WQ0009826_Monitoring - 04-2021_20210527

Monitoring Report Submittal
........................................................................................................................................
Permit Number #* WQ009826
Name of Facility:* Wayne Farms LLC
Month:* April
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter:*
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
Elkin NC Hatchery - 2021 04 4.28MB
NDMR.pdf
FDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Jeremy Bowfin
Reviewer: Williams, Kendall N
w
5/27/2021
This will be filled in automatically

Is the project number correct?* WQ0009826
Is the monitoring report t: Yes r No
accepted?*
Regional Office* Winston-Salem
Accepted Date: 6/1/2021

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0009826
Facility Name: Wayne Farms - Dobson Hatchery WWTF County: Surry
Month: April
Year: 202
PPI: 001
Flow Measuring Point: ❑€nvuent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent ❑Effluent ❑Groundtimer Lowering ❑Surface Water
Parameter Code — ►
50050
00310
06916
00940
50060
31616
00927
00610
00626
00620
00600
00400
00665
WQ09C
00931
00929
Q%
a
aa.
c
�%
W
b 7 L
,c
�()
LL o
U
a
,c
m
az
y
z
0-
L
Z
°
z
7"
a�
c
C''O
to
(n a
N
24-hr
hrs
GPD
mg1L
mglL
mg/L
mglL
#I100 mL
mg1L
mg/L
mg/L
mg1L
mg1L
su
mg/L
mglL
Ratio
mgJL
1
6:30am
9
0
2
6:30am
10.5
0
3
0
4
0
5
6am
9
0
6
6am
9.5
0
7
lam
8.5
0
8
6.30am
9
0
1.3
6.6
9
6:30am
9
0
10
0
11
0
12
6:30am
9
0
13
6am
9.5
0
14
7am
8.5
0
1.4
6.7
15
6:30am
9
0
16
6:30am
9
0
17
0
18
0
19
6:30am
9
0
20
6:30am
9
0
2
7.4
21
7am
8
0
22
6:30am
8
0
23
6:30am
8
0
24
0
25
0
26
6am
9
0
27
6am
8
0
28
7am
8
0
29
6:30am
9
0
4.1
7.1
30
6:30am
5
0
31
Average:
0
2.20
Daily Maximum:
0
4.10
7.40
Daily Minimum:
0
1.30
6.60
Sampling Type:
Monthly Limit:
Daily Limit:
Sample Frequency:
Estimate
5,000
Monthly
Grab
3 X Year
Grab
3 X Year
Grab
3 X Year
Grab
Weekly
Grab
3 X Year
Grab
3 X Year
Grab
3 X Year
Grab
3 X Year
Grab
3 X Year
Grab
3 X Year
Grab
Weekly
Grab
3 X Year
Calculated
3 X Year
Calculated
3 X Year
Grab
3 X Year

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Permit No.: WQ0009826
Facility Name: Wayne Farms - Dobson Hatchery WWTF
county: Surry
Month: April Year: 2021
PPI: 001
Flow Measuring Point: ❑inruent ❑Effluent ❑e Na Flow generated
Parameter Monitoring Point: ❑Influent FAEffluent ❑Groundwater Lowering ❑Surface Water
Parameter Code — ►
70300
00530
Z
o
O
d
a
0
a
y
o
N
N
24-hr
hrs
mg/L
mg1L
1
6:30am
9
2
6:30am
10.5
3
4
5
6am
9
6
6am
9.5
7
lam
8.5
81
6:30am
9
91
6:30am
9
10
11
12
6:30am
9
13
6am
9.5
14
7am
8.5
16
6:30am
9
16
6:30am
9
17
18
19
6:30am
9
20
6:30am
9
21
7am'
8
22
6:30am
8
23
6:30am
8
24
25
261
6am
9
27
6am
8
28
7am
8
29
6:30am
9
30
6:30am
5
31
Average:
#DIVIO!
Daily Maximum:
0.00
Daily Minimum:
0.O0
Sampling Type:
Grab
Grab
Monthly Limit:
Daily Limit:
Sample Frequency:
3 XYear
3 X Year

FORM: NDMR 05-16
NON -DISCHARGE MONITORING REPORT (NDMR)
Page of
Sampling Person(s)
Name: Jeremy Bowlin
Name: John Anderson
Name: MerlteC
Name: 164
Certified Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? Qcompridnt []Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification Permittee Certification
ORC: John Anderson Permittee: Wayne Farms LLC
Certification No.: 1003158 Signing Official: Matthew Wooten
Grade: S-1 Phone Number: 336-386-5682 Signing Official's Title: Complex Manager
Has the ORC changed since the previous NDMR? ❑Yes ONO Phone Number: 336-386-5800 Permit Expiration: 4/30/2024
Signature
By thi signature, I certify that this report is accurate and complete to the best of my knovrledge.
Yo _; � 2 � � a ��w 4 kaO_ --- - - "
Date Signature Date
I cerM, 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 all qualified personnel properly gathered and evaluated 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 hest of my knowledge and belief, true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knovring violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: W00009826
Facility Name: Wayne Farms -Dobson Hatchery WWTF
County: Surry
Month: April
Year: 2021
Did irrigation
Field Name:
1
Field Name:
2
Field Name:
3 zone 1
Field Name:
Field 3 Zone 4
occur
facility?
Area (acres):
0.75
Area (acres):
0.75
Area (acres):
0.63
Area (acres):
0.6
at this
❑YES ONO
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Hourly Rate (in):
0.2
Hourly Rate (in):
0.2
Hourly Rate (in):
0.059
Hourly Rate (in):
0.062
Annual Rate (in):
52
Annual Rate (in):
52
Annual Rate (in):
12.92
Annual Rate (in):
13.58
Weather
Freeboard
Field Irrigated?
OYES RNO
Field Irrigated?
❑YES RNO
Field Irrigated?
DYES ❑No
Field Irrigated?
AYES ❑No
T
d
0
U
ro
d
2
N
L
a
H
o
IyC
s+
°
'v
CL
OT
ro
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v
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u1
67
7 Q
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6'I
'fl
ro ro
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i= "6
o ro
= O
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'
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rn
}=. .`
c1
'6
ro ro
❑ p
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61
T '6
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❑ O
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1a
z O
J
°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
PC
48
5.75
660
0
0
0
472
333
664
664
0
0
0
992
336
671
336
0
0
0
674
487
0
672
0
0
338
0
0
1007
336
0.04
299
0
0
0
594
633
507
297
768
0
0
0
515
326
972
325
0
0
0
650
325
0
953
0
0
238
0
0
648
521
0.02
2
PC
46
5.75
0.00
0.00
3
PC
59
5.75
0.00
0.00
4
C
71
5.75
0.00
0.00
5
C
73
5.75
0.03
0.04
6
C
1 78
5.75
0.02
0.03
7
C
80
5.75
0.04
0.03
8
PC
75
5.75
0.04
0.02
9
R
78
0.01
1 5.75
1644
0.04
0,05
10
R
68
0.08
5.75
0.00
0.00
11
PC
73
5.75
0.00
0.00
12
PC
75
5.75
0.00
0.00
13
PC
71
5.75
0.06
0.03
14
C
78
5.75
0.02
0.02
15
PC
64
5.75
0.04
0.06
16
PC
66
5.75
0.02
0.02
17
PC
62
5.75
0.00
0.00
181
PC
64
5.75
0.00
0.00
19
R
64
0.05
5.75
UD
0,00
20
PC
61
5.75
0.04
0.04
21
PC
55
5.75
0.03
0.02
22
PC
43
5.75
0.00
0.00
23
PC
59
5.75
0.04
0.06
241
R
48
0.4
5.75
0.00
0.00
251
C
64
5.75
0.00
0.00
26
CL
73
5.75
0.02 1
0.01
27
CL
80
5.76
0.00
0.00
28
CL
82
5.75
0.00
0.00
29
PC
80
5.75
0.06
6.04
30
PC
73
5.75
0.02
1
0.03
31
Monthly Loading:
0
0.00
0
0.00
9,286
0.54
8,471
0.52
12 Month Floating Total (in}:
44.77
44.77
1.08
1.05

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page
Permit No.: WQ0009826
Facility Name: Wayne Farms - Dobson Hatchery WWTF
County: Surry
Month: April
Year: 2021
Field Name:
3 Zone 2
Field Name:
3 zone 5
Field Name:
4 Zone 6
Field Name:
4 Zone 3
Did irrigation occur
Area (acres):
0.78
Area (acres):
0.82
Area (acres):
1.18
Area (acres):
1.11
at this facility?
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
>rescue
❑� YES ❑No
Hourly Rate (in):
0.069
Hourly Rate (in);
0.065
Hourly Rate (in):
0.054
Hourly Rate (in):
0.057
Annual Rate (in):
14,54
Annual Rate (in):
13.8
Annual Rate (in):
12.07
Annual Rate (in):
12.6
Weather
Freeboard
Field Irrigated?
❑ ❑N0
Field Irrigated?
DYES ❑NO
Field Irrigated?
DYES ❑ND
Field Irrigated?
❑YFS ❑NO
°7a
C
LE
M
Q1
w
L
0
N n
C
a
!
C
0 aa
Q
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Q
o
7 L C
E
E a aJ
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o a
!
E a
rn
rno
C
o 0r
OF
in
ft
ft
gal
min
in
in
gat
min
in
in
gal
min
in
in
gal
min
in
in
1
PC
48
1
453
0
0
0
913
911
911
914
911
0
0
0
1365
456
910
455
0
0
0
920
455
0
1375
0
0
465
0
0
911
912
0.02
918
0
0
0
920
459
920
913
916
0
0
0
1305
460
1003
454
0
0
0
909
455
0
919
0
0
455
0
0
1400
469
0.04
1085
0
0
0
1086
544
1086
1085
1086
0
0
0
1628
542
1086
1086
0
0
0
543
1087
0
1086
0
0
0
0
0
1636
545
0.03
528
0
0
0
1053
1056
1056
528
1581
0
0
0
1083
535
1070
536
0
0
0
1070
536
0
1606
0
0
0
0
0
1078
1061
0.02
2
PC
46
0.00
0.00
0.00
0.00
3
PC
59
0.00
0.00
0.00
0.00
4
C
71
0.00
0.00
0.00
0.00
5
C
73
0.04
0.04
0.03
0.03
6
C
78
0.04
0.02
0.02
0.04
7
C
80
0.04
0.04
0.03
0.04
8
PC
75
0.04
0.04
0.03
0.02
9
R
78
0.01
0.04
0.04
0.03
0.05
10
R
68
0.08
0.00
0.00
0.00
0.00
11
PC
73
0.00
0.00
0.00
0.00
12
PC
75
0.00
0.00
0.00
0.00
13
PC
71
0.06
0.06
0.05
0.04
14
C
78
0.02
0.02
0.02
0.02
15
PC
64
0.04
0.05
0.03
0.04
16
PC
66
0.02
0.02
0.03
0.02
17
PC
62
0.00
0.00
0.00
0.00
18
PC
64
0.00
0.00
0.00
0.00
19
R
64
0.05
0.00
0.00
0.00
0.00
20
PC
61
0.04
0.04
0.02
0.04
21
PC
55
0.02
0.02
0.03
0.02
221
PC
43
0.00
0.00
0.00
0.00
23
PC
59
0.06
0.04
0.03
0.05
24
R
48
0.4
0.00
0.00
0.00
0.00
25
C
64
0.00
0.00
0.00
0.00
26
CL
73
0.02
0.02
0.00
0.00
27
CL
80
0.00
0.00
0.00
0.00
28
CL
82
0.00
0.00
0.00
0.00
29
PC
80
0.04
0.06
0.05
O,04
30
PC
73
0.04
0.02
0.02
0,04
31
Monthly loading:
13,237
0.63
12,874
0.58
15,211
0.47
14,377
0.48
12 Month Floating Total (inj:
1.28
1.18
0.92
0.96

FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
PCompliant ❑Non -Compliant
ECompliant ❑Won -Compliant
(]Compliant ❑Won -Compliant
OCompliant []Non -Compliant
[ACompliant ❑Ran -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: John Anderson
Pormittee:
Wayne Faarms LLC
Certification No.: 1003158
Signing Official: Matthew Wooten
Grade: S-1 Phone Number: 336-386-5682
Signing Official's Title: Complex Manager
Has the ORC changed since the previous NDAR-1? ❑Yes ORo
Phone Number: 336-386-5800 Permit Exp.: 4/30124
aylollua�
5a
S*a
Signature Date
Signature Date
By this signature, I certfy that this report is accurrate and complete to the best of my knowledge.
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 all quarrfied personnel property gathered and evaluated the informalion submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMLR 05-16 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page
Permit No.: WQ0009826
Facility Name: Wayne Farms - Dobson Hatchery WWTF
County: Surry
Month: April
Year: 2021
Field Name:
3 Zone 5
Field Name:
4 Zone 6
Field Name:
4 Zone 3
Field Name:
Field Name:
Area (acres):
0.82
Area (acres):
1.18
Area (acres):
1.11
Area (acres):
Area (acres):
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Load Typo:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
I]YES ONO
Field Loaded?
EYES LINO
Field Loaded?
DYES ❑No
Field Loaded?
[AYES ONO
Field Loaded?
MYES ❑ND
ao
z
$
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QU
n
j
;
aU
;
aU
Month
gal
mgIL
lbslac
Ibslac
gal
mg1L
Ibslac
Ibslac
gal
mg1L
Ibslac
Ibslac
gal
mglL
Ibslac
Ibslac
gal
mglL
Ibslac
Ibslac
May
June
July
August
September
October
November
December
January
February
March
13,342
21
2.8
2.8
14,563
21
2.2
2.2
14,486
21
2.3
2.3
April
12,874
21
2.7
5.6
15,211
21
2.3
4.4
14,377
21
2.3
4.6
12 Month Floating PAN Load
5.6
4.4
4.6
0.0
0.0
(lbslaelyr):
Annual PAN Load Limit
188
247
247.00
Mwz=
(lbslaclyr):

FORM: NDMLR 05-16 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Permit No.: WQ0009826
Facility Name: Wayne Farms - Dobson Hatchery WWTF
County: 5urry
Month: April
Year: 2021
Field Name:
1
Field Name:
2
Field Name:
3 Zone 1
Field Name:
3 Zone 4
Field Name:
3 Zone 2
Area (acres):
0.75
Area (acres):
0.75
Area (acres):
0.63
Area (acres):
0.6
Area (acres):
0.78
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Cover Crop:
Fescue
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
❑YES ENO
Field Loaded?
❑YES ENO
Field Loaded?
DYES ONO
Field Loaded?
EYES ONO
Field Loaded?
EYES LINO
0) 'a
aca
y
z
a
a
�Qa¢5o
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Month
gal
76,032
mg1L
Ibslac
Ibslac
gal
mg1L
lbslac
Ibslac
gal
mglL
Ibslac
lbslac
gal
mg1L
Ibslac
Ibslac
gal
mg1L
Ibslac
Ibslac
May
28
23.7
23.7
76,032
1 28
23.7
23.7
June
69,120
28
21.5
45.2
69,120
1 28
21.5
45.2
July
82,944
28
25.8
71.0
82,944
28
25.8
71.0
August
96,768
28
30.1
101.1
96,768
28
30.1
101.1
September
89,856
28
28.0
129.1
89,856
28
28.0
129A
October
82,944
28
25.8
155.0
82,944
28
25.8
155.0
November
76,032
26
22.0
176.9
76,032
26
22.0
176.9
December
89,856
26
26.0
202.9
89,856
26
26.0
202.9
January
76,032
26
22.0
224.9
76,032
26
22.0
224.9
February
69,120
26
20.0
244.9
69,120
26
20.0
244.9
March
96,768
31
33.4
278.2
96,768
31
33.4
278.2
9,224
21
2.6
2.6
8,578
21
2.5
2.5
13,679
21
1 3.1
3.1
71
April
0
31
0.0
278.2
0
31
0.0
278.2
9,286
21
2.6
5.1
8,471
21
2.5
5.0
13,237
21
3.0
6.0
12 Month Floating PAN Load
2782
278.2
5.1
5.0
6.0
(lbslaclyry
IN
Annual PAN Load Limit
158
158
188.00
188.00
188.00
(lbslaclyr):
------------
-------------

FORM: NDMLR 05-16 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of
Did the mass loading rates exceed the limits in Attachment B of your permit? ❑� Comprart ❑Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance_ Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
IOperator in Responsible Charge (ORC) Certification 11 Permittee Certification
ORC: John Anderson
Certification Number: 1003158
Grade: S-1 Phone Number. 336-386-5682
Has the ORC changed since the previous NDMLR? ❑Yes ONo
` Signature
By this signature, I certify that this report is accurraie and complete to the best of my knowledge.
Permittee:
Wayne Farms LLC
Signing Official:
Matthew Wooten
Signing Officials Title: Complex Manager
Phone No.: 336-386-5800 Permit Exp.: 4130/24
� at X�i
Dale Signature Dale
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance Wth a system designed to assure that all qualified personnel properly gathered and evaluated 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, We,
accurate, and complete. I am aware that there are sign1unnt penalties for submitting false informal on, including the
possibility of fines and imprisonment for knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: WQ0009826
Facility Name: Wayne Farms - Dobson Hatchery WWTF
County: Surry
Month: April
Year: 2021
PPI: 002 Flow Measuring Point: PInfluent ❑Effluent ❑No flow generated
Parameter Monitoring Point: ❑Influent ❑� EFfluert ❑Groundwater Lowering ❑Surface Water
Parameter Code —► 50060
00310
00916
00940
50060
31616
00927
00610
00625
00620
00600
00400
00665
WQ09C
00931
00929
p Q F
c
O
N !
m
r
o
�N
o
E
O
5
m
z
f—
2
�
C
O
a0
m
o
c
sE
O }'
yrl
n
C
O
cn0
24-hr
hrs GPD
mg1L
mg1L
mg/L
mg1L
#1100 mL
mg1L
mg/L
mg1L
mg/L
mg1L
su
mg1L
mg1L
Ratio
mg1L
1 6:30am
9 5,914
2 6:30am
10.5 51990
3
0
4
0
5 6am
9 5,252
6 6am
9.5 4,669
7 7am
8.5 330
8 6:30am
9 4,243
1.3
6.6
9 6:30am
9 6,183
10
0
11
0
12 6:30am
9 4,826
13 6am
9.5 5,038
14 7am
8.5 468
1A
6.7
15 6:30am
9 5,311
16 6:30am
9 5,162
17
0
18
0
19 6:30am
9 5,011
20 6:30am
9 4,961
2
7.4
21 7am
8 1,304
22 6:30am
8 4,875
23 6:30am
8 2,112
24
651
26
839
26 6am
9 4,859
27 Sam
8 521
28 7am
8 1,039
29 6:30am
9 4,588
4.1
7.1
30 6:30am
5 6,598
31
Average: 3,025
2.20
Daily Maximum: 6,598
4,10
7.40
Daily Minimum: 0
1,30
6.60
Sampling Type: Estimate
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Calculated
Calculated
Grab
Monthly Limit: 5,000
Daily Limit:
Sample Frequency: Monthly
3 X Year
3 X Year
3 X Year
Weekly
3 X Year
3 X Year
3 X Year
3 X Year
3 X Year
3 X Year
Weekly
3 X Year
3 X Year
3 X Year
3 X Year

FORM: NDMR 05-16 NON -DISCHARGE MONITORING REPORT (NDMR) Page
Permit No.: W00009826
Facility Name: Wayne Farms - Dobson Hatchery WWTF
County: Surry
Month: April
Year: 2021
PPI: 002
Flow Measuring Point: ❑Influent DEHluent ❑No Flow generated
Parameter Monitoring Point: ❑Influent DEtfluent ❑Groundtivater Lovre0g ❑Surface water
Parameter Code ►
70300
00530
m
i
O
O
E ar
0
O
m
0
V) 0
T uy
C
° a o
H (A
-
24-hr
hrs
mglL
mg1L
_
1
6:30am
9
2
6:30am
i0.5
3
4
5
6am
9
6
6am
9.5
7
7am
8.5
8
6:30am
9
9
6:30am
9
10
11
12
6:30am
9
13
6am
9.5
14
7ani
8.5
15
6.30am
9
16
6:30am
9
17
18
19
6:30am
9
20
6:30am
9
21
7am
8
22
6:30am
8
23
6:30am
8
24
25
26
6am
9
27
6am
8
28
7am
8
29
6:30am
9
30
6:30am
5
31
Average:
##DIV/O!
Daily Maximum:
0.00
Daily Minimum:
0.00
Sampling Type:
Grab
Grab
Monthly Limit:
Daily Limit:
Sample FrequenGy:j
3 XYear
3 X Year

FORM: NDMR 05-i6 NON -DISCHARGE MONITORING REPORT (NDMR) Page of
Sampling Person(s) Certified Laboratories
Name: Jeremy Sowiin Name: Meritec
Name: John Anderson Name: 164
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? QComprant ❑Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance- Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: John Anderson
Permittee: Wayne Farms LLC
Certification No.: 1003158
signing Official: Matthew Wooten
Grade: S-1 Phone Number: 336-386-5682
signing Official's Title: Complex Manager
Has the ORC changed since the previous NDMR? Dyes [TNo
Phone Number: 336-386-5800 Permit Expiration: 4/30/2024
ma6n-C2)
70i_�Signature
5 -�
Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knovAedge.
I certify, under penalty of law, that this document and all attachments ware prepared under my direction or supervision fn
accordance with a system designed to assure that all qualified personnel property gathered and evaluated 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 knrnvledge and belief, true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the possiblity of fines and imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617