NC0006548_Renewal (Application)_20230622

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
RICHARD E. ROGERS, JR.
Director
Jonathan Green
Wayne Farms LLC
4110 Continental Dr
Oakwood, GA 30566
Subject: Permit Renewal
Application No. NC0006548
Dobson Plant
Surry County
Dear Permittee
NORTH CAROLINA
Environmental Quality
June 22, 2023
The Water Quality Permitting Section acknowledges the May 8, 2023 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https•//dgg nc gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
ec: WQPS Laserfiche File w/application
Sincerely,
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
D Q��
North Carolina Department of Environmental QuaW I Division of Water Resaaces
Winston-Salem Regional Office 1 450 West Hanes MR[ Road. Suite 300 1 Winston-Salem. North Carolina 27105
336.776.9800

V0"
WAY N E
SANDEit,
-
TOGETWE MAKE CHICKEN AMAZING
Certified Mail #: 7021 2720 0000 4465 1506
Division of Water Resources
Water Quality Permitting Section — NPDES
1617 Mail Service Center
Raleigh, NC 27699-1617
May 2, 2023
To whom it may concern,
Laserfiche
Enclosed are the original and two copies of Form 1 NPDES and Form 2C NPDES for the Wayne Farms LLC
Dobson Fresh Plant WWTP renewal. The permit number is NC0006548.
Please contact me at 601-426-1572 or stephanie.shoemaker(a)waynesanderson.com with any questions.
Thank you,
Stephanie Shoemaker
Sr. Director of Environmental
Wayne -Sanderson Farms LLC
4110 Continental Drive, Oakwood, Georgia 30566 800.392.0844 waynesandersonfarms.com

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NC0006548
Wayne Farms Dobson Fresh
OMB No. 2040-0004
Form
U.S. Environmental Protection Agency
1
EPA Application for NPDES Permit to Discharge Wastewater
NPDES
GENERAL INFORMATION
SECTION-D
Applicants Not Required to Submit Form 1
1.1
1.1.1
Is the facility a new or existing publicly owned
1.1.2
Is the facility a new or existing treatment works
treatment works?
treating domestic sewage?
If yes, STOP. Do NOT complete No
If yes, STOP. Do NOT No
Form 1. Complete Form 2A.
complete Form 1. Complete
Form 2S.
1.2
Applicants Required to Submit Form 1
1.2.1
Is the facility a concentrated animal feeding
1.2.2
Is the facility an existing manufacturing,
operation or a concentrated aquatic animal
commercial. mining, or silvicultural facility that is
a
production facility?
currently discharging process wastewater?
oYes
4 Complete Form 1 No
Yes 4 Complete Form No
a
and Form 2B.
1 and Form 2C.
1.2.3
Is the facility a new manufacturing, commercial.
1.2.4
Is the facility a new or existing manufacturing,
mining, or silvicultural facility that has not yet
commercial, mining, or silvicultural facility that
—
commenced to discharge?
discharges only nonprocess wastewater?
❑ Yes 4 Complete Form 1 E✓ No
❑ Yes 4 Complete Form No
and Form 2D.
1 and Form 2E.
°7
1.2.5
Is the facility a new or existing facility whose
discharge is composed entirely of stormwater
associated with industrial activity or whose
discharge is composed of both stormwater and
non-stormwater?
❑ Yes -+ Complete Form 1 ❑� No
and Form 2F
unless exempted by
40 CFR
122.26(b)(14)(x) or
b 15).
SECTION•D•
• • i
2.1
Facility Name
Wayne Farms Dobson Fresh Plant WWTP
`0
2.2
EPA Identification Number
cc
0
0
J
ca
2.3
Facility Contact
Name (first and last)
Title
Phone number
Jeremy Bowlin
Complex Environmental Manager
[phone]
Q
Email address
[e-mail]
2.4
Facility Mailing Address
Street or P.O. box
z
P.O. Box 383
City or town
State
ZIP code
Dobson
NC
27017
EPA Form 3510-1 (revised 3-19) Page 1

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NC0006548
Wayne Farms Dobson Fresh
OMB No. 2040-0004
CD
2.5
Facility Location
=
Street, route number, or other specific identifier
�w
a 0
802 East Atkins st
CM
c
County name
County code (if known)
ccc
Surry
E
City or town
State ZIP code
z
Dobson
NC 27017
SECTION
• NAICS CODESr
Description (optional)
3.1
SIC Code(s)
2015
Poultry Slaughtering and Processing
'A
G1
O
O
U
H
U
z
3.2
NAICS Code(s)
Description (optional)
-o
V
311615
rn
4.1 Name of Operator
Wayne Farms LLC
0
4.2
Is the name you listed in Item 4.1 also the owner?
w
o
❑ Yes [D No
4.3
Operator Status
g
IE
❑ Public —federal ❑ Public —state ❑ Other public (specify)
C
0 Private ❑ Other (specify)
4.4
Phone Number of Operator
[phone]
4.5
Operator Address
Street or P.O. Box
E d
4110 Continental Drive
IZE C
City or town
State
ZIP code
`o o
Oakwood
GA
30566
� U
o
Email address of operator
O
[e-mail]
SECTION-r
5.1
Is the facility located on Indian Land?
a
❑ Yes 0 No
EPA Form 3510-1 (revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh OMB No. 2040-0004
SECTION•
1
all that apply and print or type the corresponding permit number for each)
R
6.1
Existing Environmental Permits (check
m NPDES (discharges to surface
❑ RCRA (hazardous wastes)
❑ UIC (underground injection of
a
water)
fluids)
'=
E
NCO06548
>
w a
❑✓ PSD (air emissions)
❑ Nonattainment program (CAA)
❑ NESHAPs (CAA)
05124R11
w
❑ Ocean dumping (MPRSA) ❑ Dredge or fill (CWA Section 404) ❑ Other (specify)
SECTION
7.1
Have you attached a topographic map containing all required information to this application? (See instructions for
CL
specific requirements.)
❑� Yes ❑ No ❑ CAFO—Not Applicable (See requirements in Form 2B.)
SECTIONOF
i
Describe the nature of your business.
8.1
Poultry processing
N
N
C
.N
m
O
d
R
Z
SECTION•
• l
9.1
Does your facility use cooling water?
❑� Yes ❑ No 4 SKIP to Item 10.1.
d L
is a
9.2
Identify the source of cooling water. (Note that facilities that use a cooling water intake structure as described at
a,
40 CFR 125, Subparts I and J may have additional application requirements at 40 CFR 122.21(r). Consult with your
o Y
NPDES permitting authority to determine what specific information needs to be submitted and when.)
v c
Cooling towers(condensers) for ammonia refrigerations system - city water (less than 25% of total water used, and
—
less than 2 MGD)
SECTION1
VARIANCE
REQUESTS1 1
Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)? (Check all that
10.1
H
apply. Consult with your NPDES permitting authority to determine what information needs to be submitted and
when.)
❑ Fundamentally different factors (CWA ❑ Water quality related effluent limitations (CWA Section
Section 301(n)) 302(b)(2))
❑ Non -conventional pollutants (CWA ❑ Thermal discharges (CWA Section 316(a))
R
Section 301(c) and (g))
❑✓ Not applicable
EPA Form 3510-1 (revised 3-19) Page 3

EPA Identification Number
NPDES Permit Number
Facility Name Form Approved 03/05/19
NC0001054 T
Wayne Farms Dobson Fresh Pla OMB No. 2040-0004
SECTION•
1
In Column 1 below, mark the sections of Form 1 that you have completed and are submitting with your application.
11.1
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to provide attachments.
Column 1
Column 2
❑✓ Section 1: Activities Requiring an NPDES Permit
❑ w/ attachments
❑✓ Section 2: Name, Mailing Address, and Location
❑ w/ attachments
❑✓ Section 3: SIC Codes
❑ w/ attachments
❑✓ Section 4: Operator Information
❑ w/ attachments
❑✓ Section 5: Indian Land
❑ w/ attachments
•-
❑✓ Section 6: Existing Environmental Permits
❑ w/ attachments
d
E
�+
❑✓ Section 7: Map❑
w/ topographic
❑ w/ additional attachments
is
ma
y
c
❑✓ Section 8: Nature of Business
❑ w/ attachments
w
❑✓ Section 9: Cooling Water Intake Structures
❑ w/ attachments
~C
-o
Section 10: Variance Requests
❑ w/ attachments
❑✓ Section 11: Checklist and Certification Statement
❑ w/ attachments
_q
Y
d
11.2
Certification Statement
z
1 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 qualified personnel properly gather and evaluate 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 fine and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Kevin McDaniel
Senior VP and GM Fresh
Signature
Date signed
/`
EPA Form 3510-1 (revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant OMB No. 2040-0004
Form U.S. Environmental Protection Agency
2C 48/ EPA Application for NPDES Permit to Discharge Wastewater
NPDES EXISTING MANUFACTURING, COMMERCIAL, MINING, AND SILVICULTURE OPERATIONS
SECTIONOUTFALL LOCATIONr
1.1 Provide information on each of the facility's outfalls in the table below.
Outfa
Nu ber Receiving Water Name Latitude Longitude
5
001 Fisher River 36' 24' 36.3' N 8CP 41' 26.5' W a
ca
7
0
SECTION1 1
a, 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
3 balance? (See instructions for drawing requirements. See Exhibit 2C-1 at end of instructions for example.)
a ✓❑ Yes ❑ No
SECTION• 1 r
3.1 For each outfall identified under Item 1.1, provide average flow and treatment information. Add additional sheets if
necessary.
"*Outfall Number" 001
Operations
Operation Average Flow
Processing Plant 0.527 mgd
c
E Condenser 0.01 mgd
A
(LD Stormwater 0.0005 mgd
v
c
mgd
0Treatment Units
m Description Code from Final Disposal of Solid or
(include size, flow rate through each treatment unit, Table 2C-1 Liquid Wastes Other Than
a' retention time, etc.) by Dischar e
Meat Screen 1-T Renderer
Feather Screen 1-T Renderer
Screen Effluent Tank 0.035 MG; 0.753 MGD; 0.05 days RT 2-B
Flow EQTank (FEB TANK) 0.5 MG; 0.753 MGD; 0.66 days RT 2-B
EPA Form 3510-2C (Revised 3-19) Page 1

Section 3: Treatment Units (continued)
Description
Code from
Exhibit 2C-2
Final Disposal of Solid or Liquid
Waste other than By Discharge
Dissolved Air Flotation (DAF) —1200 gpm; 0.753
MGD
2-D
Covered FEB Lagoon; 2.5 MG; 0.538 MGD; 7
days
3-C
Anoxic Reactor 0.6 MG; 0.538 MGD; 1.1 days
3-D
Nitrification Reactor 1.5 MG; 0.538 MGD; 2.8
days
3-A
35-ft. Clarifier 0.058 MG; 0.2 MGD; 7.6 hours
1-U
60-ft. Clarifier 0.317 MG; 0.338 MGD; 18 hours
1-U
Chlorine Contact Chamber; 0.538 MGD; 30 min.
2-F
Dechlorination Chamber; 0.538 MGD; 10 min.
2-E

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NC0006548
Wayne Farms Dobson Fresh Plant
OMB No. 2040-0004
3.1
**Outfall Number**
cont.
Operations,
Operation
Average Flow
mgd
mgd
mgd
mgd
Treatment
Description
Units
Code from
Final Disposal of Solid or
(include size, flow rate through each treatment unit,
Table 2C-1
Liquid Wastes Other Than
retention time, etc.)
by Dischar e
v
d
0
U
c
a
E
m
m
H
o
**Outfall Number**
cc
Operations
0
Operation
Average Flow
W
o,
mgd
a
mgd
mgd
mgd
Treatment
Description
Units
Code from
Final Disposal of Solid or
(include size, flow rate through each treatment unit,
Table 2C-1
Liquid Wastes Other Than
retention time, etc.)
by Discharge
3.2
Are you applying for an NPDES permit to operate a privately owned treatment works?
m
❑ Yes ✓❑ No 4 SKIP to Section 4.
y
3.3
Have you attached a list that identifies each user of the treatment works?
❑ Yes ❑ No
EPA Form 3510-2C (Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant OMB No. 2040-0004
SECTIONFLOWS
4.1
Except for storm runoff, leaks, or spills, are any discharges described in Sections 1 and 3 intermittent or seasonal?
❑ Yes ❑✓ No 4 SKIP to Section 5.
4.2
Provide information
on intermittent or seasonal flows for each applicable outfall.
Attach additional pages, if necessa .
Frequency
Flow
Rate
Outfall
Operation
Duration
Average
Average
Long -Term
Maximum
Number
(list)
Da sMMeek
MonthsNear
Average
Dail
days/week
months/year
mgd
mgd
days
cdays/week
months/year
mgd
mgd
days
U_
days/week
months/year
mgd
mgd
days
E
days/week
monthstyear
mgd
mgd
days
a>
c
dayslweek
months/year
mgd
mgd
days
dayslweek
months/year
mgd
mgd
days
days/week
monthstyear
mgd
mgd
days
days/week
monthstyear
mgd
mgd
days
days/week
months/year
mgd
mgd
days
SECTION•'•1
5.1
• 1
Do any effluent limitation guidelines (ELGs) promulgated by EPA under Section 304 of the CWA apply to your facility?
❑✓ Yes ❑ No 4 SKIP to Section 6.
5.2
Provide the following information on applicable ELGs.
w
ELG Category
ELG Subcategory
Regulatory Citation
a
co
40 CFR Part 432
K
432.112
U
a
a
Q
5.3
Are any of the applicable ELGs expressed in terms of production (or other measure of operation)?
❑✓ Yes ❑ No -+ SKIP to Section 6.
0
R
5.4
Provide an actual measure of daily production expressed in terms and units of applicable ELGs.
J
Outfall
Operation, Product, or Material
Quantity per Day
Unit of
a
Number
Measure
d
M
m
001
Birds processed
150,000
1,350,000 live lb
c
0
v
0
L
a
EPA Form 3510-2C (Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant OMB No. 2040-0004
SECTION-•
6.1 Are you presently required by any federal, state, or local authority to meet an implementation schedule for constructing,
upgrading, or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes ❑✓ No 4 SKIP to Item 6.3.
6.2
Briefly identify each applicable project in the table below.
Affected
Final Compliance Dates
E
Brief Identification and Description of
Outfalls
Source(s) of
—
Project
(list outfall
Discharge
Required
Projected
c
number
E
w
d
a
cc
L
d
6.3
Have you attached sheets describing any additional water pollution control programs (or other environmental projects
that may affect your discharges) that you now have underway or planned? (optional item)
❑ Yes ❑ No ✓❑ Not applicable
SECTIONi
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn, the tables you must
complete. Not all applicants need to complete each table.
Table A. Conventional and Non -Conventional Pollutants
7.1
Are you requesting a waiver from your NPDES permitting authority for one or more of the Table A pollutants for any of
your outfalls?
❑ Yes ❑✓ No 4 SKIP to Item 7.3.
7.2
If yes, indicate the applicable outfalls below. Attach waiver request and other required information to the application.
Outfall Number Outfall Number Outfall Number
to
7.3
Have you completed monitoring for all Table A pollutants at each of your outfalls for which a waiver has not been
requested and attached the results to this application package?
No; a waiver has been requested from my NPDES
❑✓ Yes ❑permitting
authority for all pollutants at all outfalls.
Table B.
Toxic Metals, Cyanide, Total Phenols, and Organic Toxic Pollutants
7.4
Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry categories
=
listed in Exhibit 2C-3? (See end of instructions for exhibit.)
❑ Yes ❑✓ No 4 SKIP to Item 7.8.
3
7.5
Have you checked "Testing Required" for all toxic metals, cyanide, and total phenols in Section 1 of Table B?
LU
❑ Yes ❑ No
7.6
List the applicable primary industry categories and check the boxes indicating the required GC/MS fraction(s) identified
in Exhibit 2C-3.
Primary Industry Category
Required GC/MS Fraction(s)
Check applicable boxes.
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
❑ Volatile ❑ Acid ❑ Base/Neutral ❑ Pesticide
EPA Form 3510-2C (Revised 3-19) Page 4

EPA Identification Number
NPDES Permit Number
Facility Name
Form Approved 03/05/19
NC0006548
Wayne Farms Dobson Fresh Plant
OMB No. 2040-0004
7.7
Have you checked 'Testing Required" for all required pollutants in Sections 2 through 5 of Table B for each of the
GC/MS fractions checked in Item 7.6?
❑ Yes ❑ No
7.8
Have you checked 'Believed Present' or "Believed Absent" for all pollutants listed in Sections 1 through 5 of Table B
where testing is not required?
❑✓ Yes ❑ No
7.9
Have you provided (1) quantitative data for those Section 1, Table B, pollutants for which you have indicated testing is
required or (2) quantitative data or other required information for those Section 1, Table B, pollutants that you have
indicated are 'Believed Present' in your discharge?
✓❑ Yes ❑ No
7.10
Does the applicant qualify for a small business exemption under the criteria specified in the instructions?
❑ Yes 4 Note that you qualify at the top of Table B, ❑✓ No
then SKIP to Item 7.12.
7.11
Have you provided (1) quantitative data for those Sections 2 through 5. Table B, pollutants for which you have
c
determined testing is required or (2) quantitative data or an explanation for those Sections 2 through 5. Table B,
pollutants you have indicated are 'Believed Present' in your discharge?
AG
✓❑ Yes ❑ No
0
Table C. Certain Conventional and Non -Conventional Pollutants
2
7.12
Have you indicated whether pollutants are 'Believed Present' or `Believed Absent' for all pollutants listed on Table C
for all outfalls?
❑✓ Yes ❑ No
C5
7.13
Have you completed Table C by providing (1) quantitative data for those pollutants that are limited either directly or
indirectly in an ELG and/or (2) quantitative data or an explanation for those pollutants for which you have indicated
"Believed Present"?
C
d
❑✓ Yes ❑ No
W
Table D. Certain Hazardous Substances and Asbestos
7.14
Have you indicated whether pollutants are 'Believed Present' or "Believed Absent' for all pollutants listed in Table D for
all outfalls?
✓❑ Yes ❑ No
7.15
Have you completed Table D by (1) describing the reasons the applicable pollutants are expected to be discharged
and (2) by providing quantitative data, if available?
❑ Yes ❑✓ No
Table E. 2,3,7,8-Tetrachlorodibenzo- -Dioxin 2,3,7,8-TCDD
7.16
Does the facility use or manufacture one or more of the 2,3,7,8-TCDD congeners listed in the instructions. or do you
know or have reason to believe that TCDD is or may be present in the effluent?
❑ Yes 4 Complete Table E. ❑✓ No 4 SKIP to Section 8.
7.17
Have you completed Table E by reporting qualitative data for TCDD?
❑ Yes ❑ No
SECTIONOR
MANUFACTURED TOXICSr
Is any pollutant listed in Table B a substance or a component of a substance used or manufactured at your facility as
8.1
m
an intermediate or final product or byproduct?
w
ca
❑ Yes ❑✓ No SKIP to Section 9.
8.2
List the pollutants below.
0
1. 4. 7.
0
m
a
2. 5. 8.
F3. 6. 9.
EPA Form 3510-2C (Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant OMB No. 2040-0004
SECTION• • • i
9.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made
within the last three years on (1) any of your discharges or (2) on a receiving water in relation to your discharge?
0 Yes ❑ No 4 SKIP to Section 10.
U3
..
4)
9.2
Identify the tests and their
ourposes below.
Z
Test(s)
Purpose of Test(s)
Submitted to NPDES
Date Submitted
x
Permitting Authority?
0
cc c'
Ceriodaphnia
Acute pass or fail
✓❑ Yes ❑ No
05/13/2022
CM
0
0
m
Ceriodaphnia
Acute pass or fail
❑✓ Yes ❑ No
08/03/2022
Ceriodaphnia Acute pass or fail
✓❑ Yes ❑ No 11/14/2022
•N
10. CONTRACT
Were any of the analyses reported in Section 7 performed by a contract laboratory or consulting firm?
10.1
M Yes ❑ No -+ SKIP to Section 11.
10.2
Provide information for each contract laboratory or consulting
firm below.
Laboratory Number 1
Laboratory Number 2
Laboratory Number 3
Name of laboratory/firm
Mentech Inc. Environmental
Laboratory
a
m
T
Laboratory address
642 Tamco Road, Reidsville,
�o
Q
North Carolina 27320
c�
c
0
c�
Phone number
[phone]
Pollutant(s) analyzed BOD, TSS, Nh3-N, TN, TP,
Fecal, Turbidity, Oil and
Grease. Toxiccity
Has the NPDES permitting authority requested additional
information?
11.1
❑ Yes
No SKIP to Section 12.
0
11.2
List the information requested and attach it to this application.
0
1. 4.
Ta
c
0
a
2. 5.
-a
Q
3. 6.
EPA Form 3510-2C (Revised 3-19) Page 6

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant OMB No. 2040-0004
SECTION•
I . .
In Column 1 below, mark the sections of Form 2C that you have completed and are submitting with your application.
12.1
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to com lete all sections or provide attachments.
Column 1
Column 2
❑✓ Section 1: Outfall Location
❑✓ w/ attachments
❑✓ Section 2: Line Drawing
✓❑ w/ line drawing ❑ w/ additional attachments
w/ list of each user of
Section 3: Average Flows and
Q
,/❑ w/ attachments ❑ privately owned treatment
Treatment
works
❑ Section 4: Intermittent Flows
❑ w/ attachments
❑✓ Section 5: Production
❑ w/ attachments
w/ optional additional
❑ Section 6: Improvements
❑ w/ attachments ❑ sheets describing any
additional pollution control
tans
❑ w/ request for a waiver and ❑ w/ explanation for identical
supporting information outfalls
d
w/ small business exemption w/ other attachments
❑ ❑
d
request
❑ Section 7: Effluent and Intake
❑✓ w/ Table A ❑✓ w/ Table B
Characteristics
0
✓❑ w/ Table C ❑✓ w/ Table D
d
w/ Table E w/ analytical results as an
❑ ❑
c�
attachment
Section 8: Used or Manufactured
❑
❑ w/ attachments
e
Toxics
❑ Section 9: Biological Toxicity
❑ w/ attachments
r
Tests
U
❑ Section 10: Contract Analyses
❑ w/ attachments
❑ Section 11: Additional Information
❑ w/ attachments
0 Section 12: Checklist and
❑ w/ attachments
Certification Statement
12.2
Certification Statement
1 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 qualified personnel properly gather and evaluate 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. 1 am aware that there are significant penalties for submitting false information, including the
possibility of fine and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Kevin McDaniel
Senior VP and GM Fresh
Signature
Date signed
EPA Form 3510-2C (Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Oulfall Number
NC0006548 Wayne Farms Dobson Fresh Plani, 001
Form Approved 03/05/19
OMB No. 2040-0004
• •
• •
• ••
Pollutant
Waiver
Requested
(if applicable)
Units
(specify)
Effluent
Intake
o fionar
Maximum
Daily
Maximum
Monthly
Discharge
Long -Term
Average Daily
Discharge
Number of
Analyses
Long-TermLNum
berofDischarge
Average ValueAnalyses
(required)
if available
if available
❑ Check here if you have applied
to your NPDES
permitting authority
for a waiver
for all of the pollutants listed on this table for the noted outfall.
1'
Biochemical oxygen demand
(BOD5)
Concentration
mg/L
20.4
6.8
5.1
155
Mass
2.
Chemical oxygen demand
(COD)
❑
Concentration
mg/L
34
1
--
Mass
3
Total organic carbon (TOO)
❑
Concentration
mg/L
6.40
1
Mass
4
Total suspended solids (TSS)
❑
Concentration
mg/L
12
6.75
5.28
155
—
Mass
5.
Ammonia (as N)
❑
Concentration
mg/L
1.2
0.18
0.13
155
—
Mass
6.
Flow
❑
Rate
MGD
1.031
0.632
0.541
365
Temperature (winter)
❑
°C
°C
26
22
125
7.
Temperature (summer)
❑
°C
°C
31
30
128
pH (minimum)
❑
Standard units
S.U.
6.7
253
8.
pH (maximum)
ElStandard
units
S.U.
8.3
253
' Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 9

This page intentionally left blank.

Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05119
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No. 2040-0004
Pollutant/Parameter
(and CAS Number, if available)
Testing
Required
Presence or Absence
check one
Units
(specify)
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
(if available)
Long -Term
Average
Disa Daily
chr a
isch(ifarg
Number
Analyses
Long -
Term
Average
Value
Number
of
Analyses
Check here if you qualify as a small business per the instructions to Form 2C and, therefore, do not need to submit quantitative data for any of the organic toxic pollutants in Sections
2 through 5 of this table. Note, however, that you must still indicate in the appropriate column of this table if you believe any of the pollutants listed are present in your discharge.
Section 1. Toxic Metals, Cyanide, and Total Phenols
1.1
Antimony, total
(7440-36-0)
Concentration
Mass
1.2
Arsenic, total
(7440-38-2)
Concentration
Mass
1.3
Beryllium, total
(7440-41-7)
Concentration
Mass
Concentration
1.4
Cadmium, total
(7440-43-9)
Mass
1.5
Chromium, total
(7440-47-3)
❑ E]❑
Concentration
Mass
1.6
Copper, total
(7440-50-8)
El
El
IZI
Concentration
Mass
1.7
Lead total
(7439-92-1)
Concentration
Mass
1.8
Mercury, total
(7439-97-6)
El El
El
©
Concentration
Mass
1'9
Nickel, total
(7440-02-0)
El
Concentration
Mass
1.10
Selenium, total
(7782-49-2)
El El
El
Concentration
Mass
1.11
Silver, total
(7440-22-4)
El El
El
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0006548 I Wayne Farms Dobson Fresh Plant 001 OMB No. 2040-0004
Units
(specify)
Effluent
Intake
(optional)
Pollutant/Parameter
(and CAS Number, if available)
Testing
Required
Presence or Absence
check one
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
e ge
(required)
Maximum
Monthly
Dfavailable)
(
Long -Term
Average
Daily
Discharge
if available
Number
of
Analyses
Long.
Term
AValuee
Number
of
Analyses
1.112
Thallium, total
(7440-28-0)
El
El
❑
Concentration
Mass
1.13
Zinc total
(7440-66-6)
El
❑
✓❑
Concentration
Mass
1.14
Cyanide, total
(57-12-5)
El
❑
✓❑
Concentration
Mass
1.15
Phenols, total
El
ElM
Concentration
Mass
Section 2.Organic Toxic Pollutants (GC/MS Fraction
—Volatile Compounds)
21
Acrolein
(107-02-8)
❑
❑
Concentration
Mass
2.2
Acrylonitrile
(107-13-1)
El
❑
✓❑
Concentration
Mass
2.3
Benzene
(71-43-2)
El
El
©
Concentration
Mass
2.4
Bromoform
(75-25-2)
Concentration
Mass
2.5
Carbon tetrachloride
(56-23-5)
Concentration
Mass
2.6
Chlorobenzene
(108-90-7)
11
El
©
Concentration
Mass
2.7
Chlorodibromomethane
(124-48-1)
❑
❑
❑✓
Concentration
Mass
2.8
Chloroethane
(75-00-3)
❑
1
✓❑
1
Concentration
1 Mass
EPA Form 3510-2C (Revised 3-19) Page 12

Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No.2040-0004
TABLE B. TOXIC METALS, CYANIDE,
TOTAL PHENOLS,
AND ORGANIC TOXIC
POLLUTANTS (40 CFR
122.21(g)(7)(v))'
Presence or Absence
Intake
check one
Effluent
(optional)
Pollutant/Parameter
Testing
Units
Maximum
Maximum
Long -Term
Long -
(and CAS Number. if available)
Required
Believed
Believed
(specity)
Daily
Monthly
Average
Number
Term
Number
Present
Absent
Discharge
Discharge
Daily
of
Average
of
(required)
(if available)
Discharge
Analyses
Value
Analyses
if available
2-chlor12.9oethylvinyl ether
ElEl
❑
Concentration
Mass
(110-75-8)
2.10
Chloroform (67-66-3)
❑
❑
❑✓
Concentration
Mass
2.11
Dichlorobromomethane
❑
❑
❑
Concentration
Mass
(75-27-4)
212
11-dichloroethane
❑
❑
❑
Concentration
Mass
(75-34-3)
2.13
1 2-dichloroethane
El
El
El
Concentration
Mass
(107-06-2)
2.14
11-dichloroethylene
❑
❑
©
Concentration
Mass
(75-35-4)
2.15
1,2-dichloropropane
❑
❑
❑
Concentration
Mass
(78-87-5)
216
13-dichloropropylene
❑
❑
❑
Concentration
Mass
(542-75-6)
2.17
Ethylbenzene
❑
❑
❑
Concentration
Mass
(100-41-4)
2.18
Methyl bromide
❑
❑
❑
Concentration
Mass
(74-83-9)
2.19
Methyl chloride
❑
❑
❑
Concentration
Mass
(74-87-3)
2.20
Methylene chloride
❑
❑
0
Concentration
Mass
(75-09-2)
2.21
1 1,2 2- tetrachloroethane
❑
❑
❑
Concentration
Mass
(79-34-5)
EPA Form 3510-2C (Revised 3-19) Page 13

LNA loentiticabon Number NrUtb rermlr NUMDer Facility Name Outtall Number
NC0006548 Wayne Farms Dobson Fresh Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE
B. TOXIC METALS, CYANIDE,
PollutantlParameter
(and CAS Number, if available)
TOTAL PHENOLS,
Testing
Required
AND ORGANIC TOXIC
Presence or Absence
check one
POLLUTANTS (40 CFR
Units
(specify)
122.21(g)(7)(v))'
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Daily
Dof
requi ed e
Maximum
Monthly
(i available)
Long -Term
Average
Daily
Discharge
rf available
Number
of
Analyses
Long-
Term
verage
AValuescharge
Number
Analyses
2.122
Tetrachloroethylene
(127-18-4)
❑
❑
❑✓
Concentration
Mass
2.23
Toluene
(108-88-3)
El El
✓❑
Concentration
Mass
2.24
1 2-trans-dichloroethylene
(156-60-5)
El ❑
❑✓
Concentration
Mass
Concentration
2.25
1 1,1-trichloroethane
(71-55-6)
El ❑
Mass
2 26
1 1,2-trichloroethane
(79-00-5)
Trichloroethylene
(79-01-6)
Concentration
Mass
2.27
✓❑
Concentration
Mass
2.28
Vinyl chloride
(75-01-4)
El
1Mass
❑
[a
Concentration
Section 3.Organic Toxic Pollutants(GC/MS
Fraction
—Acid Compounds
31
2-chlorophenol
(95-57-8)
❑
❑❑
Concentration
Mass
3.2
2,4-dichlorophenol
(120-83-2)
❑
El
✓❑
Concentration
Mass
3.3
2,4-dimethylphenol
(105-67-9)
❑
❑
✓❑
Concentration
Mass
3.4
4,6-dinitro-o-cresol
(534-52-1)
❑
❑✓
Concentration
Mass
3.5
2 4-dinitrophenol
(51-28-5)
El
1
❑
1
✓❑
1
Concentration
1 Mass
EPA Form 3510-2C (Revised 3-19) Page 14

NPOES Permit Number I I Facility Name Outfall Number Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No. 2040-0004
Pollutant/Parameter
(and CAS Number, if available)
Testing
Required
Presence or Absence
check one
Units
(specify)
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
(if available)
Long -Term
Average
Daily
Discharge
if available
Number
of
Analyses
Long -
Term
Average
Value
Number
of
Analyses
3.6
2 nitrophenol
(88-75-5)
El
El
El
Concentration
_
Mass
3.7
4-nitrophenol
(100-02-7)
El
11
✓❑
Concentration
Mass
3.8
p-chloro-m-cresol
(59-50-7)
❑
11
✓❑
Concentration
Mass
3.9
Pentachlorophenol
(87-86-5)
❑
❑
©
Concentration
Mass
3.10
Phenol
(108-95-2)
El
IZI
Concentration
Mass
3.11
2 4,6-trichlorophenol
(88-05-2)
❑
❑
0
Concentration
Mass
Section 4.Organic Toxic Pollutants (GC/MS Fraction
—Base /Neutral
Compounds
41
Acenaphthene
(83-32-9)
❑
El
Concentration
Mass
4.2
Acenaphthylene
(208-96-8)
_ _
❑
❑✓
Concentration
Mass
4.3
_
Anthracene
(120-12-7)
Concentration
Mass
4.4
Benzidine
(92-87-5)
El
❑
✓❑
Concentration
Mass
4.5
Benzo (a) anthracene
(56-55-3)
Q
Concentration
Mass
4.6
Benzo (a) pyrene
(50-32-8)
1:1
1
El
1
IZI
1Mass
Concentration
EPA Form 3510-210 (Revised 3-19) Page 15

NPDES Permit Number
NC0006548
Name
Wayne Farms Dobson Fresh Plant
Outfall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
•N11111411
PolIutant/Parameter
(and CAS Number, if available)
felt-111111:1111:•
Testing
Required
1 • ' • ' • 1
Presence or Absence
check one
Units
Believed Believed (specify)
Present Absent
Effluent
Intake
(optional)
Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
(if available)
Long -Term
Average
Disahay a
ifschabl9
Number
of
Analyses
Long -
Term
Average
Value
Number
of
Analyses
4.7
3 4-benzofluoranthene
(205-99-2)
❑
❑
✓❑
Concentration
Mass
4.8
Benzo (ghi) perylene
(191-24-2)
❑
❑
0
Concentration
Mass
4.9
Benzo (k) fluoranthene
(207-08-9)
Concentration
Mass
4.10
Bis (2-chloroethoxy) methane
(111-91-1)
El
❑
Concentration
Mass
4 11
Bis (2-chloroethyl) ether
(111-44-4)
Concentration
Mass
4.12
Bis (2-chloroisopropyl) ether
(102-80-1)
❑
IZI
Concentration
Mass
4.13
Bis (2-ethylhexyl) phthalate
(117-81-7)
❑
❑
❑�
Concentration
Mass
4.14
4-bromophenyl phenyl ether
(101-55-3)
❑
❑
❑✓
Concentration
Mass
4.15
Butyl benzyl phthalate
(85-68-7)
❑
❑
❑✓
Concentration
Mass
4.16
2-chloronaphthalene
(91-58-7)
Concentration
Mass
4.17
4-chlorophenyl phenyl ether
(7005-72-3)
Concentration
Mass
4.18
Chrysene
(218-01-9)
O
Concentration
Mass
4.19
Dibenzo (a,h) anthracene
(53-70-3)
11
1
❑
1
❑✓
1Mass
Concentration
EPA Form 3510-2C (Revised 3-19) Page 16

EPA Identification Number NPDES Permit Nu
NC0006548
Name
Wayne Farms Dobson Fresh Plant
Outtall Number
001
Form Approved 03/05/19
OMB No. 2040-0004
Units
(specify)
Effluent
Intake
(optional)
14.2012-dichlorobenzene
PollutantlParameter
(and CAS Number. if available)
Testing
Required
Presence or Absence
check one
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
(if available)
Long -Term
Average
Daily
Discharge
if available
Number
of
Analyses
Long-
Term
Average
Value
Number
of
Analyses
(95-50-1)
Concentration
Mass
4.21
13-dichlorobenzene
(541-73-1)
Concentration
Mass
4.22
1 4-dichlorobenzene
(106-46-7)
El
❑
✓❑
Concentration
Mass
4.23
3 3-dichlorobenzidine
(91-94-1)
El
❑
Concentration
Mass
- -
4.24
Diethyl phthalate
(84-66-2)
❑
©
Concentration
Mass
4.25
Dimethyl phthalate
(131-11-3)
Concentration
Mass
4.26
Di-n-butyl phthalate
(84-74-2)
❑
©
Concentration
Mass
4.27
2 4-dinitrotoluene
(121-14-2)
❑
El
✓❑
Concentration
Mass
4.28
2 6-dinitrotoluene
(606-20-2)
El
El
❑
Concentration
Mass
4.29
Di-n-octyl phthalate
(117-84-0)
❑
El
El
❑✓
El
Concentration
Mass
Concentration
4.30
1,2-Diphenylhydrazine
(as azobenzene) (122-66 7)
El
Mass
4.31
Fluoranthene
(206-44-0)
El
❑
❑✓
Concentration
Mass
4.32
Fluorene
(86-73-7)
a
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 17

itb rermir rvumoer Facmty Name Outtall Number
NC0006548 Wayne Farms Dobson Fresh Plant 001
Form Approved 0105119
OMB No. 2040-0004
• 1
Pollutant/Parameter
(and CAS Number if available)
•
Testing
Required
• 1 •'I Lega•
Presence or Absence
check one
•• 1
Units
(specify)
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
(required)
Maximum
Monthly
Discharge
(if available)
Long -Term
Average
aily
DisDchar a
9
if available
Number
of
Analyses
Long-
Term
Average
Value
Number
of
Analyses
4.33
Hexachlorobenzene
(118-74-1)
❑
❑�
Concentration
Mass
4.34
Hexachlorobutadiene
(87-68-3)
11
El
El
Concentration
Mass
4.35
Hexachlorocyclopentadiene
(77-47-4)
El
✓❑
Concentration
Mass
4.36
Hexachloroethane
(67-72-1)
El
El
La
Concentration
Mass
4.37
Indeno (1,2,3-cd) pyrene
(193-39-5)
❑
0
Concentration
Mass
--
— --
-
4.38
Isophorone
(78 59-1)
❑
❑
❑✓
Concentration
Mass
-
4.39
Naphthalene
(91-20-3)
Concentration
Mass
4.40
Nitrobenzene
(98-95-3)
El
❑
✓❑
Concentration
Mass
4.41
N-nitrosodimethylamine
(62-75-9)
❑
0
Concentration
Mass
4.42
N-nitrosodi-n-propylamine
�(621-64-7)
Concentration
Mass
--
4.43
N-nitrosodiphenylamine
(86-30-6)
El
❑
✓❑
Concentration
Mass
4.44
Phenanthrene
1(85-01-8)
❑
Concentration
Mass
4.45
Pyrene
(129-00-0)
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 18

Number NPDES Permit Number I Facility Name Outfall Number I Form Approved 03/06/19
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No. 2040-0004
Presence or Absence
Intake
check one
Effluent
(optional)
Pollutant/Parameter
Testing
Units
Maximum
Maximum
Long -Term
Long"
(and CAS Number, if available)
1
Required
Believed
Believed
(specify)
Daily
Monthly
Average
Number
Term
Number
Present
Absent
Discharge
Discharge
aily
of
Avalueerage
of
rfavailable)
Discharge
Analyses
Analyses
rf available
4.46
1 2 4-trichlorobenzene
❑
Concentration
Mass
(120-82-1)
Section 5. Organic Toxic Pollutants(GC/MS Fraction
—Pesticides
5.1
Aldrin
Concentration
Mass
(309-00-2)
5.2
a-BHC
Concentration
Mass
(319-84-6)
5.3
R-BHC
Concentration
Mass
(319-85-7)
5.4
y-BHC
El
El
IZI
Concentration
Mass
(58-89-9)
5.5
S-BHC
Concentration
Mass
(319-86-8)
5.6
Chlordane
El
El
a
Concentration
Mass
(57-74-9)
5.7
4 4'-DDT
El
El
El
Concentration
Mass
(50-29-3)
5.8
4,4'-DDE
1(72-55-9)
1:1
El
0
Concentration
Mass
5.9
4,4'-DDD
Concentration
_
-
Mass
(72-54-8)
5.10
Dieldrin
Concentration
Mass
(60-57-1)
511
a-endosulfan
Concentration
Mass
(115-29-7)
EPA Form 3510-2C (Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number Facility Name Outfall Number
NC0006548 Wayne Farms Dobson Fresh Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
TABLE
15.12R-endosulfan
13. TOXIC METALS, CYANIDE,
Pollutant/Parameter
(and CAS Number. if available)
TOTAL PHENOLS,
Testing
Required
AND ORGANIC TOXIC
Presence or Absence
check one
POLLUTANTS (40 CFR
Units
(specify)
122.21(g)(7)(v))'
Effluent
Intake
(optional)
Believed
Present
Believed
Absent
Maximum
Daily
Discharge
Maximum
Monthly
ischaeAvalueerage
Drf availabblle)
Long -Term
Average
aily
Discharge
rf available
Number
of
Analyses
Lon
Term
Number
of
Analyses
(115-29-7)
El
El
ElConcentration
Mass
5.13
Endosulfan sulfate
(1031-07-8)
Concentration
Mass
5.14
Endrin
(72-20-8)
El
El
ID
Concentration
Mass
5.15
Endrin aldehyde
(7421-93-4)
El
❑
Concentration
Mass
5.16
Heptachlor
(76-44-8)
❑
❑
❑
Concentration
Mass
5.17
Heptachlor epoxide
(1024-57-3)
❑
❑
0
Concentration
Mass
5.18
PCB-1242
(53469-21-9)
El
ElMass
Concentration
5.19
PCB-1254
(11097-69-1)
❑
❑
IZI
Concentration
Mass
5.20
PCB-1221
(11104-28-2)
❑
❑
121
Concentration
Mass
5.21
PCB-1232
(11141-16-5)
❑
❑
0
Concentration
Mass
5.22
PCB-1248
(12672-29-6)
❑
El
Concentration
Mass
5.23
PCB-1260
(11096-82-5)
❑
❑
F/I
Concentration
Mass
- -
5.24
PCB-1016
(12674-11-2)
❑
❑
0
Concentration
Mass
EPA Form 3510-2C (Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Nu
NC0006548 Wayne Farms Dobson Fresh Plant 001
Form Approved 03/05/19
OMB No. 2040-0004
• 1
• gnel1
•'
• '•1 11
Presence or Absence
check one
Effluent
Intake
(optional)
Pollutant/Parameter
Testing
Units
Maximum
Maximum
Long -Term
Long
(and CAS Number if available)
Required
Q
Believed
Believed
(P �)
(specify)
Daily
Monthly
Average
Number
Term
Number
Present
Absent
Daily
of
of
Discharge
Discharge
Discharge
Analyses
Average
Analyses
(required)
(if available)
if available
Value
Toxaphene
5.25
❑
ElMass
Concentration
(8001-35-2)
Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) pane 21

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No.2040-0004
• • • • • •• r
Presence or Absence
Intake
check one Effluent
(Optional)
Pollutant Units Maximum Long -Term
Believed Believed (specify) Maximum Daily Long -Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
(required) Discharge Discharge Analyses Value Analyses
f available if available
Check here if you believe all pollutants on Table C to be present in your discharge from the noted outfall. You need not complete the "Presence or Absence" column of Table C for
each pollutant.
Check here if you believe all pollutants on Table C to be absent in your discharge from the noted outfall. You need not complete the "Presence or Absence" column of Table C for
each pollutant.
1
Bromide
Concentration
Mass
(24959-67-9)
2'
Chlorine, total
El
Concentration
ug/L
45
22.2
17.2
251
Mass
residual
3.
Color
El
❑
Concentration
ntu
6.9
3.9
2.7
52
Mass
4
Fecal coliform
✓❑
❑
Concentration
CFu
110
20
8.3
156
Mass
5
Fluoride
❑
✓❑
Concentration
Mass
(16984-48-8)
6
Nitrate -nitrite
�
Concentration
mg/L
30.3
24.78
20.1
52
Mass
7'
Nitrogen, total
Concentration
mg/L
31.0
25.1
21.0
52
Mass
organic (as N)
8.
Oil and grease
✓❑
Concentration
mg/L
<5
<5
<5
156
Mass
g
Phosphorus (as
Concentration
mg/L
37.2
27.62
21.18
52
Mass
P), total (7723-14-0)
10.
Sulfate (as SO4)
El
Concentration
mg/L
106
1
Mass
(14808-79-8)
11.
Sulfide (as S)
✓❑
Concentration
mg/L
<0.100
1
Mass
EPA Form 3510-2C (Revised 3-19) Page 23

EPA Identification Number
Pollutant
NPDES Permit Number Facility
NC0006548 Wayne Farms
Presence or Absence
check one
Units
Believed Believed (Specify)
Present Absent
Name Outfall Number
Dobson Fresh Plant 001
Effluent
Form Approved 03105/19
OMB No.2040-0004
Intake
(Optional)
Maximum Daily
Discharge
(required)
Maximum
Monthly
Discharge
if available
Long -Term
Average Daily
Discharge
if available
Number of
Analyses
Long -Term
Average
Value
Number of
Analyses
12
Sulfite (as S03)
(1426545-3)
❑
❑
Concentration
Mass
13.
Surfactants
✓❑
❑
Concentration
mg/L
<0.100
1
Mass
14.
Aluminum, total
(7429-90-5)
❑✓
❑
Concentration
mg/L
<0.050
1
Mass
-
15.
Barium, total
(7440-39-3)
❑
❑✓
Concentration
Mass
16
Boron total
(744042-8)
❑
ID
Concentration
Mass
17
Cobalt total
(744048-4)
❑
❑✓
Concentration
Mass
18
Iron total
(7439-89-0)
El
❑✓
Concentration
Mass
19'
Magnesium, total
(7439-95-4)
Concentration
Mass
20.
Molybdenum,
total
7439-98-7
❑
El
Concentration
Mass
21
Manganese, total
(7439-96-5)
❑
❑
Concentration
Mass
22.
Tin total
(7440-31-5)
❑
❑✓
Concentration
Mass
23
Titanium, total
(7440-32-0)
❑
❑✓
Concentration
M ass
EPA Form 3510-2C (Revised 3-19) Page 24

EPA Identification Number
NPDES Permit Number
Facility Name
OuHall Number
Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant
001
OMB No. 2040-0004
Presence or Absence
check
one
Effluent
Intake
(Optional)
Pollutant
Believed
Believed
Units
(specify)
Maximum Daily
Maximum
Long -Term
Long -Term
Present
Absent
Discharge
Monthly
Average Daily Number of
Average Number of
(required)
Discharge
Discharge Analyses
Analyses
Value
if available
if available
24. Radioactivity
Alpha, total
❑
❑✓
Concentration
Mass
-
❑
❑✓
Beta, total
Concentration
Mass
Radium, total
❑
❑✓
Concentration
Mass
Radium 226, total
❑
❑✓
Concentration
Mass
' Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 25

This page intentionally left hlank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No.2040-0004
•1• I • r
Presence or Absence
Pollutant check one Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
1.
Asbestos
❑
Ej
2.
Acetaldehyde
❑
0
3.
Allyl alcohol
❑
0
4.
Allyl chloride
❑
10
5.
Amyl acetate
❑
❑✓
6.
Aniline
❑
❑�
7.
Benzonitrile
❑
✓❑
8.
Benzyl chloride
❑
0
9.
Butyl acetate
❑
❑✓
10.
Butylamine
❑
❑✓
11.
Captan
❑
❑✓
12.
Carbaryl
❑
✓❑
13.
Carbofuran
❑
0
14.
Carbon disulfide
❑
❑
15.
Chlorpyrifos
❑
❑✓
16.
Coumaphos
❑
❑✓
17.
Cresol
❑
✓❑
18.
Crotonaldehyde
❑
❑✓
19.
Cyclohexane
❑
❑✓
EPA Form 3510-2C (Revised 3-19) Page 27

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No.2040-0004
'1� I • 1
Presence or Absence
Pollutant check one Available Quantitative Data
Believed Believed Reason Pollutant Believed Present in Discharge (specify units)
Present Absent
20.
2,4-D (2,4-dichlorophenoxyacetic acid)
❑
❑✓
❑✓
21.
Diazinon
❑
22.
Dicamba
❑
❑✓
23.
Dichlobenil
❑
❑✓
24.
Dichlone
❑
❑✓
25.
2,2-dichloropropionic acid
❑
26.
Dichlorvos
❑
✓❑
27.
Diethyl amine
❑
✓❑
28.
Dimethyl amine
❑
❑✓
29.
Dintrobenzene
❑
❑✓
30.
Diquat
❑
❑✓
31.
Disulfoton
❑
✓❑
32.
Diuron
❑
❑✓
33.
Epichlorohydrin
❑
0
34.
Ethion
❑
❑✓
35.
Ethylene diamine
❑
✓❑
36.
Ethylene dibromide
❑
✓❑
37.
Formaldehyde
❑
✓❑
38
Furfural
❑
✓❑
EPA Form 3510-2C (Revised 3-19) Page 28

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No. 2040-0004
Presence or Absence
Pollutant check one Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
39.
Guthion
❑
❑✓
40.
Isoprene
❑
❑✓
41.
Isopropanolamine
❑
❑�
42.
Kelthane
❑
43.
Kepone
❑
0
44.
Marathion
❑
0
45.
Mercaptodimethur
❑
0
46.
Methoxychlor
❑
El
47.
Methyl mercaptan
❑
IZI
I
48.
Methyl methacrylate
❑
49.
Methyl parathion
❑
❑
50.
Mevinphos
❑
51.
Mexacarbate
❑
52.
Monoethyl amine
❑
53.
Monomethyl amine
❑
54.
Naled
❑
0
55.
Naphthenic acid
❑
❑
56.
Nitrotoluene
❑
57.
Parathion
❑
0
EPA Form 3510-2C (Revised 3-19) Page 29

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant 001 OMB No.2040-0004
1I I I'I• 1 Mile 1
Presence or Absence
Pollutant check one Reason Pollutant Believed Present in Discharge Available Quantitative Data
Believed Believed (specify units)
Present Absent
58.
Phenolsulfonate
❑
❑�
_
59.
Phosgene
❑
❑✓
60.
Propargite
❑
61.
Propylene oxide
❑
✓❑
62.
Pyrethrins
❑
✓❑
63.
Quinoline
❑
❑✓
64.
Resorcinol
❑
❑✓
65.
Strontium
❑
❑✓
66.
Strychnine
❑
❑✓
67.
Styrene
❑
❑✓
✓❑
68
2,4,5-T (2,4,5-trichlorophenoxyacetic
acid
❑
69.
TDE (tetrachlorodiphenyl ethane)
❑
❑✓
70
2,4,5-TP [2-(2,4,5-trichlorophenoxy)
ro anoic acid
❑
❑
71.
Trichlorofon
❑
❑✓
72.
Triethanolamine
❑
❑✓
73.
Triethylamine
❑
❑✓
74.
Trimethylamine
❑
❑✓
75.
Uranium
❑
❑✓
76.
Vanadium
❑
❑✓
EPA Form 3510-2C (Revised 3-19) Page 30

EPA Identification Number
NPDES Permit Number Facility Name Outfall Number
Form Approved 03/05/19
NC0006548 Wayne Farms Dobson Fresh Plant 001
OMB No.2040-0004
Presence or Absence
Pollutant
check one
Reason Pollutant Believed Present in Discharge
Available Quantitative Data
Believed Believed
(specify units)
Present Absent
77.
Vinyl acetate
❑
❑✓
78.
Xylene
❑
❑✓
79.
Xylenol
❑
❑✓
80.
Zirconium
❑
❑✓
' Sampling shall be conducted according to sufficiently sensitive test procedures (i.e., methods) approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I, subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C (Revised 3-19) Page 31

This page intentionally left blank.

EPA Identification Number
Pollutant
2,3,7,8-TCDD
Facility Name
NC0006548 Wayne Farms Dobson Fresh Plant
r,ENZO P 1 • 11 1
TCDD Presence or
Congeners Absence
Used or check one
Manufactured Believed Believed
Present I Absent
❑ I ❑ 1❑
Outfall Number
Results of Screening Procedure
Form Approved 03/05/19
OMB No. 2040-0004
EPA Form 3510-2C (Revised 3-19) Page 33

EPA Identification Number
NPDES Permit Number Facility Name Form Approved 03/05/19
NC0006548 Wayne Farms j(� 1((S�„ � OMB No. 2040-0004
SECTIONCERTIFICATION
In Column 1 below, mark the sections of Form 2C that you have completed and are submitting with your application.
12.1
For each section, specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to com lete all sections or provide attachments.
Column 1
Column 2
❑✓ Section 1: Outfall Location
❑ w/ attachments
❑✓ Section 2: Line Drawing
✓❑ w/ line drawing ❑ w/ additional attachments
w/ list of each user of
Section 3: Average Flows and
❑✓
✓❑ w/ attachments ❑ privately owned treatment
Treatment
works
❑ Section 4: Intermittent Flows
❑ w/ attachments
❑� Section 5: Production
❑ w/ attachments
w/ optional additional
❑ Section 6: Improvements
❑ w/ attachments ❑ sheets describing any
additional pollution control
plans
❑ w/ request for a waiver and ❑ w/ explanation for identical
supporting information outfalls
d
w/ small business exemption w/ other attachments
El
❑
request
Nd
❑ Section 7: Effluent and Intake
❑✓ w/ Table A w/ Table B
Characteristics
0
✓❑ w/ Table C ❑✓ w/ Table D
d
❑✓ w/ Table E ❑ w/ analytical results as an
0
attachment
8: Used or Manufactured
El
w/
❑ w/ attachments
Toxics
Section 9: Biological Toxicity
❑
❑ w/ attachments
r
Tests
U
❑ Section 10: Contract Analyses
❑ w/ attachments
❑ Section 11. Additional Information
❑ w/ attachments
❑✓ Section 12: Checklist and
❑ w/ attachments
Certification Statement
12.2
Certification Statement
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 qualified personnel properly gather and evaluate 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 fine and imprisonment for knowing violations.
Name (print or type first and last name)
Official title
Kevin McDaniel
Senior VP and GM Fresh
Signature
Date signed
EPA Form 3510-2C (Revised 3-19) Page 7

Attachments
Attachment #1: Topographic Map of the Facility with property lines
Attachment #2: Process Flow Diagram
Attachment #3: Facility and Discharge Point Diagram

Attachment 1

Attachment 2
Processing Plant
0.527 MGD average
Nitrification Reactor
1.5 MG
Splitter Box
I Meat Screen I
I Feather Screen I
Anoxic Reactor
0.6 MG
35-ft. Clarifier
0.05 MG
60-ft. Clarifier
0.317 MG
Screen Effluent Tank
0.035 MG
Condenser Water
0.010 MGD average
FEB Tank
0.5 MG
Stormwater (First Flush)
Covered FEB Lagoon 2.5 MG D.A.F
1200 gpm
Chlorine Contact
Chamber
Dechlorination
Chamber
Outfall 001
Fisher River

Attachment 3
{ • ow13�9 • _
N-�w Hope
Outfall 001
/ '•',,1 - `�`` 1;` ,' (flows S)
:htil.& Ct
Hwy 601 bypass { •• >
u \.
Discharge line (flows north);
r in F1wy 601 right-of-way, i
(approximate location) i
_ f Rockford Street
(US Hwy 60 1Shp
Wayne Farms LLC
1 Fisher River
•� (flows SE)
i >
As
11
S.1ti4ain Street ;of
Wayne
Farms LLC
Dobson Fresh Plant W WTP
State Grid:
BihNW
USGS Ouad: Dvhson, Vi
Receiving Stream: Fisher River
Stream Class: C
Draninaee Basin: Yadkin -Pew Dee
Stream Seemeot: 12-63-191
Latitude:
36' 24' 3'7- N
Sub -Basin: 03-'i7-02
Louatude:
80' 41 ' 22- W
Ht C: 03,01401411
U North
NPDES Permit N00006548
Surn- County