WQ0002857_Monitoring - 11-2021_20211229

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0002857
Piedmont Custom Meats
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
Piedmont Custom_Nov.pdf 1.32MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Jessica Mize
jwd rA lip
Reviewer: Zhong, Vivien
12/29/2021
This will be filled in automatically

Is the project number correct?* WQ0002857
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date:
1 /31 /2022

Page t of 3
NON -DISCHARGE WASTE WATER MONITORING REPORT
PERMIT NUNIBER: W00002857 MONTH: November YEAR: 202I
FACILITY NAME: Piedmont Custom bleats NNAN'TF COUNTY: Caswell
Point:i Monitoring ■ !�
Parameter Monitoring -. ■ .,
Ill 1 MUM ■ ■
t
operator.
rime on
Site
Daily
Treatment_
S'vern
.
:..
worn
Operator in Responsible Charge (ORQ: Glenn Price Grade: SI Phone: [phone]
Check Box if ORC Has Changed: = ORC Certification Number: 987931120771
Certified Laboratories (1): Pace Analytical Services ii
Persons) Collecting Samples: Glenn Price
Mail ORIGINAL and Two COPIES to: j
ATTN: Nan -Discharge Compliance Unit X/�
4
DENR (SIGNATURE OF OPERATOR IN RESPONSIBLE CHA
Division of Water Quality By this signature, 1 certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Farm NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
FACILITY STATUS:
Please answer the following question: Compliant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"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 a qualified personnel properly gather and evaluate 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."
/" Z 10 5 - a , Baron Neal McDuffie
(Signs re of Permitee)* Date (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorized Agent) Field Services Director (Pace Analytical Services
(Pertnittee-Please print or type)
9683 Kerr's Chanel Road
Gibsonville NC
(Permittee Address)
01002 Arsenic
01022 Boron
00310 BODS
01027 Cadmium
00916 Calcium
00940 Chloride
50060 Chlorine, Total
Residual
01034 Chromium
00340 COD
PARAMETER CODES
31504
Coliform, Total
00094
Conductivity
01042
Copper
00300
Dissolved Oxygen
31616
Fecal Coliform
01051
Lead
00927
Magnesium
71900
Mercury
00610
NH3 as N
01067
Nickel
(Position or Title)
336-582-8247
(Phone Number)
00600 Nitrogen, Total
00630-NO2 & NO3
00620 NO3
00556 Oil & Grease
W 09 PAN Plant Available)
00400 pH
32730 Phenols
00665 Phosphorus, Total
00937 Potassium
00545 Settleable Matter
03/31/21
(Permit Exp. Date)
00929
Sodium
00931
SAR
00745
Sulfide
00515
TDS
00010
Temperature
00625
TKN
00680
TOC
00530
TSS/TSR
00076
Turbidity
01092
Zinc
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone], extension 529.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only units designated in the reporting -
facility's permit for reporting data.
* If signed by other than the Permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b) (2) (D).

Page 2 of 3
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITES)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADD)DTiONAL PAGES AS NEEDED
PERMIT NUMBER: W 0002857 MONTH: November YEAR: 2021
FACILITY NAME: Piedmont Custom Meats WWTF COUNTY: Caswell
Formulas:
Daily Loading {inches) = (Volume Applied (gallons) x 0.1336 (cubic fee0gailon) x 12 (inchesffol ! [Area Sprayed (acres) x 43,560 (square feetlacre) or
_ [Volume Applied (gallons( / IArea Sprayed (acres) x 27.152 (gallonslacre-inch).
Maximum Hourly Loading (inches) = Daily Loading (inches) ! [rime irrigated (minutes)160 (minutes/hour)) Monthly Loading (inches) =Sum of Daily Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly Loading (inches/month) / Number of days in the month (dayslmonth )] x 7 (daysAveek)
Did •n Occur At This lil
Did Irrigation Occur On This Field:
Did Irrigabon !7r On This Field: No: il
i
•weather Codes: C-clear, PC-panly cloudy, Cl-cloudy. R-rain. Sn-,a(­, SI d�(
Spray Irrigation Operator in Responsible Charge (ORC): Glenn Price Phone: [phone]
ORC Certification Number: 987931120771 Check Sox if ORC Pas Changed❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X �� M
DENR (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By this signature, I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

FACILITY STATUS:
Please indicate( by inserting Y(es) or N (o) in the appropriate box) whether the facility has been compliant
with the following permit requirements: (Note: If a requirement does not apply to your facility put (NA) in the
compliant box.)
Compliant (Y,N)
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application. Ct�
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the
limit(s) specified in the permit.
If the facility is non -compliant , please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"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 a qualified personnel properly gather and evaluate 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."
- Baron Neal McDuffie
(Signature of Permitee)* Date (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorized Aeent
(Permittee-Please print or type)
9683 Keres Chapel Road
Gibsonville. NC
(Permittee Address)
Field Services Director (Pace Analytical Services)
(Position or Title)
336-582-8247
(Phone Number)
03/31/21
(Permit Exp. Date)
* If signed by other than the Permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b) (2) (D).
DENR Form NDAR-1 (5/2003)

Page 3 of 3
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDIDTIONAL PAGES AS NEEDED
PERMIT NUMBER: W00002857 MONTH: November YEAR: 2021
FACILITY NAME: Piedmont Custom Meats WWTF COUNTY: Caswell
Formulas:
Daily Leading (inches) = [Volume Applied (gallons) x 0.1336 {cubic feet/gallon) x 12 (inchesdoot)] 1 [Area Sprayed (acres) x 43,560 (square feel/acre) or
= [Volume Applied (gallons) I [Area Sprayed (acres) x 27.152 (gallonslacre-inch).
Maximum Hourly Loading (inches) = Daily Loading (inches) I [Time irrigated (minutes) / 60 (mmutesmour)i Monthly Loading (inches) =Sum of Daily Loading (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly Loading (inches/month) I Number of days in the month (days/month )l x 7 (days/week)
•ri Occur At This Facility:
Yes ,
Did Irrigabon Occur On This Field:
■ w
oT
Did Irrigation Occur On This Field:
■
MEN
MENEM.
•1N ealher Codes: C-clear. PC -partly cloudy, Cbcloudy, R-ni■. 50-snow. 5"itel
Spray Irrigation Operator in Responsible Charge (ORC): Glenn Price Phone: [phone]
ORC Certification Number: 987931/20771 Check Box if ORC Has Changed.❑
Mail ORIGINAL and Two COPIES to:
ATTN: Non -Discharge Compliance Unit X
DENR (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
Division of Water Quality By (his signature, I certify that this report is accurate and
1617 Mail Service Center complete to the best of my knowledge.
RALEIGH, NC 27699-1617
DENR Form NDAR-1 (5/2003)

FACILITY STATUS:
Please indicate( by inserting Y(es) or N (o) in the appropriate box) whether the facility has been compliant
with the following permit requirements: (Note: If a requirement does not apply to your facility put (NA) in the
compliant box.)
Compliant (Y,N)
I. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
S. The freeboard in the treatment and/or storage lagoon(s) was not less than the
limit(s) specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"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 a qualified personnel properly gather and evaluate 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."
/,,,I, Baron Neal McDuffie
(Signature of Pennitee * ate (Name of Signing Official -Please print or type)
Baron Neal McDuffie (Authorized Aeent
(Permittee-Please print or type)
9683 Keres Chapel Road
Gibsonville. NC
(Permittee Address)
Field Services Director ( Pace Analytical Services)
(Position or Title)
336-582-8247
(Phone Number)
03/31/21
(Permit Exp. Date)
* If signed by other than the Permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b) (2) (D).
DENR Form NDAR-1 (5/2003)