Loading...
HomeMy WebLinkAboutWQ0020793_Monitoring - 12-2016_20170117FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page i of�_ Sampling Person(s) Certified Laboratories Name: James Brown Name: Statesville Analytical 122 court Street Statesville, NC 28687 Name: Max Byers Name: Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑Compliant ONon-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. �r%\ASID JAN 1 � 2011 Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: James Brown Permittee: Tyson Farmsjnc. Hays Hatchery Certification No.: 1001810 Signing Official: Kirk Church Grade: 2 Phone Number: 336-838-2171 Signing Officials Title: Complex Manager Has the ORC changed since the previous NDMR? ❑Yes ENo Phone Number: 336-838-2171 Permit Expiration: 11/30/2020 -9-j7 XA�t 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 Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699-1617 FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page '�. of �z Permit No.: w11 1 •3 Facility Name: Tyson Farms, Inc. Hays Hatchery- December1 Flow Measuring Point: ElInfluent F -]Effluent EjNo flow generated Parameter Monitoring Point: DInfluent E]Effluent [:]Groundwater Lowering Elsurface water ,Parameter Code —po • • m 1 : 1 ®®-----------®--- M MIN 1 ® ®-----------®---