WQ0020793_Monitoring - 07-2022_20220722

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DWR - NonDischarge Monitoring Report Submittal
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NORTH CAROLINA
Enrlranmenlel QHaflly
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0020793
Name of Facility:* Tyson Farms, Inc. Hays Hatchery
Month:* July Year:* 2022
Report Information
Type* Upload Document*
GW-59 G59 DMR July 2022.pdf 2.33MB
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:
[ ,111 O#w
Date of submittal: 7/22/2022
This will be filled in automatically
Initial Review
.............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Reviewer: Gerald,Wanda

Is the project number correct?* WQ0020793
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 8/5/2022

TM
Tyson
July 22, 2022
DEPARTMENT OF ENVIRONMENT &NATURAL RESOURCES
DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER,
RALEIGH,NC 27699-1617 Phone: [phone]
Subject: Ground Water Quality Monitoring
Tyson Farms, Inc. Hays Hatchery
Compliance Report—July, 2022
To whom it may concern:
Enclosed is the quarterly Groundwater Compliance report for Hays Hatchery.
Please contact me at 336- 651-3836, should you have any questions.
Sincerely,
9/T7-1, S477&#---
James Brown
Complex Environmental Manager
Tyson Farms Inc.Fresh Retail Division 704 Factory Wilkesboro,N.C.28697
336-651-3836 336.838.2171 Fax:[phone] www.tysonfoods.com

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to:i DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0020793 Expiration Date: 07/31/2026
Facility Name: Tyson Farms,Inc. I Non-Discharge WQ0020793 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Box 936/3649 Airport Road TYPE OF PERMITTED OPERATION BEING MONITORED
NORTH WILKESBORO (Street) NC 28659 County
Wilkes ❑ Lagoon ❑Remediation: Infiltration Gallery
(cry) (State) (Zip)• El Spray Field ❑Remediation:
Co' ntact Person: James Brown Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
• 'Well Location/Site Name:Hays Hatchery No.of wells to be sampled:4 ❑ Water Source Heat Pump ❑� Other: Evaporation/Infiltration Pond
(from Permit)
SAMPLING INFORMATION If WELL
' WELL ID NUMBER(from Permit): MW-4 Date sample collected:7/7/22 FIELD ANALYSES: WAS
Well Depth: 27 ft. Well Diameter: 2 in. pH 00400:5.6 units Temp.00010: 14.7 °C DRY at
I
Depth to Water Level 82546: 13 ft. below measuringSpec.Cond.00094: Mhos time of
point Screened Interval: 12 ft. to 27 ft.
sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation: 1324.13 ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 6.84 gallons Appearance clear here:❑
Samples for metals were collected unfiltered: ❑YES ❑U NO and field acidified: ❑YES ❑■ NO
LABORATORY INFORMATION
Date sample analyzed:7/7/2022 Laboratory Name: Statesville Analyitical Certification No. 440/3775
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 3.08 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.1 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
'Dissolved Solids:Total 70300 124 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 21.3 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑■ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 _mg/L VOC 78732: ,method#
Total Ammonia 00610<0.1 mg/L Mg-Magnesium 00927 _mg/L ,method#
(Ammonia Nitrogen;NH,as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 _ug/L ,method#
TKN as N 00625 mg/L Ni-Nickel 01067 ug/L , method#
t
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Ir
James Brown Complex Environmental Manager /////.-,I it 7 9.p,poles
Permittee(or Authorized Agent)Name and Title-Please print or type Signature V ermittee(or Authorized Agent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy t0: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0020793 Expiration Date: 0713112026 _
Facility Name: Tyson Farms,Inc. Non-Discharge WQ0020793 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Box 93613649 Airport Road TYPE OF PERMITTED OPERATION BEING MONITORED
NORTH WILKESBORO (street) NC 28659 County
Wilkes ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (State) 4ziai ❑ Spray Field ❑Remediation:
Contact Person: James Brown Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Hays Hatchery No.of wells to be sampled:4 ❑ Water Source Heat Pump •Other: Evaporation/Infiltration Pond
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-3 Date sample collected:7/7/2022 FIELD ANALYSES: WAS
Well Depth: 36 ft. Well Diameter: 2 in. pH 00400:5.2 units Temp.00010: 15.3 °C DRY at
(Depth to Water Level 82546: 18 ft.below measuring point Screened Interval: 21 ft. to 36 ft. Spec.Cond.0009a: µMhos time of
1sampling,
Measuring Point is 2 ft.above land surface Relative M.P. Elevation: 1306.40 ft. Odor 00085: none check
'Volume of water pumped/bailed before sampling: 8.80 gallons Appearance clear here:❑
!Samples for metals were collected unfiltered: ❑YES in NO and field acidified: ❑YES in NO
LABORATORY INFORMATION
Date sample analyzed:71712022 Laboratory Name: Statesville Analyitical Certification No. 44013775
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
' Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N o0620 5.29 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.1 mg/L
(Note:Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 177 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 11.5 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC, GC/MS,HPLC)
Phenol 32730 ug/L Fe- Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑■ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 _mg/L VOC 78732: ,method#
Total Ammonia 00610 0.11 mg/L Mg-Magnesium 00927 _mg/L ,method#
(Ammonia Nitrogen;NH,as N:Ammonia Nitrogen.Total) Mn-Manganese 01055 ug/L ,method#
TKN as N 00625 mg/L Ni-Nickel 01067 ug/L ,method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
James Brown Complex Environmental Manager F ©
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of rmittee(or Authorize Agent) (Date)
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original •EPARTMENTOF ENVIRONMENT&NATURAL RESOURCES .-----.1
GROUNDWATER QUALITY MONITORING: and l copy t0: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: W00020793 Expiration Date: 07/31/2026
Facility Name: Tyson Farms,Inc. 'Non-Discharge WQ0020793 UIC
Permit Name(if different): NPDES _ Other
Facility Address: P.O.Box 936/3649 Airport Road (TYPE OF PERMITTED OPERATION BEING MONITORED
(street)NORTH WILKESBORO (str NC 28659 County Wilkes ❑ Lagoon ❑ Remediation: Infiltration Gallery
(city) (state) (ZIP) ❑ Spray Field ❑Remediation:
I
Contact Person: .James Brown Telephone#: [phone] ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:Hays Hatchery No.of wells to be sampled:4 ❑ Water Source Heat Pump 0 Other: Evaporation/Infiltration Pond
(from Permit}
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-2 Date sample collected: 7/7/2022 FIELD ANALYSES: WAS
Well Depth: 36 ft. Well Diameter: 2 in. pH 00400:6.3 units Temp.00010: 16.9 °C DRY at
Mhos time of
Depth to Water Level 82546: 32 ft. below measuring point Screened Interval: 21 ft. to 36 ft. Spec.Cond.00094: µ sampling,
Measuring Point is 2 ft.above land surface Relative M.P.Elevation:1329.59 ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 1.96 gallons Appearance clear here:❑
Samples for metals were collected unfiltered: ❑YES ❑■ NO and field acidified: ❑YES ■❑NO
LABORATORY INFORMATION
Date sample analyzed:7/7/2022 Laboratory Name: StatesvileAnalyitical Certification No. 440/3775
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 1.06 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.1 mg/L
(Note. Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 72 mg/L Al-Aluminum 01105 mg/L
pH (Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 20.4 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS: (by GC,GC/MS,HPLC)
Phenol 32730 ug/L Fe-Iron 0104s ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 0094s mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑■ No(0)
Specific Conductance moss µMhos K-Potassium 00937 mg/L VOC 78732. ,method#
Total Ammonia 00610 4.48 • mg/L Mg-Magnesium 00927 _mg/L ,method#
(Ammonia Nitrogen;NH3 as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L ,method#
TKN as N 00625 mg/L Ni-Nickel 01067 ug/L , method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
I certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations. ?
James Brown Complex Environmental Manager ����!* ""`� ! a ,a' c �„�"
Permiltee(or Authorized Agent)Name and Title-Please print or type Signature of rmittee(or AuthorizetrAgent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy t0: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0020793 Expiration Date: 07/31/2026
Facility Name: Tyson Farms,Inc_ Non-Discharge WQ0020793 UIC
Permit Name(if different): NPDES _ Other
Facility Address: P.O.Box 936/3649 Airport Road TYPE OF PERMITTED OPERATION BEING MONITORED
NORTH WILKESBORO (Street) NC 28659 County Wilkes ❑ Lagoon ❑Remediation: Infiltration Gallery
(City) (State) (zict ❑ Spray Field ❑ Remediation:
Contact Person: James Brown Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Hays Hatchery No.of wells to be sampled:4 ❑ Water Source Heat Pump ❑i Other: Evaporation/Infiltration Pond
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-1 Date sample collected:7/7/2022 FIELD ANALYSES: WAS
Well Depth: 40 ft- Well Diameter: 2 in. pH 00400:6.3 units Temp.00010: 16.3 °C DRY at
time of
Depth to Water Level 82546: 28 ft.below measuring point Screened Interval: 23 ft. to 40 ft. Spec.Cond.00094: µMhos sampling,
Measuring Point is 2 ft.above land surface Relative M.P. Elevation: 1344.85 ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 5.87 gallons Appearance clear here:❑
Samples for metals were collected unfiltered: ❑YES ■❑ NO and field acidified: ❑YES ■❑NO
LABORATORY INFORMATION ..
Date sample analyzed:7/7/2022 Laboratory Name: Statesville Analyitical Certification No. 440/3775
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 2.01 mg/L Zn-Zinc 01092 mg/L
• Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 <0.1 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 272 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 <10 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 ug/L Chromium:Total 01034 ug/L
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC, GC/MS,HPLC)
Phenol 32730 ug/L Fe-Iron 01045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? ❑ Yes(1) ❑� No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610 <0.1 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NH,as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L ,method#
TKN as N 00625 mg/L Ni-Nickel 01067 ug/L ,method#
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
1 certify that,to the best of my knowledge and belief,the information submitted in this report is true,accurate,and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
James Brown Complex Environmental Manager 7-;2 — 4dr9.Z.
Permittee(or Authorized Agent)Name and Title-Please print or type Signature of rmittee(or Authorized pent) (Date)
GW-59 Rev.2/2010

Analytical Results STATESVILLE
,. ANALYTICAL
Tyson Foods-Wilkesboro +
704 Factory Street
Wilkesboro, NC 28697
Receive Date: 07/07/2022
Reported: 07/14/2022
For:
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
220707-28-01 Ammonia Nitrogen MW1 <0.1 mg/L SM4500NH3C2011 07/11/2022 CE/LE
220707-28-01 Chloride MW1 <10 mg/L SM450001C-2011 07/11/2022 MD
220707-28-01 Fecal Coliforms MW1 <1 CFU100 ML SM9222D-2oo6 07/07/2022 WC
220707-28-01 Nitrate MW1 2.01 mg/L SM4500NO3F-2011 07/11/2022 CL
220707-28-01 T. Phosphorous MW1 <0.1 mg/L SM4500PE-2011 07/08/2022 CL
220707-28-01 Total Dissolved MW1 272 mg/L SM 2540 C 18th Edition 07/07/2022 MD
Solids
220707-28-02 Ammonia Nitrogen MW2 4.48 mg/L SM4500NH3C-2011 07/11/2022 CE/LE
220707-28-02 Chloride MW2 20.4 mg/L SM4500CIC-2011 07/11/2022 MD
220707-28-02 Fecal Coliforms MW2 <1 CFU100 ML SM9222D-zoo6 07/07/2022 WC
220707-28-02 Nitrate MW2 1.06 mg/L SM4500No3F-2011 07/11/2022 CL
220707-28-02 T.Phosphorous MW2 <0.1 mg/L SM4500PE-2011 07/08/2022 CL
220707-28-02 Total Dissolved MW2 72 mg/L SM 2540 C 18th Edition 07/07/2022 MD
Solids
220707-28-03 Ammonia Nitrogen MW3 0.11 mg/L SM4500NH3C-2011 07/11/2022 CE/LE
220707-28-03 Chloride MW3 11.5 mg/L SM4500CiC-2011 07/11/2022 MD
220707-28-03 Fecal Coliforms MW3 <1 CFU100 ML SM9222D-2oo6 07/07/2022 WC
220707-28-03 Nitrate MW3 5.29 mg/L SM4500No3F-2011 07/11/2022 CL
220707-28-03 T.Phosphorous MW3 <0.1 mg/L SM4500PE-2011 07/08/2022 CL
220707-28-03 Total Dissolved MW3 177 mg/L SM 2540 C 18th Edition 07/07/2022 MD
Solids
220707-28-04 Chloride MW4 21.3 mg/L SM45000IC-2011 07/11/2022 MD
220707-28-04 Nitrate MW4 3.08 mg/L 5M4500NO3F-2011 07/11/2022 CL
220707-28-04 T.Phosphorous MW4 <0.1 mg/L SM4500PE-2011 07/08/2022 CL
220707-28-04 Total Dissolved MW4 124 mg/L SM 2540 C 18th Edition 07/07/2022 MD
Solids
PO Box 228 • Statesville, NC 28687 •704/872/4697
Page 1 of 5

Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
220707-28-04 Ammonia Nitrogen MW4 <0.1 mg/L SM4500NH3C-2011 07/11/2022 CE/LE
220707-28-04 Fecal Coliforms MW4 <1 CFU100 ML SM9222D-2oo6 07/07/2022 WC
Respectfully submitted,
Melissa Myers
NC Cert#440,
NCDW Cert#37755,
EPA#NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 5

Condition of Receipt
Sample Number 220707-28-01 TemEon Arrival: 3.0
e
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: Nitrate
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 220707-28-02 Temp on Arrival: 3.0
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule: Nitrate
Sulfuric Acid Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 220707-28-03 Temp on Arrival: 3.0
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 3 of 5

Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule: Nitrate
Sulfuric Acid Received on Ice
Parameter Schedule: T.Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 220707-28-04 Temp on Arrival: 3.0
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule: Nitrate
Sulfuric Acid Received on Ice
Parameter Schedule: T.Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 4 of 5

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Received by: Time am,pm Date /_! Compliance work: I —
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Initials:

GW-59A COMPLIANCE REPORT FORM Tyson Farms,Inc. Permit#W00020793
(Submit one each monitoring period with GW-59 forms.)
Enter date monitoring results were due.( ) Will this monitoring report(GW-59 and GW-59A) YES NO
be submitted after the established due date?
Was any required information missing on the GW-59 report forms? YES NO
IF the answer to question 1 or 2 is"YES" list in the space provided below the well identification number(s)and
explain the problems encountered in obtaining the required information.
3 Are any of the monitor wells in need of repair or maintenance(damaged casing,unlocked or missing cap,missing YES l�
identification plate,area overgrown,etc.)?If the answer is "Yes", contact the Regional ice for guidance.
4 Are any monitored constituents equal to or above the established standards? ®E NO
If the answer to question 4 is"NO'; skip to section 8.
If the answer to question 4 is"YES"list the affected wells individually with constituent(s)and concentration(s)
exceeding standards in the space provided below
7/7/22 PH 6.5-8.5 Ammonia 1,5 Nitrate 10 Fecal
MW-1 PH-6.3
MW-2 PH-6.3 4.48 mgA
MW-3 PH-5.2
MW-4 PH-5.6
5 For the constituents identified in question 4 above,have standards been exceeded previously for the 'E NO
same constituent(s)in the same well(s)in the last two years?
If the answer to question 5 is"NO", skip to section 8.
If the answer to question 5 is"YES",list in the space provided below, each well with constituent(s)exceeding
standards, concentration(s)reported, and sample collection date for each occurrence(for the last two years).
G W Standards Nitrate 10 G W Standards ammonia 1.5
MW-2 7-7-22 4.48mg/
MW-2 3-3-22 4.03 mgA
MW-2 11-11-21 4.82 mgA
MW-2 7-1-21 5.60 mgA
MW-2 3-4-21 4.82 mgA
MW-2 11-5-20 4.14 mg/I
6 Are the monitoring wells listed in section 5 located at or beyond the review boundary? E ' NO
If the answer is"YES",a groundwater quality problem may be occurring.CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE.If the answer is "NO",monitoring wells may be improperly
located; contact the Regional Office.
7 Is the permittee implementing previously approved actions required by the Division involving this ®E NO
groundwater quality problem?
If the answer to question 7 is"YES", describe those actions in the space provided below.
If the answer to question 7 is"NO",contaal7g,eggionai Office-lYltlaia_$4-f1>1JC;i.:,aagaitiatLQa.QaaK,Eag
rouirgd.k2 determiaaiLLQ.►mpact.tLlS.w to disposiLA3cakaiiabaziagatILLeazialumIsmnaliangs
ilf211.01i2dl0.211Caliindingi fggllLtL' Failurg.tQsl4zLQmK lalet.11)g.tarmittgg.lalli4ti .tYLQLatLQIL
tiagg� nd&iRenalties,
8 The person completing this portion(GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
I hereby acknowledge that the above information was evaluated and the information submitted in this
report(Compliance Report GW-59A)is true and complete to the best of my knowledge.
Signature opermittee(or Authorized Agent) Date
!'RI cn A 1910/'111112

Tyson Farms,Inc.
Worksheet#4b
Completed by: Max Byers
Title: WWf Operator
Date: 18-Jul-22
No.of Wells to be Sampled 4 Hays Hatchery
GroundWate Water sampling data Hays Hatchery Compliance Data
Constituents equal to or above the established Standards
Hays 1 per 100ML 500 mg/I 250 mg/ 1.5 mg/I 10 mg/I NA 6.5-8.5 •
Date Wells ID: Fecal TDS Chloride Total NH3_ Nitrate _ Phosphours PH
July-16-2020 MW-1 <1 188 <10 <0.5 6.21 0.2 6.9
MW-2 <1 176 16.2 4.70 1.83 0.1 7.1
MW-3 <1 79 <10 <0.5 5.76 0.5 5.6
MW-4 <1 112 19.6 <0.5 3.78 0.1 6.0
Nov-5-2020 MW- 1 <1 206 <10 <0.5 6.43 0.1 6.2
MW-2 <1 181 17.9 4.14 1.35 0.1 6.3
I MW-3 <1 63 11.0 <0.5 6.10 I 0.1 I 5.3
MW-4 _ <1 106 _ 20.4 <0.5 2.17 0.1 5.7
Mar-4-2021 MW-1 <1 212 <10 <0.5 7.05 <0.1 6.3
MW-2 <1 187 14.5 4.82 2.00 <0.1 6.4
I MW-3 <1 69 <10 <0.5 6.19 I <0.1 I 5.0
_ MW-4 <1 118 19.6 <0.5 6.17 0.1 5.3
July-1-2021 MW-1 <1 265 <10 <0.5 5.45 <0.1 6.0
I MW-2 8 162 19.6 5.60 1.78 <0.1 6.3
MW-3 <1 64 <10 <0.5 6.06 <0.1 4.9
MW-4 <1 134 19.6 <0.5 7.17 <0.1 5.4
Nov-11-2021 MW-1 <1 204 <10 <0.1 4.61 <0.1 6.3
MW-2 <1 143 14.0 4.82 1.03 <0.1 6.4
MW-3 <1 53 14.8 <0.1 5.93 <0.1 5.0
MW-4 <1 96 21.1 <0.1 6.49 <0.1 5.5
Mar-3-2022 MW- 1 <1 243 <10 <0.1 2.54 <0.1 6.0
MW-2 <1 160 13.3 4.03 0.84 I <0.1 6.3
I MW-3 <1 75 11.5 <0.1 6.10 j <0.1 5.0
MW-4 <1 115 18.6 <0.1 3.13 <0.1 5.7
July-7-2022 MW- 1 <1 272 <10 <0.1 2.01 <0.1 6.3
MW-2 <1 72 20.4 4.48 1.06 <0.1 6.3
MW-3 <1 177 11.5 0.11 5.29 <0.1 5.2
MW-4 <1 124 21.3 <0.1 3.08 <0.1 5.6
-Maximum 8 331 43 6 8 2 7
Minimum <1 53 11 4 1 0 5