the outfall Covered under the above subject permit and certificate coverage. Please contact me at 704-546-2602 ext. 236, should you have any questions. Sincerely, Mike Campbell ORC Tyson Foods Harmony, N.C. Rain began : 1856 PM 6-9-14 Rain Guage @ 0.01 : 1910 PM Grab sample = # 3 outfall : 1917 PM Rain at end of storm event: .21 inches Rain stopped at 2011 PM 6-9-14 Sampling Point # 3 : Drainage Area = 1.0 Q = CIA I = .21 in. C = 1.0 Q = .009 mg STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC Go & ate o 0 or Certificate of Coverage Number: NCG © 00 A ;L, FACILITY NAME (}0 PERSON COLLECTING AMPLE(S) / CERTIFIED LABORATORY(S) Lab # A o Lab # Part A: Specific Monitoring Requirements SAMPLES COLLECTED DURING CALENDAR YEAR- .2 -0/ (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampiing results from the laboratory.) COUNTY Z'�PP_cle�J % _ PHONE NO. G (o ^.'L� D (SIGNATURE OF PEAMRUE OR DESIGNEE) By this signature, I certify that this report is accurate complete to the best of my knowledge. Ji Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no (if yes, complete Part B) Part B: Vehicle Maintenance Activity Monitoring Requirements Autfalv :,, No. Date Sample Collected 5t)050 00556 00530 00404 v:. Total' Flow tsd Grease Total Suspended Solids pll (NewMotor "OiiUsage molddl r MG. m Il 5u'nit allmo' 6 - /el,.s i 9=vc /�- -Sa Ch cr ant s .a kG Form S WU-246-051100 Page I of 2 STORM EVENT CHARACTERISTICS: Date Total Event Precipitation (inches): • �- Event Duration (hours): , a S (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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 knowledgean elief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including they "of fines and imprisonment for knowing violations." (Date) Form SWU-246-051100 Page 2 of 2 P� UFZ PRO MPT•ACCU RATE• QEf_IABLE LABORATORIES, INC NVWNV.PARLABS.00M REPORT OF ANALYSES Attn: MIKE CAMPBELL TYSON FOODS -HARMONY PO BOX 158 501 SHEFFILED ROAD HARMONY, NC 28634- PROJECT NAME: JUN 14 DATE: 06/17/14 SAMPLE NUMBER- 114381 SAMPLE ID- STORMWATER #301 DATE SAMPLED- 06/09/14 DATE RECEIVED- 06/10/14 SAMPLER- MC TIME RECEIVED- 1200 DELIVERED BY- CM Page 1 of 1 SAMPLE MATRIX- WW TIME SAMPLED- 1929 RECEIVED BY- DJ TYPE SAMPLE- Grab ANALYSIS ANALYSIS METHOD DATE TIME BY RESULT UNITS pH VALUE SM 450OH-B 06/09/14 1929 MC 6-99 units CHEM.OXY.DEMAND EPA 410.4 06/16/14 0845 CT 37 mg/L TOTAL SUSPENDED SOLIDS SM 2540 D 06/16/14 0820 DJ 20 mg/L LABORATORY DIRECTOR P.O. Box 411483 • Charlotte, NC 28241-1483 Phone: (704) 588-8333 • Fax: (704) 588-8335 PAR tASORA TORrES. INC. CHAIN OF CUSTODY PAR Laboratories, Inc Phone (704) 588-8333 Fax (704) 588-8335 Shipping_ Mailing: 2217 Graham Park Drive PO Box 411483 Charlotte, NC 28273 Charlotte, NC 28241-1483 It is essential that all information recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North Carolina Department of Environmental and Natural Resources, Company Name (billing) TYSON FOODS Address 501 Sheffield Road 1 City, State & Zip Code Harmony, NC 28634 Point of Contact & Telephone Number Mike Campbell 704-546-2602 Comments/Special Instructions Sample taken by: 2? 1)-.��_ Of IS THIS FOR STATE or EPA REPORTING? YES NO *Sample type: DW WW _ _ GWMW HW Soil Other _SW Sample Temp upon receipt: �_ °C "Preserved: Yes ✓ No Teflon Linert Zero Headspace: Yes _ No — NIA Client Sample I.D. Sample Location / Number) Comp Grab Preserv, Set Up Datemme Collection Datemme Analyses Requested TORMWATER # 301 X H2SO4 - OD X 55 x .%9.29 PH , q Relinquished by: C=Composite Other Side rzsr_�; ter_ Raraivari hv Doteffime Well HW=Hazardous Waste "See 'o; /'5�