450002_More Information (Received)_20201222

Animal Waste Storage Fond and Lagoon Closure Report Form
(Pleaso type or print all information that does not require a sigimeve)
Gwnet(s)
Mailing )
fc.FY/tIE'/V )V �$732:
Operation Description (remaining animals onlvl:
11 lease cheekthis box if then: will be no animals on this fans: after lagoon closure: bribers will still be animals on the site after
)a on closure,. please, provide the following information on the animals that will remain. -
Operation Description:
Type ofSWme No. ofAnrmals Type gfPoulay Na. of Animals. Type of Dairy No, of Animals
. Wean. to Feeder aLayer .Milking A
a Feeder to Finish a Non -Layer q Dry O
•Farrow to Wean. 1'ype of Beef No., ofAninals
.Farrow to Feeder -.Brood gCalves
o Farrow to Finish o Feeders
o Gilts aStookers
o@oarg Other Type of Livestock. NnmberofAnlmalr:
Will the farm maintain a number of animals greater than the G.S. § 143-215. IOB threshold? Yes o: N`o
Will other lagoons be in operation at this farmafter this one closes? Yes o. No
How many lagoons are left in use on this farm?; Idt
(Name),SM 17c')S of the Water Quality Regional Operations Section staff in: the
Division of Water Resources' SNEV S(.,4.�_.._.. Regional Office (see map on back). was
contacted on 7^ 7T_7-4n-(dote) for notification of the pending olVuc ofthis pond or lagoon. This notification was.
at least 24 hours: prior to the stark of closure, which began on. i-° � ` .7.f7 (elate).
I verify that the above information is correct and complete. Ihave followed a closure plan, which meets. all NRCS
specificationsand criteria, I realize that I willbe subject to, enforcementaction per Article21 of the North Carolina
General Statutes if I fail to properly close out the lagoon, -
Name. of Land
The facility has followed a closure plan whichmeets all requirrements set forth in the MRCS Technical Guide Standard
360, The following items werre. completed by the ownor mul verified by me: all waste liquids and sludges have been
removed and land applied at agronomic rate, all input pipes have been removed, all slopes have been stabilized as
necessary, and vegetation established on all disturbed areas.
Name of Technical Specialist(Please Print);Jake Stokes
Affiliation: USDA NRCS Area Engineer
.a.a.. ff ...,., %, 58RRaccoartRoad. Wavnesville. NC 28786 nl,,., m. - 119R-506-9953
Return within 15 days fallowing completion of animal water storage pond or lagoon closure to:
N. C. Division of Water Resources
Animal. Feeding Operations Branch
1636 Mail Service Center
Raleigh,NC 27699-1636
PLC - 1 Nov 19, 2013