HomeMy WebLinkAboutWQ0005681_Monitoring - 08-2022_20220907Monitoring Report Submittal
Permit Number #* WQ0005681
Name of Facility:* Pilgrims
Month: * August
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
Aug 22 signed.pdf 274.24KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
tina.pedley@pilgrims.com
Tina Pedley
9 "i
Reviewer: Gerald, Wanda
9/7/2022
This will be filled in automatically
Is the project number correct?* WQ0005681
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 9/13/2022
FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page Of
Permit No.: W00005681
Facility Name: Pilgrim's Corporation - Staley County: Randolph
Month: August
Year: 2022
Did irrigation occur
at this facility?
YES NO
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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?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑./ Compliant ❑ Non -Compliant
❑� Compliant ❑ Non -Compliant
❑ Compliant ❑ Non -Compliant
❑r Compliant ❑ Non -Compliant
[D Compliant ❑ 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: SVWW4 Phone Number: 919-895-3457 Signing Officials Title: Complex Manager
Has the ORC changed since the previous NDAR-1? Lj yes L-] Nn Phone Number: 9198953455 Permit Exp.: 11/30/26
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Signature Date Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge. certify, under penalty of law, that this document and all attachments were prepared under my direolion or supervision in accordance
vrth 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 erectly responsible for gathering the information, the
ormation submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are sgrriltcant
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 3 of 5
FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page A of
Permit No.: W00005681
Facility Name: Pilgrim's Pride - Staley WWTP
County: Randolph
Month: August
Year: 2022
PPI: 001
Flow Measuring Point: 0 Influent ❑ Effluent ❑ No flow generated
Parameter Monitoring
Point: ❑ influent ❑r Effluent ❑ Groundwater Lowering ❑ surface water
Parameter Code
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FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page � 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? M Compliant ❑ 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.: 9976171994534 Signing Official: Dan Shaw
Grade: SI/WW4 Phone Number: 919-895-3457 Signing Official's Title: Complex Manager
Has the ORC changed since the previous NDMR? ❑ Yes No Phone Number: 9198953455 Permit Expiration: 11/30/2026
Signature Date Signature Date
By this signature, I certify That this report is aocurrale and complete to the best of my knowtedge. I certify: under penalty of law, that this document and all attachments were prepared under my direewn 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 info lion, the information submitted is, to the test of my knOwled90 and belief, true, accurate, and complete I arn
aware that there are significant penalties for submitting false info lion, including the possibility of fines and imprisonment for
knowingviolations
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617