WQ0005681_Monitoring - 10-2023_20231127

Monitoring Report Submittal
..................................................
Permit Number#* WQ0005681
Name of Facility:* Sanford Staley WWTP
Month: * October Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Xerox Scan_11272023150718.pdf 351.44KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * [e-mail]
Name of Submitter: * Daniel Shaw
Signature:
Date of submittal: 11/27/2023
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0005681
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 11/28/2023

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page ! of
Permit No.:
W00005681
Facility Name:
Pilgrim's Pride - Staley WWTP
County:
Randolph
Month:
October
Year:
2023
PPI:
001
Flow Measuring Point:
Q Influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point:
❑ Influent
❑ Effluent
❑ Groundwater Lowering
❑ Surface
Water
Parameter Code
o 5005D_
00310
00916
00940
50060
31616
00927
00610
M25
00620
00600
00400
00665
00931
00929
70300
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'.
mg/L
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mg/L
mg/L =
su
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mg/L
mg/L
1
1,452
.
2
9,676
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3
4
3.815
5
9,944.'
6
5,157
o.02
6.69
7
5,813
-
8
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9
6,367
10
10,543=
11
4,548
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.
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10,291_`3
7.84
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16
7,615
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10,392
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27
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Daily Maximum: `"
Daily Minimum:' d a: F .1 N 6.69� s
SamDlina Tvoe l ide Grab 0;40, .0 Grab �� Grab a �Gea . ,,,.. � _ .�� �i Grab � ar Grab atct'1faf� Grab ft—Meli.,� Calculated ��iff6=1Grab
Daily Limit:vr �3? w=9
✓%.4w r. S
Sample Frequency: L'}au 3 X Year Yr Annually 3 X Year9 3 X Year & 3 X Year "� Weekly xi. 3 X Year Annually

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page _ of S
Permit No.: W00005681
Facility Name: Pilgrim's Pride - Staley WWTP
Flow Measuring Point:
2 Influent F] Effluent 0 No flow generated
•
INN
201 14:30 1 2 12
21-T
10:15 2
15:15 2
10:15 2
10:45 2
311 10.45 1 2
Min
Limit:
County: Randolph Month: October Year: 2023
Parameter Monitoring Point: ❑ influent [] Effluent ❑ Groundwater Lowering ❑ Surface water

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 3 of S/
Sampling Person(s) Certified Laboratories
Name: Dennis Sumpter Name: Pilgrims Field Lab
Name: Don Kidney Tina Pedley Name: Cameron Testing
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ Compliant ❑ 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: Tina Pedley
Permittee: Pilgrim's Corporation
Certification No.: 997617/994534
Signing Official: Dan Shaw
Grade: SI/WW4 Phone Number: 919-895-3457
Signing Official's Title_ Complex Manager
Has the ORC changed since the previous NDMR? ❑ Yes 2] No
Phone Number: 9198953455 Permit Expiration: 11/30/2026
- ,1,fir
cJ �t-Zj -L3
Signature Date
Signature Date
By this signature, I certify 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 qualified personnel propedy 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, 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: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page f of
Permit No.: WQ0005681
Facility Name: Pilgrim's Corporation - Staley
County: Randolph
Month: October
Year: 2023
Did irrigation
Field Name:
1
Field Name:
Field (dame:
Field Name:
occur
Area (acres):
6.27
Area (acres):
Area (acres):
Area (acres):
at this facility?
Cover Crop:
Cover Crop:
Cover Crop:
Cover Crop:
0 YES 0 No
Hourly Rate (in):
0.3
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
35,88
Annual Rate (in):
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
;21 YES ❑ No -
Field Irrigated?
❑ YES CI NO
Field Irrigated?
❑ YES Q! NO
Field Irrigated?
❑ YES NO
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FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
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?
Page S of S
❑J Compliant ❑ Non -Compliant
❑� Compliant ❑ Non -Compliant
❑� Compliant ❑ Non -Compliant
Q Compliant ❑ Non -Compliant
R Compliant ❑ 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: Tina Pedley
Permittee:
Pilgrim's Corporation
Certification No.: 997617/994534
Signing Official: Daniel Shaw
Grade: SI/WW4 Phone Number: 919-895-3457
Signing Officials Title: Complex Manager
Has the ORC changed since the previous NDAR-1? ❑ Yes [D No
Phone Number: 9198953455 Permit Exp.: 11/30/26
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penally 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 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 Quality
Information Processing Unit
1617 Mail Service Center