WQ0020793_Monitoring - 11-2021_20211209 (2)

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0020793
Tyson Farms, Inc. Hays Hatchery
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Year:* 2021
Upload Document*
NDMR November 2021.pdf 1.52MB
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: * James Brown
Signature:
Date of submittal: 12/9/2021
This will be filled in automatically
Initial Review
Reviewer: Saunders, Erickson G

Is the project number correct?* WQ0020793
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date:
1 /19/2022

December 2, 2021
North Carolina Department of Environment, Health and Natural Resources
Division of Water resources
Information Processing Unit
161.7 Mail Service Center
Raleigh, N.C. 27699-1617
Subject: Permit No. WQ0020793
Tyson Farms, Inc.
Hays Hatchery
Evaporation/Infiltration Pond
Non- Discharge Monitoring Report
NDMR Report —November 2021
To whom it may concern:
Enclosed is the Monthly Non- Discharge Monitoring report for Hays Hatchery.
Please contact me at 336- 651-3836, should you have any questions.
Sincerely,
James Brown
Complex Environmental Manager
Tyson Farms Inc. Fresh Retail Division 704 Factory Wilkesboro, N.C. 28697
336-65i-2871 336-651-38,36 Fax:33.651._9867 wwwAysonfoods.com

FORM: 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? E-1 compliant El Non-Comptant
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: James Brown Permittee: Tyson Farms, Inc. Hays Hatchery
Certification No.: 1001810 Signing Official: James Brown
Grade: 2 Phone Number- 336-651-3836 Signing Official's Title: Complex Environmental Manager
Has the ORC changed since the previous NDMR? D Yes No Phone Number, 336-651-3836 Permit Expiration: 7131/2026
'R
L92220
Signature Date Signature Date
By this signature, 1 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 Linder 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
'aleiah. North Carolina 27699-1617

Permit No.. WQ00207 3
Facility Name:
Tyson Farms, Inc. Hays Hatchery
1:
WilkesMonth:
November
2021
PPI:
Flow Measuring Point: Influent - Effluent _j No flaw generated
Parameter Monitoring Point:
Influent
_ Effluent
Groundwater Lowering
El Surface water
Parameter Code
04310
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Analytical Results A'71i� 8 V I L, F
Tyson Foods -Wilkesboro
704 Factory Street
Wilkesboro, NC 28697
Receive Date: 11/11/2021
Reported: 1111512021
For:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
211111-26-01 Chloride Hays Eff 32.0 rngI SM4,90MG-2011 1111V2021 MD
211111-26-01 Total Dissolved Hays Eff 347 mgIL SM 2540 C I Sth Ediflon 11/12/2021 MD
Solids
Respectfully submitted,
Melissa Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
PO Box 228 * Statesville, NC 28687 e 704/872/4697
Page 1 of 3

Condon of Receipt
Sample Number 211111-26-01 Temp on Arrival: 2.3
Parameter Schedule: Total Dissolved Solids
Received on ice
Parameter Schedule: Chloride
Received on Ice
PO Box 228 * Statesville, NC 28687 e 704/872/4697
Page 2 of 3

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