WQ0014565_Monitoring - 09-2021_20220221

Monitoring Report Submittal
Permit Number #* wg0014565
Name of Facility:* Pilgrims
Month: * September
Report Information
Type *
Revised - NDMR, NDAR-1, NDAR-2,
NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
revised sept.pdf 196.95KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Tina Pedley
Reviewer: Gerald, Wanda
2/21 /2022
This will be filled in automatically

Is the project number correct?* wQ0014565
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Accepted Date:
4/5/2022

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page __�_ of �
Permit No.: W00014565 F iti Name; Pilgrim's Prid j'i F i i County: Lee Month: September Year: 2021
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FORM. NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page , 4;:3i?.... of
Permit No.: W00014565
Facility Name:
Pilgrim's Pride Sanford Facility
County:
Lee
Month:
September
Year:
2021
PPI: 001
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❑ Influent
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❑ Surface Water
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page -� of- ­3
Sampling Person(s) Certified Laboratories
Name: ,fared Guerrero Name: Cameron Testing Services
Name: Don Kidney Name: Pilgrims Field Lt�
Compliant ❑ Non•fomptlant
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit?
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
taKen. Auacn aaaiuonai sneeis It
0 to the flow on sheet 1.
Operator in Responsible Charge (ORC) Certification
Perm ittee Certification
ORC: Tina Pedley yes 01 NaPermittee:
Pilgrims
Certification No.: 997617
Signing Official: Daniel Shaw
Grade: SI Phone Number: 919-895-3457
Signing Official's Title: Complex Manager
Has the ORC changed since the previous NDMR?
Phone Number: 919-774-7333 Permit Expiration: 10/31/2025
Signature Date
Signature Date
By this signature. I certify that this report is aacurraile and mmplete 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 property 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 € am
aware that there are sigrdficam 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