WQ0020793_Monitoring - 10-2022_20221102

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * October
Report Information
WQ0020793
Tyson Farms, Inc. Hays Hatchery
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
NDMR Signed October 22.pdf 1.01MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
James Brown
Reviewer: Gerald, Wanda
11 /2/2022
This will be filled in automatically

Is the project number correct?* WQ0020793
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 11/2/2022

November 1, 2022
North Carolina Department of Environment, Health and Natural Resources
Division of Water resources
Information Processing Unit
1617 Mail Service Center
Raleigh, N.C. 27699-1617
Subject- Permit No. WQO,020793
Tyson Farms, Inc.
Hays Hatchery
Evaporation/Infiltration Pond
Non- Discharge Monitoring Report
NDMR Report — October 2022
To whom it may concern:
Enclosed is the Monthly Non- Discharge Monitoring report for I -lays Hatchery,
Please contact me at 336- 651-3836, should you have any questions.
Sincerely,
Jarnes Brown
Complex Environmental Manager
Tyson Farxnsmesa Fresh Retail DivisiOn 704FaetoiTWi1kcsbor-o,N,C,28697
336-651-2871 336.651-3836 Fax:[phone] www.tysonfoods.coin

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page j of
Sampling Person(s) 11 Certified Laboratories
Name: James Brown 11 Name: Statesville Analytical 122 court Street Statesville, NC 28687
Name: Max Byers 11 Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? -Z Compliant ._7 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: James Brown
Permittee: Tyson Farms, Inc. Hays Hatchery
Certification No.: 1001810
Signing Official: Marty Parsons
Grade: 2 Phone Number: 336-651-3836
Signing Official's Title. Sr. Live Production Marnager
Has the ORC changed since the previous NDMR? �7� Yes No
Phone Number: 336-651-3764 Permit Expiration: 7/31/2026
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61 Signature Date
Signature Date
By this signature. I certify that this report is accurate and complete to the best of my krimviedge
I certify, under penalty of law, "hat 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. used 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 Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page .. of
Permit No.: WQ0020793 Facility Name: Tyson Farms, Inc. Hays Hatchery
County: Wilkes Month: October Year: 2022
PPl:
Flow Measuring Point: :Z Influent D Effluent ❑ No flaw generated
Parameter Monitoring Point: Influent Effluent Groundwater Lowering Surface Water
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