WQ0005681_Monitoring - 02-2022_20220303

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DWR - NonDischarge Monitoring Report Submittal
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NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* wq0005681
Name of Facility:* Pilgrims
Month:* February Year:* 2022
Report Information
Type* Upload Document*
NDMR, NDAR-1, NDAR-2, NDMLR Feb signed.pdf 263.73KB
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:* Tina Pedley
Signature:
Date of submittal: 3/3/2022
This will be filled in automatically
Initial Review
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* wg0005681
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Accepted Date: 4/5/2022

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FORM:NDAR-1 08-11 NON-DISCHARGE APPLICATION REPORT(NDAR-1) Page of
Did the application rates exceed the limits in Attachment B of your permit? p compliant ❑Non-Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? E Compliant ❑Non-Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? p Compliant ❑Non-Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? p compliant ❑Non-Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? pcomptiant ❑Non-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.
Operator in Responsible Charge(ORC)Certification Permittee Certification
ORC: Tina Pedley Permittee: pilgrim's Corporation
Certification No.: 997617/994534 Signing Official: Daniel Shaw
Grade: Si/WW4 Phone Number: 919-895-3457 ` Signing Official's Title: Complex Manager
Has the ORC changed since the previous NDAR-1? Yes No Phone Number: 9198953455 Permit Exp.: 11/30/26
e 2-
Signature Dale Signature Date
By this signature,I certify that this report is accurrate and complete to the best of my knowledge. ` I certify.under penally 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.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 Quality
Information Processing Unit
1617 Mail Service Center

FORM:NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page of S -
Permit No.:W00005681 I Facility Name: Pilgrim's Pride-Staley WWTP I County: Randolph I Month: February I Year: 2022
PPI: 001 Flow Measuring Point: l]Influent ❑Effluent ❑No flow generated Parameter Monitoring Point: ❑Influent ❑r Effluent 0 Groundwater lowering ❑Surface Water
Parameter Code —11.. 5 p\-''''' 00310 '00916 00940 \50060\ 31616 00927\\\\\° 00610 \\\\`00625 00620 \ 00400 'i00665n 00931 00929k 70300
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Average: \\ 5,16400 1A41t411 1 Al0.16 ,\\\\.> \:,\...... \. a\\\ \\
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Daily Maximum: j\9,73k3". \\�\*1 s 0.28\1 N4 N\\ \...\\.\ \\\:ea., \\O\�\ \\\\\��.*
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Daily Minimum: \\\475\ \\\\ 0.09\ \\\\.; \\\\\\\\ \\\\ 7.22 \\\\\\\ \\A
Sampling Type \\\Recorsfer,:, Grab ,,,Grab` Grab \Grab,,, Grab C\Cztab&11 Grab ,;:Grab,,,;; Grab Calculated Grab E,1Grab�� Calculated \`GrabC: Grab
Monthly Avg.Limit: \13,1DQo ke itVluit. a\\\\\\ \ \\' \\\ \\\\\, k\\i t,\ \\
Daily Limit: �\\\\\\\\ \\\it\a .\\\\\1 \\\>\W �\��\\\�NO \.\\\\\\\� ;�\O��O\ \�. 14 a
Sample Frequency: Continuous 3 X Year 3,X Year Annually 1 WeieklY4 3 X Year 3 X Year` 3 X Year o3X.Yearr 3 X Year ,,3 XYear Weekly 113 X=Year1 3 X Year 3 X Year;: Annually

FORM:NDMR 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page q of S.
Permit No.: WQ0005681 I Facility Name: Pilgrim's Pride-Staley WWTP I County: Randolph L Month: February I Year: 2022
PPI: 001 I Flow Measuring Point: El Influent 0 Effluent ❑No now generated Parameter Monitoring Point: ❑Influent El Effluent Groundwater Lowering 0 Surface Water
Parameter Code — 00530 ' \`\'\\ \\�\\ \\\ ` o\\\o\ \\\ \\\\\\\' \
yro A \ ` `A` A \ vy.
13 \ , \ \ W\\\V H \}"" \ g. \� \ . \° \\\\ , \\ , ,N \,r- er
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Average: _ ,: _y ii ._ _ . .._
Daily Maximum: .;.,.. ... '_,', *. >._ >, at y`
Daily Minimum: ti\ '\`_ \�. oil\ ;` :.\` \
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Sample Frequency: i3 X Year, \ \. \\.`.... .\. 44 ,.\. \\` oil,.,,..\_

FORM:NOMA 03-12 NON-DISCHARGE MONITORING REPORT(NDMR) Page i of
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 your permit? ` Compliant ❑Non-Compliant
It 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 i Permittee Certification
ORC: Tina Pedley Permittee: Pilgrim's Corporation
Certification No.: 997617/994534 Signing Official: Dan Shaw
Grade: SUW W4 Phone Number: 919-895-3457 Signing Official's Title: Complex Manager
Has the ORC changed since the previous NDMR? pYes N0 Phone Number: 9198953455 Permit Expiration: 11/30/2026
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 signilicant penalties for submitting false rnformalion,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