WQ0016376_Monitoring - 08-2023_20240103

Monitoring Report Submittal
Permit Number#* WQ0016376
Name of Facility:* S&J VILLARI LIVESTOCK PROCESSING FACILITY - WARSAW
Month: * August Year: * 2023
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR WWT August 2023.pdf 8.02MB
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: * Gerald Matthews
Signature:
Date of submittal: 1/3/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald

Is the project number correct?* W00016376
Is the monitoring report accepted?* Yes NO
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 1/30/2024

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT Page of _...
--- Perm!! No.: br'i i)C1f)1 6,;7f'.a,..
r-8 f; �l,i ~Il^u�7 �!'. .,P -, ,l ,'' j�..,..,........_....�.......,.,.,r
s ,r �.jvestock i• recessing Facility Wars
r,..«.,...n......-,.,. ..�.,....,,,.....�....,.R-. •._..., ..._..ny.... _
r ii
'Jut iti9ontn: Auy:_jst
.,.m.�..�...,�...,.r.,„.�...i
Yaar: �UI3
Did h I"igation occur
_
F,ie:d f�artre:i 1 Field Name: 2 - 1�,'
_--____-. n
F!e;d Name; Field Name:
-
1
ti
at this facility?
Area (acres):�--- 0.65 Area (acres):' 1.16
Area (acres): 1.12 I� Area (acres):
1.07
Cover Crop: Coastal Bermuda Cover Crop: Coastal Bermuda
-
Cover Crop: Coastal Bermuda Cover Crop:
Coastal Bermuda
YES F ] Ne
Hourly Rate (in): 0.6 Hourly Rate (in): - 0.6
Hourly Rate (in): -- 0.6 Hourly Rate (in):
0.6
�.
Annual Rate (in):
41.96
Annual Rate (in):
- 41.96
Annual Rate (in):
41.96
Annual Rate (in):
41.96
Weather
Freeboard
Field Irrigated?
❑ YE5 ❑ No
Field Irrigated?
❑ YES ❑ No
Field Irrigated?
] YES ❑ No
Field Irrigated?
YES ❑ No
c m
o
rn
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°F
in
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
36
48
2
CL
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--
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3
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-
-
--
--
4
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9
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11
CL
12
CL
_
~
13
CL
14
15
CL
CL
-
-0.34
16
Ct_
-_
-
_
5.992 _ _ 19 0.34 0-34 , 0,694 33
3.074 12 _ 0,17 0,17 5,486 21
0.34_
0.17
0.17
10,325 32_ 0.34 _0.34 _9,864 31
5,297 20 0.17 0 17 5,060
19
0.34
0.17
0.34
17
18
CL�
CL
--
-
I 7,235 23 0.41 0.41 1 12_,912 42
--- -{�-- -
_
0.41
--
-0.41
_ _ _
12,467 40 0.41 0.41 11,911 _ 39
- h- -
0.41
--
_0.17
0.41
19
C
-
21
22
C
C
-
-
--�1
4,975 18 028 0.28 1: 8,878 31
-
- -- L --
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0.28
8,572 30 0.28 028 Ii 8.189 29
0.28
0.28
23
24
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-
27
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0.02--
-
-
'
28
2.9
R
CL
2.5
-
i
30
CL
j
31 R
5.5 68
4847
Monthly Loaciing
21
1_
12
Month Floating Total
(in)
- x
�21 c

FORM: NDAR-1 08-11 140N- DISCHARGE APPLICATION REPORT (NDAR-i) Page-_ Z, _ of
Permit No.: WQ0016376
Facility Name: S&J Villari Livestock Processing Facility Warsaw
County: t)uplin Month: August
Year: 2'23
Did irrigation OCGur
Field Name:
5
Field Name:
6
Field Name.
Field Name:
at this facility?
Area (acres):
1.19
Area (acres):
1.17
Area (acres):
1.05
Area (acres):
1.25
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
jJ YES ❑ NO
Hourly Rate (in):
0.6
Hourly Rate (in):
06
Hourly Rate (in):
0.6
Hourly Rate (in):
0.6
Annual Rate (in):
41.96
Annual Rate (in):
41.96
Annual Rate (in):
41.96
Annual Rate (in):
41.96
Weather
Freeboard
Field Irrigated?
(,YES
Fi
eld ield Irrigated?
YES NO
Field Irrigated?
Y No
Field Irrigated?
YES ❑ NO
0
L)
0
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in
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48
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10,970
- 34
0.34 1034
11 10,786
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034
0.34 9,680 30 0.34 0 34
11,524
36
0.34
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16 CL628
17 CL.
21
43
---
0.17 0.17
0.41 0,41
5.533
13 024
21
0.17
0.41
0 17 4,966 18 0.17 0.17
0.41 11,688 38 041 0 1
4:
1,912
13,914
22
45
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0.17
0.41
CL
9 C
19
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0 C-
21 C
22 C
23 C
9,108
32
---
0,28 1 0.28
8-955
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---
9,567
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25 C
26
27 R
28 R
0.02
2.5
29 CIL
if
30 CL
Jk-
- -------
- - ------ - --- --
31 R
68
48
I'll
Monthly Loading
Month Float;ng Total
(in
52
HQU
7
1.21
4(

FORM: NDAR-1 08-11 N(,If>--Ol'ir:,. iJaF;'-. ::AFIFILIC ATlOt4 REPORT INI:i' R-1) Page_ 0
Permit No �`rICJ0016 .?0
__ , _...._.....__....�.._,
�; �ar.ility Marne:
S&)'✓ill�ri )V ,,,_.stock
Pi'o-,esSing t^;.1C'
._.,.._a....,.,.__....�.._...
lly-1,� a!saw u.
y
Count � Du
9_a.,
pin R- ..c ,�
p n fJo, t;
5 h . � +
August
aar:
20?_3
�'y occur
G✓ I C� irrigation Q Ulu U r
p-
at�it'aaCllltj/
Field Nar
Name:
Area(acres):,�w
9
i T 1
i Field Marne:'
Area (acres):
10
1.46 --
Field Name:
�^ Area (acres):
11 _
1.43 -lL
; Field Name:
Area (acres):
12
1.23
Cover Crop:
Coastal Bermuda----
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal
YES ❑ No
-_
Hourly Rate m
y C ):
0.6
Hourly Rate (in):
0.6
-
Hourly Rate (in):
0.6
�i~
r1 Hourly Rate (in):
Bermuda
0.6
Annual Rate (in):
41.96
Annual Rate (in):
41.96
Annual Rate (in):
41.96
Annual Rate (in):
41.96
Weather Freeboard
Field Irrigated?
YES ❑ NO
Field Irrigated?
Q YES No
Field irrigated?
Jl YES ❑ NO
-Field Irrigated?
YES ❑ NO
"a Do @
° m a o rn o
(4 U 1- `
� y�
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4
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in in
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in in
- -
gal min
-
in in
gal min
in in
gal min
in in1
C36
48
2
CL3
C4
R
5
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8
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10
911
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12
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13
14
16 CL i
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-
9,219
- l 4,729
t9
18 I
0.34
0.17
- 0.34 _ 13,460
0.1_7_-� 6,905
42 _0.34
26 OA7
_0.34_
0.17
i 3.183
H6,763
-
41
2.6
0.34
0.17
0.34
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11.339
�5.817
35
22
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17 CL.
19
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36
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15,918
r
51
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44
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1 0.41
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7,653
27
- 0.28
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11,174
-- -_�-
39 0.28
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0.944
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30 CL i
31 R I 5.5
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---
68
Loading
Monthly
h
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... ...,....-.
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FORM: NDAR-1 08-11 V 14ON -DISCH A 1'. APPLICATION REPORT (NDAR-1), Page_ . _ of_ 10-
Permit No.: 'AWn 16376
Did irrigation occur
at this facility?
Facility Name: Livestock Procossing Facilitv. 71M aw
Field Name: I Field Name: 14E
Area (acres): 2. 16 Area (acres): 13.73
Count) --Pi in Month: August~
Field Name: 14VV i Field Name:
Area (acres): 7.7 Area .-- (acres): ---
_E �TL
Year: 2023
15
_O
73
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
Cover Crop:
-
Coastal Bermuda
Cover Crop:
Coastal Bermuda
F_,1 YES rL_1 NQ
Hourly Rate (in):
0.6
Hourly Rate (in):
0.6
Hourly Rate (in):
0.6
Hourly Rate (in):
0.6
Weather Freeboard
Annual Rate (in):
41.96
F7 YE ^ :NO
Annual Rate (in):
Field Irrigated?
31.6
Annual Rate (in):
_
_24-21
Annual Rate (in):
30.44
Field Irrigated?
L YES Fj NO
Field Irrigated?
[J YES Ei NO
Field Irrigated?
Q YES ❑ NO
o
0
U
T
(U
CL
E
_�F�
0
N
AL
0 2
Cn 0
2
0
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a
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-
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>
(D
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0)
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>
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.21
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M
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i-. .5
0
E rn
S
E
0 M
M x 0
1
C
in
in
36
in
48
gal
min
in
in
gal
min
In
in
gal
min
in
in
gal
min
in
in
2
3
4
6
6
CL
C
R
C
C
1.2
_0.09
7
8
=R
CL
9
CL
CL
10
R
11
CL
12
CL
13
14
15
16
-7
1
18
CL
CL
CL
CL
-
CL
CL
19,913
1U15
24,044
62
39 -4
78
0.34
0.17
_1
4
0.33
0.17 __
032
__
-.-1
1 6,730
3,452
__ 1 _
I 8,126 -
21
0.34
0.34
13
-
0.17
0.1.7
26
0.41
0.41
i-9
20
21
22
23
24
C
C
C
C
-C
C
- - ---
-------
--
-
--
- i
48
g:
if
16,531 58 028 0.28 127,164
02,956
-� _- - --- -- 30,842
126,755
777_:.'
384
-
384
77
384
U4
0.28
0.&8-
0.34 3-4
0.05
0.04
-0,0-,6---
0 05
71,316 216 0.34 0.09 5,587
_U -4
57,739 216 0.28 108 1
17,297 43 OM 0-08
71
2 1
20
0.28
-
0.28
26
C
26 C
27 R 0.02
28 R 2.5
CL
30 CL.
5 5 68
i rig Tol
1.04 1
14.54
1.21

-- /
Did irrigation occull"
Field Name;
Area (acres):
16
1.2
Field Name.
17
Field Narne:1
Field Naryle:j
at this facility
Cover Crop:
Coastal Bermud
-a
Cover Crop:
Coastal Bermuda
Cover Crop:
Area
Cover Crop
YE.s NO
Hourly Rate (in):
Annual Rate (in):
0.6
13.83
Hourly Rate (in):
Annual Rate (in):
0.5
16.95
Hourly Rate (in):
Annual Rate (in):
Hourly Rate (in):
Annual Rate (in):
Weather Freeboard
Field Irrigated?
YES N 0
Field Irrigated?
DYES NO
Field Irrigated?
YES [7! NO
Field Irrigated?
YES NO
I
OF
in
In
III
gal
min
in
in
gal
min
in
gal
min
in
in
gal
min
in
in
246
C
17,

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page 4 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?
17,1 Compliant
❑ Non -Compliant
❑� Compliant
L] Non -Compliant
Q Compliant
❑ Non -Compliant
❑✓ Compliant
❑ Non -Compliant
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: Gerald Lamar Matthews
Permittee:
Sam Villari
Certification No.: 993131
Signing Official:
Grade: SI Phone Number: 910-289-7500
Signing Official's Title: Owner
Has the ORC changed since the previous NDAR-1? ❑ Yes E No
Phone Number: 910-293-2157 Permit Exp.: 11/302025
-;23
Signature Date
Signature Date
By this signature, I certify th3l 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 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
Raleigh, North Carolina 27699-1617

FORM: NDMR 03-12 NOWDISC'1tj4011- MR1, Pase._- Cc -.-
Permit No: WQ0016376��Facility
?dame: S&J Villari Livestock t'n�essinu Facili dV r �
ty- a -3��
county: Duplin
Month: August
Year: 202.3
PPI: 001
Flow Measuring Point: ❑ Influent 21 Effluent ❑ No flow generated
Parameter Monitoring Point: n Influent [�] Effluent ❑ Groundwater Lowering Surface Water
Parameter Code --;0
50050
00310
00940
50060
31616
00610
00625
00620
00600
00400
00665
70300
00530
>
.L N
O
to
v
;O
m
7 S
w
i
G
d
w
_ 0
v
� N
'O N
I
❑
F-
U N
LL
❑
s
} y L
lJ 6
E
"
! Z
F•- t
a
F- N
n
F N
O
U
U
U
Q
o z
Z
t
(n
0
V7
3
0
_
a
cn
24-hr
hrs
GPD
mg/1-
mg/L
mglL
#1100 mL
mg1L
mg/L
_
mg/L
mg/L
su
mg/L
mg/L
mg/L
1
07:00
10
78,920
2
07:00
10
81,210
3
07:00
10
80,130
<0.10-
4
07:00
10
75,100
—
5
07:00
8 _
50,000
—^--
---
-
6
07:00
4
50,000
---
----
- -
-
---
7
07:00
10
80,120
-- --
- --
---
-"-
8
07:00
10
76,770
-
- - - -
-
----
9
07:00
10
77,830
--�0-
-
----
----
-
-"
10
U7:00
10
76,780
- ----
-- 7.3 -
- -
--
-
11
07:00
10
79,100
---
-- ---
12
07:00
7
50,000
---- -
---
----
---
13
07:00
1
50,000-
-
--- -
-
--- -
14
15
07:00
07:00
10
69,890
i ----
-
- --
-
--- -
- --
10
78,110
-___.�-
I
16
07:00
10
19,210
17
-.
18
_.07:00
07:00
10
10
76,410
<0 1 -
-
_ _
I -"" -- --
6.9
- - -
--
-
- -
19
0700
8
50,000
20
07.00
5
50,000----
_-
-
- --
----;------
--..
21
07:00
10
70,810--
22
07 OU
10
70,110
I--T-
--
-----
--
---
23
07 00
10
89,100
24
07 00
10
78,920
-- -----
-
- - --- -
- - - -- - -- -
---- ----
-f-- --
8.4
t----
-�----
- -
--
----
- -+—
--
---
--- --
25
26
07.00
07:00
10
8
80,110 _ <0.1
50.000 ------
27
28
29
30
07:00
07:00
07:00
07:00
2
10
10
10
50.000 I
91;080
-- ---- --
79;120-
78,900--
�----------
-- -_ .. -- - - ` -
- --; -- -
---
F-
I
- -- --i
- --
---
—�-----
----
—
----
311
07:00
10
77.840 21_ I <0.1
71,089 21.00
91.05; 1 21.00 0.20
� 3 �.00 0.10
10800 ' 70.4 I 6 -62
.74Tl
.70.4?4 9G 000
10,800.001 70.40 74.90 0.02
<.— }
1,80.0070.40Dail 74.93
----74.-.5
490
4.9G
8.2--
8.
---7.37--�_---
37
737
I -4
00.
- 7-.4
74 UDaily
Q—� --- -
- -
�(--
-
- -_- -
Average:
Maximum:
---_m Nlinimum
0.02 i74
9-
6.90
7.37
_ T 74 00
Sa)Ii l Type,
Grab Grab
Grab Grab i c :rab
,ac
' Grab
Grab
i �,t; ,
Monthly Avg. Limit
Daily Limit:
Sample hreal,sen -
1 �
n;pf r,, Monthly i Monthly
�
f ! Monthl
,Th
-
Monthly
_ ._--
on'thly _
-- a
_ - . --
L -
_. --- -
-
-- - -

FORM: NDf,^R 03-2 NON —DISCHARGE iw"'ONI' lw RING REPORT ;!NDAAR) ?a?e .�_._ ,T `+
Permit No.: VJG0016376
Facility Name: S&J Villas: Livestock Processing Faclli,'.r-Warsa
County ^�i i_r)iin
Month: August
Year: 2023
PPI: 002
Flow Measuring Point: _; influent 0] Effien, No fiov; aenerated
Parameter Monitoring Point: �] Influent ❑ Effluent El Groundwater I:c surface Water
Parameter Code -►
50050
1 00625
00610
00620
00665
31616
00600
c
I
M U i- in
Y 0
E
r
O C
o
U
tL
m z
7
p
O O
o
F-
`�
_
_
n-
U
24-hr
hrs
GPD
mg/L
mg/L
mg/L
mg/L
#/100 mL
mg/L
1
07:00
10
78,920
2
07:00
10
81,210
3
07:00
10
80,130
4
07:00
10
75,100
5
07:00
_8
50,000
---
-
--
6
0_7:00
4
50,000
—
-
--
-
--
—
--
7
07:00
10
80,120-
--
—
-
—
--
--
8
07:00
10
76,770
9
07:00
10
77,830
-_--
10
07:00
10
76,780
—
--
11
07:00
10
79,100
-
-
-
12
13
07:00
07:00
7
1
50,000
50,000
-
14
07:00
10
69,890
-
—
- ---
__
-------- ----
-
--
15
07:00
_ 10
78,11_0�—
--
16
07:00
10
79,210
-
- -
17
07:00 !
10
78,190
i
18
07:00
10
76,410
-
-- --
-
-
-
-
--
--.. -
--
---
19
07:00
8
50,000
—
— --
20
07:00
5
50.000-
----
21
07:00 l
1.0
70,810
22
07:00
10
70:110-
_
23
24
07:00 i
07:00
-
10
10
89,100
78,920--
—
----
1
I
---- -
-- �-
—
_---
-
--
---
-
25
26
27
0700
07:00 -�
07 00
10
8
2
80,110
50,000-
50,000--
—
--1—'
----
---
-- --
—
28
07-00
10
91080
1
--
-
----
-�---
--
29
07:00
10
�—
I
-
30
07:00 FFF---
0
-79.120
78:900 j
--
--
------
----
--_
- -
---- -�
-
-- -
--
-------
31
07
77.840
0.8
<0.2
18
0.17
24500
1
I
Average:
7i.089
0.80
0.00 I
0.16 M
d.1' 1
24`50d 00
1.00
Daily Maximum:
91,080 11F
080
0.20 0.16
- -0.16
017 24,50 01 1.00 1
--
Daily Minimum:
TYPe.
50,000- I
0.80
0.2U
rt 4 500 001-1.00
r--
—
.�..,..,._a....-,..
--
-- —
—
..,...,.�.�a._.�,
{
---
---- r7;..;,',a3
Racar...er
u:ab
GrabM i Grab
Gla., ' Grob
-1--------•___ ._ ___-.---.�_
_ -.-.-
_-.
.-. --i-•----
__ ...
�
-----j
I
tAorAnly Avg. i_Imit:
Daily Limit: Limit•
3
-
�._--
-- •--
I.
-- -
-
-----
I----
--- ----
�
-
- -
-- -
S'--nnpe Fraquency'.
Re:cra'a,- ! 4:3nth;y
Mo^>r j Monthly
Mon,( Monthly

!=ORM: NDMR 03-12 srV'ON-DI.•-'S�'',HARGREPORT i 'tir.3ia�v24 � --1--
Permit No.: 4NQOu'•Ei3i f : acility Name: is--, ;/iliari Livestock Processing F�,�i '\'arsa count �' t
�_ C� y y vupiin f.3onth. A � silyy Year. 2023
PPI: 003 Flow Measuring Point: ❑ Influent U Effiuent ❑ No flow generated Parameter MonitoringPoint: ❑ Influent Effluent �,
�] U Groundwater L.::eer',g _I S; ace Water
Parameter Code - 50050 l 00625 00610 -0062� 00665 I 31616 00600
to
O
iv
a
�,
a
E
` ID
Q H
E;
3
i °'tM
O
E
ro
I to
_
OO
1,
rn
O`
i
U
z
Q
«`.
O In
H s
U
O
~ Z
O
O
24-hr
hrs
GPD
mg/L.
mg/L
rng/L
-
mg/L
#/100 mL
mg/L
r
1
07:00
10
78,920
--
2
07:00
10
81,210
—
3
07:00
10
80,130
4
07:00
_ 10
75100
_ -
-
5
07:00
8
50,000
-- -
-
----
-- ---
6
07.00
4_
50,000
- --
- -
-
-
-
-
-
7
07:00
10
80,120
----
~�-
-
--
8
07:00
10
76,770
-----
-
9
07:00
10
77,830
- ---
-----
-
10
11
_ 07:00
10
76,780
-
- -- -
-- - --�
-- -
-
- --�
-
-
--
07:00
10
79,100
-
131
07:00
1
50,000
-- -
—
-- --
--
-
--
14
07:00
10
69,890
--
15
07:00
10
78,110
16
07:00 '
_ 10
79,210
-
--
u
-
-
17 07:00 10
78,190
--
18 07:00 -10
76,410 ---- _---
-_.-i------_
I_._...----
------
---�---
---
----
--- ----
-----
19 07:00 8
50,000
--�'
-- - -
1
-------
- —
20 07:00 5 _
----
50,000_--
-.
21 07:00 10
22 07:00 10
70'810
70,110_--
---
--
^ ^�
--
---- - -
23 0.:00 10
89,100
-- -
---
- -
--
--I
--- --�
l
-
-
--
- ---
24 07:00 10
25 0700 1C
26 07:00 8
78,920
80,11D { -- ---
50.000
`
1
i
-----
-
---
-
27 07.00 2
28 07:00 10
29 07:00 10
30 0700 10
31 0700 10
50.000
91,080 -----
79.120
78:900
77.840 1 1.5
<0.?_ �
1.92 �
i
0.36 �
230DD
3.5 i
i
-^-
- --
--- —
Average:
Daily Maximum:
Y Maxi_rnum:
-f --�
71,089 i 1.50 i ' 1.50
9 08C i
-
0.00
0.2�
1.92
--
192 I
0.36 !
;---C�.--
0.36
28,000.00
28, .,00.00
3 00 m��
-- F �.-.- --
3 f
--
j -
_
--
- --
- �------
t
�-------
Dail Minimum
YJ
�-
Sampling Type
500010, ,
1.5t !
Grab
_ _
' 1
a ,
Grab
Monthly �'
-
0.36
Grab I
}
riot `t y
_.:. _ :
28 000.000
--- Y
Mont hly '
___ __. I
3 ,. j
w�,
-
___
-- ---
--
- - - :......
--
-
- .. _____
-+ - ---
- _--- -L-:
---
_.
----
Monthly Avg. Limit:-
----_----
Daily Limit
sample Freuuency.
---- -

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Page q of 1—
Sampling Person(s) 11 Certified Laboratories
Name: GERALD LAMAR MATTHEWS 11 Name: Environmental: Chemists INC.
Name: II Name: Water Agricultural Laboratories
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? El 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: GERALD LAMAR MATTHEWS
Permittee: SAM VILLARI
Certification No.: 993131
Signing Official:
Grade: SI Phone Number: 910-289-7500
Signing Official's Title: OWNER
Has the ORC changed since the previous NDMR? ❑ Yes No
Phone Number: 910-293-2157 Permit Expiration: 11/30/2025
-a -a027
-zk-2
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 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
Raleigh, North Carolina 27699-1617

/ _—
Permit No.. 'A,'Q 0 0 16 3 7 6
Pacility Name: S&I Vil'arli Livestac� Proz;essing Fau�iiy-`Vvar.�aw
County- DL!j� I
Month: August
Year: 2023
Field Name-
Zone 1
Field Name:
Zone 2
Field Name:
Zo r, e 3
Field Name:
Zone 4
Field Name:!
Zone 5
Cover Crop:
Coastal Bermude
Cover Crop:
Coastal BermudE
Cover Crop:
Coastal Bermudz
Cover Crop:
Coastal Bermude
Cover Crop:
Coastal Bermude
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
[] YES 7 �IC)
Field Loaded?
D YES NO
Field Loaded?
D, YES 1-1 NO
Field Loaded?
L—j�jl YES NO
Field Loaded?
7 YES NO
42 3j
32 , 638
J1
12 Month Floating PAN Load
1688
168.!8
1689
Annual PAN Load Limit
350
)0j
35000

FOW,r, NU-14LR 10-- NON -DISCHARGE MASS L C;A0 ,NI!G REPORT (NILIMI.JR)
Permit No.:lNCJ00163i6
name: SJ ViIlari Livestock ProcessingFacilit i%era saw
y-
County: Duplin
�W~V� r August
month:
Year ?_023
Field Name:
Zone 6 Field Name: Zone 7 Field Name:
Zone 8 1 Field Name:
Zone 9 �t-�~ Field Name:
Zone 10
Area (acres):
1.17 Area (acres): 1.05 Area (acres):
1.25 Area (acres):
1 I Area (acres):
1.46
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
Cover Crop:
Coastal Bermuda
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
E'-]' YE` h NO
Field Loaded?
YES ❑ No
Field Loaded?
_ YES F NO
Field Loaded?
,r 'YES
- ❑ NO
Field Loaded?
L_ YES NO
QN c
a
a
a
aQ
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a
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n
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a
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a
aZ
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o
a
CL
m
n
ag
m
'C�
-
E Z
CD am_
C
j
_
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9
N
j
Z
N
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z
Q
a>N
C
L O
JM
z,o
E
Q
E
2
>
O
E
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o
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a
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E
JE<
'
>
Q U
U
Q U
2
Q U
0CC
U
2
v
0Q
U
O
U n
>
Month
gal
58,931
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibslac
Ibs/ac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibslac
gal
mg/L
Ibslac
Ibs/ac
September
55.8
23.4
23.4
52,888
55.8
23.4
23.4
62,962
55.8
23.4
23.4
50,370
55.8
23A
23.4
73.539
55.8
23.4
23.4
October
0
36.7
0.0
23.4
0
36.7
0.0
23.4
0
36.7
0.0
23.4
0
36.7
0.0
23.4
0
36.7
0.0
23.4
November
55,598
50.6
20.1
43.5
49,896
%6
20.1
43.5
59.399
50.6
20.1
43.5
47,519
50.6
20.1
43.5
69.380
50.6
20.1
43.5
December
28,438
25.6
5.2
48.7
25,522
25.6
5.2
48.7
30,384
25.6
5.2
48.7
24,306
25.6
5.2
48.7
35.488
25.6
5.2
48.7
January
59.691
36.2
15.4
641
53,571
36.2
1 15.4
64.1
63.773
36.2
15.4
64.1
51.019
36.2
15.4
64.1
74,489
36.2
15.4
64.1
February
0
31.8
0.0
64.1
0
31.8
0.0
64.1
0
31.8
0.0
64.1
0
31.8
0.0
64.1
0
31.8
0.0
64.1
March
108.717
41
31.8
95.9
97,567
41
31.8
95.9
116,151
41
318
95.9
92,920
41
31.8
95.9
135.664
41
31.8
95.9
April
66.364
28.6
13.5
109.4
59,556
28.6
13.5
109.4
70,901
28.6
13.5
109.4
56,722
28.6
13.5
109.4
82,813
28.6
13.5
109.4
May
135,047
24.4
23.5
132.9
121,196
24.4
23.5
132.9
144.281
24.4
_
23.5
132.9
115,424
24.4
23.5
132.9
168.518
24.4
23.5
132.9
June
35,685
37
9.4
1423
32,025
37
9.4
142.3
38,125
37
9.4
142.3
30,500
37
9A
142.3
44.531
37
9.4
142.3
_ July_ _
41.553
55.8
16.5_
158.8
37,291
55.8
16.5
158.8
44.395
55.8
16.5
158.8
35,516
55.8
16.5
158.8
51,853
55.8
16.5_
158.8
August
38.298
36.6
10.0
168.8
34,370
36.6
10.0
168.8
40,917
36.6
10.0
168.8
32,732
36.6
10.0
1 168.8
11 47,791
36.6
10.0
168.8
12 Month Floating PAN Load
1688
s,
,�
168.8
8.
168.8
168.8
1688
---- _ _---(Ibslac/yr):
j
Annual PAN Load Limit
(lbslac/yr):
350
350.00
ha:
(
350.G0
350.00

,y;)''4-D,SCHARGr� ;y5A_SS :_r?At ING REi U's T NOMLR) Wage _-f of _
Permit ^No.: t, 000163 6
Facility Name: S .; `irilan Lives,oCk Processing Fac !,h.-`ii/arSaW
Count.,: Gtrp it
Month: Auyust�
Year: 2023
Field Name:;
Zone 11 pryl� � Field Name: Zone 12 Field Name:
Z 0 r 1 Field Name:
Zone 14E Field Name:
Name:
Zone 14Vd
Zone
I Area (acres):
1.43 I Area (acres): 1.23 Area (acres):
2.16 Area (acres):
13.73 Area (acres):
7.7
Cover Crop_iCoastal
Bermuda Cover Crop: Coastal BermudaCover Crop:
Coastal Bermuda Cover Crop:
Coastal Bermuda Cover Crop:
Coastal Bermuda
Load Type:
PAN Load Type: PAN Load Type:
PAN Load Type:
PAN Load Type:
PAN
Field Loaded?
r1 YES _ ; NO
Field Loaded?
EYES j N0
Field Loaded?
�]- YES � too
Field Loaded?
� YES r�o
Field Loaded?
': YES - NO
m
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a
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a
r 0
a
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a I
0
ro�
Q,
a. m
a
,,
a
o- m
a
io
p
me
m a>
-' m
,�, �!
u
= Z
EQ
Q
m a�i
}.°
,f=,
mJ
3 Z
EQ
Q
m
m
m
a m
s
�
Z
Q
m
yy
m aQi
m�
�
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0
cam
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�,
0
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0
0a•
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0
u
>
0
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'
12 �
>
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0
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0
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0
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0
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a
iJa
Q 0
0
Up
Q 0
g
Ua
> 0
Q
Ua
>°
0
v
;
V
;
V
Month
gal
72,028
mg/L
Ibs/ac
Ibslac
gal
mg/L
Ibs/ac
Ibs/ac
gal
mglL
Ibs/ac
Ibs/ac
gal
m /L
g
Ibs/ac
Ibs/ac
gal
mg/L
Ibs/ac
Ibslac
September
55.8
23.4
234
61,953
55,8
23.4
23.4
_
108,797
55.8
23.4
23A
568,929
55.8
19.3
19.3
319,063
55.8
19.3
19.3
October
0
36.7
0.0
23.4
0
36.7
0.0
23A
0
1 36.7
0.0
23.4
0
36.7
0.0
19.3
0
36.7
0.0
19.3
November
67.953
50.6
20.1
43.5
58,449
50.6
20.1
43.5
102,643
50.6
20.1
43.5
898,247
50.6
27.6
46.9
503,749
50.6
27.6
46.9
December
34.759
25.6
5.2
48.7
29,697
25.6
5.2
48.6
52.502
25.6
5.2
48.7
191,560
25.6
3.0
49.9
107.430
25.6
3.0
49.9
January
72,957
36.2
15.4
64.1
62,753
36.2
15.4
64.1
1 110.202
36.2
15.4
64.1
546,990
36.2
12.0
61.9
306.760
36.2
12.0
61.9
February
0
31.8
0.0
64, i
0
31.8
0.0
64.1
0
31.8
0.0
64.1
246,807
31.8
4.8
66.7
138.414
31.8
4.8
66.7
March
132.877
41
31.8
95.9
114,293
41
31.8
95.8
200.711
41
31.8
95.9
689,966
41
17.2
83.8
386.943
41
17.2
83.8
April
81,111
28.6
13.5
109A
69,768
28.6
13.5
109.4
122.517
28.6
13.5
109.4
631,610
28.6
11.0
94.8
354.21E
28.6
11.0_
94.8
May
165.057
24.4
23.5
1329
141,972
24.4
23.5
132,8
249.316
24.4
23.5
132.9
558,451
24.4
8.3
103.1
313,186
24.4
8.3
103.1
June
43.617
37
9.4
142.3
37,515
37
9.4
142.3
65.881
37
94
142.3
286,429
37
6.4
109.5
160,633
37
64
109.5
July _
50,787
55.8
16.5
158.8
43,684
55.8
16.5
158.E
76.713
55.8
16.5
158.8
413,380
55.8
14.0
123.5
231.830
55.8
14.0
12.3.5
August
46,808
36.6
10.0
168.8
40,262
36:6
10.0
168.8
70.703
36.E
10.0
168.8
387,717
36.E
8.6
132.2
217.438
36.6
8.6
132.2
12 Month Floating PAN Load
(Ibslac+yr):
168.8
,;
I
168.8
168.8
I
�I
132.2
132 7.
Annual PAN Loari limit
_
Ibsracl r
t y)
350
350.00
350.00
-
350.00
350.00

V: NDMLR 10-13 N0N-Dl5C-IH,4RGE MASS LOADING REPORI (NDMI-R)
Permit No.:
A, Q001 6,-,"6
Facility
Namo:
S&J Viliar,
Livestock
P;messing
FacilityArVais
!J�Cou-
Ity:
Dupliti
Month:
AuJgLfSt
Year:
',023
,I
Field Name:,
Zone 15
Field Name:
Zone 16
Field Name:!
Zone 17
Field Name:
Field Name:
Area
(acres):
0.73
Area
(acres):
1.25
Area
(acres):
G.82
Area (acres):
Area (acres):
II
Cover Crop:
Norfolk
Cover Crop:
Coastal Bermudz
Cover Crop:
Coastal Barmude
Cover Crop:
Cover Crop:
Load Type:
PAN
Load
Type:
PAN
Load
Type:
PAN
Load Type:
PAN
Load Type:
PAN
Field Loaded?
21 YES
i ego
Field Loaded?
YES
7- N 0
Field Loaded?
-
'L YES
L- NO
Field Loaded?
El YES
.7 NO
Field Loaded?
`"ES
'j NO
T) zr-
z
'T
za
.2
z
4
a)
'a
W
zC
0
z
<
Q)
ZC
z
zC:
T
<
z
0.
'D
>
M o
CL
a
m
(D
CL V
>
M
o
a
0.
';�
a) In
a)
(L
'a
>
0
.2
M
IL
> M
a
CL
(L �0
> M
-t� 0
:E 0
- -J
:3
z
E
<
IM a
ID
2 0
E z
<
U) C:
CD
>1 M
0
-j
E z
< 0 -
>' M
B 0
j
z
<
M 0)
M
0
_j
z
E r
0
<
n-
E
2
C
_j
0
G.
E
Q) r
_j
0
<
E (D
0
E <
E U
0
E
, <
> 0
o <
0
0
U
0
> o
<
L)
>
0 0
a.
> o
0
IL
>
>
U
>
> U
>
Month
gal
36,770
mg/L
lbs/ac
lbs/ac
gal
mg/L
I lbsIac
lbs/ac
gal
ingil-
lbs/ac
lbs/ac
gal
mg/L
lbs/ac
lbs/ac
gal
mg/L
lbstac
lbs/ac
September
55.8
23.4
23-4
22,826
55.8
8.5
8.5
14,974
55.8
8.5
8.5
October
0
36.7
0.0
23.4
0
36.7
0.0
8.5
0
36.7
0.0
8.5
November
34,689
50.6
20.1
43.5
24,072
50.6
8.1
16.6
15,791
50.6
8.1
16.6
December
17,744
1 25.6
5.2
48.7
24,662
25,6
4.2
20.8
16,178
25.6
4.2
20.8
January
37,243
1 36.2
15.4
64.1
11,612
36.2
2.8
23.6
7,618
36.2
2.8
23.6
February
0-
31.8
0.0
64.1
11,783
31.8
2.5
26.1
7,730
31.8
2.5
26.1
March
67,833
41
31.8
95.9
24,159
41
6.6
32.8
15.849
41
6.6
32.8
April
41.407
28.6
13.5
109.4
23,725
28.6
4.5
37.3
15,563
28.6
4.5
37.3
May
84,259
24.4
23.5
132.9
24,162
24.4
3.9
41.2
15,851
24.4
3.9
41.2
June
22.264
37
9.4
1423
24,801
37
6.1
47.3
16,269
37
61
47.3
July
25.927
55.8
16.5
158.8
26,666
558
9.9
57.3
17,494
1 55.8
r 9.9
57.3
23,895
36.6
10.0
168.8
20,489
36.6
5.0
62.3
13,440
36.6_
5.0
62.3
-August-I
12 Month
Floating PAN Load
(lbstac/yr):
168-8
62.3
62.3
00
0.0
Annual
PAN Load Limit
350
350.00
0
350.00
- z
am
0.00
(lbs/ac/yr):

FORM. NDMLR 10-13 NON -DISCHARGE MASS LOADING REPORT (NDMLR) Page of �_
Did the mass loading rates exceed the limits in Attachment B 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.
IOperator in Responsible Charge (ORC) Certification II Permittee Certification I
ORC: Gerald Lamar Matthews Permittee:
SAM VILLARI
Certification Number: 993131 Signing Official:
Grade: SI Phone Number: 910-289-7500 Signing Official's Title: OWNER
Has the ORC changed since the previous NDMLR? ❑ yes 2) No Phone No.: 910-293-2157 Permit Exp.: 11 /30/25
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 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 1 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

Environmental Chemists, Inc.
envirochem6602 Windmill Way, Wilmington, NC 28405 0 910.392.0223 Lab * 910.392.4424 Fax
® 710 Bowsertown.. Road, Manteo, NC 27954 * 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 * 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
The Pork Company
892 Penny Branch Road
Warsaw NC 28398
Attention:
Date of Report: Sep 20, 2023
Customer PO #:
Customer ID: 08100099
Report #: 2023-19915
Project ID: WWTF Eff - Mthly
Lab ID Sample ID:
Collect Date/Time Matrix Sampled by
23-48724 Site: PPI-001 Effluent
8/31/2023
11:02 AM Water Gerald Matthews
Test
Method
Results Date Analyzed
PAN
calculation
36.6 mg/L
09/19/2023
Used 30% Mineralization Rate.
Fecal Coliform
IdexxCoi+tert-18
10800 MPN/100ml
08/31/2023
Residue Suspended (TSS)
SM 2540 0-2015
74.0 mg1L
09101/2023
Ammonia Nitrogen
SM 4500 NH3 C-2011
70.4 mg/L
09/01/2023
Total Kjeldahl Nitrogen (TKN)
SM 4500 Norg B-2011
74.9 mg/L
09/05/2023
Total Phosphorus
SM 4500 P (F-H)-2011
7.37 mg/L
09/14f2023
BOD
Sample estimated. Did not meet quality
SM 5210 B-2016
control requirments blank= 0.26
21 mq/L
mgfL, above acceptable limit of 0,20
08131 /2023
mg;L
Nitrate Nitrogen (Cale)
Nitrite Nitrogen EPA 353 2, Rev 2 0.1993
0.08 mg/L
08/31/2023
Nitrate Nitrogen Subtraction Method
<0.02 mg/L
09/19/2023
Total Nitrogen (Cale)
iVitrate+Nitrite-Nitrogen EPA 3532, Rev 20, 1993
< 0.02 mg/L
09/06/2023
Total Nitrogen Total Nitrogen
74.9 mg/L
09/19/2023
2023-19915 �s pvry� Page t of 2 ��

F"107— 7 Environmental Chemists, Inc®
ii envirochem6602 Windmill Way, Wilmington, NC 29405 . 910.392.0223 Lab . 910.392.4424 Fax
® 710 Bowsertown Road, Manteo, NC 27954 . 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 . 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS infoli�environmentatchemists.com
The Pork Company Date of Report: Sep 20, 2023
892 Penny Branch Road Customer Pi} #:
Warsaw NC 28398 Customer ID: 08100099
Attention: Report #: 2023-19915
Project ID: WVVTF Eff - Mthly
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
23-48725 Site: PPI-002 upstream 8/31/2023 11:15 AM Water Gerald Matthews
Test Method Results Date Analyzed
Ammonia Nitrogen EPA 350.1, Rev. 20, 1993 < 0.2 mg/L 09/08/2023
Total Phosphorus SM 4500 P (F-H)-2011 0.17 mg/L 09/14/2023
Fecal Coliform SM 9222 D-2015 MF 24500 Colonies/100mL 08/31/2023
Nitrate Nitrogen (Cale)
Nitrite Nitrogen EPA 353 2, Rev 2 0, 1993 0.02 mg/L 08/31 /2023
Nitrate+Nitrite-Nitrogen EPA 3532,Rev 20,1993 0.18mg/L 09/06/2023
Nitrate Nitrogen Subtraction Method 0.16 mg/L 09/19/2023
Total Nitrogen (Cale)
Total Kjeldahl Nitrogen (TKN) EPA 351.2 Rev 2 0. 1993 0.8 mg/L 09/14/2023
Total Nitrogen Total Nitrogen 1.0 mg/L 09/19/2023
Lab ID Sample ID: Collect DatelTime Matrix Sampled by
23-48726 Site: PPI-003 Downstream 8/31/2023 11:30 AM Water Gerald Matthews
Test Method
Ammonia Nitrogen EPA 350.1, Rev 2 0.1993
Total Phosphorus SM 4500 P (F H)-2011
Fecal Coliform SM 9222 D-2015 MF
Nitrate Nitrogen (Cale)
Nitrite Nitrogen
Nitrate+Nitrite-Nitrogen
Nitrate Nitrogen
Total Nitrogen (Cale)
Total Kjeldahl Nitrogen (TKN)
Total Nitrogen
EPA 353.2, Rev 2 0 1993
EPA 353.2, Rev 2 0 1993
Subtraction Method
EPA 351 2 Rev 2 0, 1993
Total Nitrogen
,,omment: ;
Reviewed by: Q n
Results Date Analyzed
< 0.2 mg/L 09/08/2023
0.36 mg/L 09/14/2023
28000Colon ies/100mL 08/31/2023
0.03 mg/L 08/31 /2023
1.95 mg/L 09/06/2023
1.92 mg/L 09/19/2023
1.5 mg/L 09/14/2023
3.5 mg/L 09/19/2023
Report #:: 2023-19915 Page 2 of 2

Environmental Chemist, Inc., Wilmington, NC Lab #94
Sample Receipt Checklist
6602 Windmill Way
Wilmington, NC 28405
910.392.0223
ClientAIV64 COMMIN Date: J�) _ Report Number: _ 2023- JggJ5
Receipt of sample: ECHEM Pickup k Client Delivery ❑
JUPS ❑ FedEx ❑ Other ❑
❑ YE
I0 NO 0 N/A 1. Were custody seals present on the cooler?
❑ YES I ❑ NO 0 N/A 12. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt u• °C Corrected temperature upon receipt °C
How temperature taken: ❑ Temperature Blank O Against Bottles
IR Gun ID: Thomas Traceable S/N 210886869 IR Gun Correction Factor °C: 0.0
0 YES
❑ NO
3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
0 YES
❑ NO
4. Were proper custody procedures (relinquished/received) followed?
0 YES
13 NO
5. Were sample ID's listed on the COC?
0 YES
❑ NO
6. Were samples ID's listed on sample containers?
0 YES
❑ NO
7. Were collection date and time listed on the COC?
0 YES
❑ NO
8. Were tests to be performed listed on the COC?
0 YES
❑ NO
9. Did samples arrive in proper containers for each test?
0 YES
❑ NO
10. Did samples arrive in good condition for each test?
D YES
❑ NO
11. Was adequate sample volume availableT
0 YES
❑ NO
12. Were samples received within proper holding time for requested tests?
�I YES 10
NO
13. Were acid preserved samples received at a pH of <2?
❑ YES 10
NO
14. Were cyanide samples received at a pH >12?
❑ YES 10
NO
15. Were sulfide samples received at a pH >9?
YES
❑ NO
16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? **
❑ YES
❑ NO
17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑ YES
❑ NO
18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): HZSOQ HNO3 HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples. Obtain a new sample or
notify the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Sampie(s) were received with headspace
COMMENTS:
DOC. QA.002 Rev I

Way
ENVIRONMENTAL CHEMISTS, S' hNIC OF ICFin910i1392-02Wi{FAX[phone]
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
Analytical & Consulting Chemists
COLLECTION AND CHAIN OF CUSTODY
Client: The Pork Company -Warsaw
PROJECT NAME: WWTF Effluent
REPORT NO: 3 - 9/'
ADDRESS:
CONTACT NAME:
PO NO:
REPORT TO: Gerald Matthews, ORC
PHONE/FAX:
Permit Number: WQ0016376
email:
Sampled By:_ G14 I U Llli-7G SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
°i m
wCL
to
a �
E o
o
v
m _
c (9
c `o
V a
e
c
t F
v
® W
g z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Lem
z
i
=
y
i
o
=
o
a
'�
=
p
PPI-001 (Effluent-1/month)
f a
Li`I�L�
X
BOD, TSS, NO2
G
G
t�
H field): T �f 5 J
C
P
(,�'�
X
NO3, NH3, TKN, Total P, PAN, Total N
G
G
C
P
X
Fecal Coliform
G
G
PPI-001 Effluent
March, July, November
C
P
X
TDS, Chloride triannuals)
G
G
C
P
G
G
PPI-002 (Upstream)
S -
S
C
P
Ito
X
NO2
G
G
C
P01
40
X
TKN, NH3, NO3, TP, TN
G
G
C
P
X
Fecal
G
G
PPI-003 (Downstream)
C
P
X
NO2
G
G
C
P
10
v
X
TKN, NH3, NO3, TP, TN
G
G
C
P
X
lFecal
G
G
Samples due 1/month
Transfer
Relinqyid By:
Date/Time
Received By:
Date/Time
2.
Temperature when Received °C: 5C C-- Accepted: Rejected: Resample Ra ested:
Delivered By: Received By: Date: � ;� t� Time: ��,
Comments: T NAROUND: