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Home My WebLink Aboutwq0005681_Monitoring - 09-2021_20211018Monitoring Report Submittal Permit Number #* wg0005681 Name of Facility:* Pilgrims Month: * September Year: * 2021 Report Information Type* Upload Document* NDMR, NDAR-1, NDAR-2, NDMLR septsigned.pdf 327.85KB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). Confirmation Email Address:* tina.pedley@pilgrims.com Name of Submitter: * Tina Pedley Signature: 9 "i Date of submittal: 10/18/2021 This will be filled in automatically Initial Review Reviewer: Saunders, Erickson G Is the project number correct?* wg0005681 Is the monitoring report accepted?* Yes No Regional Office* Winston-Salem Accepted Date: 10/27/2021 FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page ( of 5 •��i f f 0 FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 3 f 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 vour hermit? ❑ I:ompke.a ❑ I. -Compliant me reasuntsf me lacnhy was not in compuance- wrovlae in your explanation the date(s) of the non-compliance and describe the corrective actions) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Tina Pedley Permittee Pilgrim s Corporation Certification No.: 9976171994534 Signing Official: Dan Shaw Grade: SI/WW4 Phone Number: 919-895-3457 Signing 0l1Hicial'sTitle: Complex Manager Has the ORC changed since the previous NDMR? 71ye� D No Phone Number: 9198953455 Permit Expiration: 11 /30/2026 11,11 ^ I D 1� �CAt A__ Vr",174 Signature Date Signature Date By thus sgnah me.I certify that this reports accurrate and complete to the heal of my k—ledge. I ceniny, under penaay of law, that this document and all attachments were prepared under my director, or sus efon in ccordame with a system designed to assure Ihet all qualified personnel properly gathered am evaluated the iMortnalion _had. eased on my inquiry of line person or persons wto manage are system, or those persons orectly responswe for galhedrg the. informalim, the information submitted is, to the best of my knowledge and belief, thus, accurate, and compete. I am aware that there are sigrvfcam penalties for submitting false information including the possibility of fines and impnsonment for know,ng v,018110M1s, Mail Original and Two Copies to: Division of Water Resources Information Processing Unit 1617 Mail Service Center Raleigh, North Carolina 27699.1617 FORM: NOAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page ' �111 . • - r r• M..th: September Did irrigation occur at this facility? 0YES 0 NO 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 - of - pConplant ❑ton -Compliant ❑✓ Compliant ❑ Non -Compliant p Compliant ❑ Non -Compliant Q Compliant ❑ Non{anplant ❑� Compliant ❑ Non -Compliant If the facilityis non -compliant, please explain In the space below the reason(s) the facility was not to compliance. Prcmde I, yt:.ur explanation the date(s) of the non-compliance and describe the corrective taken. Aaacn aaamonal sheets It Operator in Responsible Charge (ORC) Certification I Permittee Certification ORC: Tina Pediey Permittee: I Pilgrim's Corporation Certification No.: 9976171994534 Signing Official: Daniel Shaw Grade: SI/W W4 Phone Number: 919-895-3457 Signing Offi I ial's Title: Complex Manager Has the ORC changed since the previous NDAR-1? ti yes �i No Phone Number: 9198953455 Permit Exp.: 11 /30/26 16 ,lt-21 to-18-z1 Sig azure Date Signature Date y nus sgnatum I Ady that this report is accurate and ra oplee to the best of my kmwtedge I cenity, under penalty of law, that this document and an attachments were prepared under my direction or supervision in accordance win a system designed to assure that all quaffed personnel property gathered am evaluated the Information submitted. Based w 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 test of my knavAedge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and impnsonmem for knovnrg violations Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 Mail Service Center