290014_Rescission Request_20220712

RECEIVED
JUL 12 2022
NC DEQ/DWR
Central Office
Ramesh Ravella
Program Manager
Animal Feeding Operations Program
Division of Water Resources
North Carolina Department of Environmental Quality
1636 Mail Service Center
Raleigh, NC 27699-1636
RE: Request for Rescission of NCDEQ AFO Permit
Dear Mr. Ravella:
Crousedale Farm, LLC.
Leslie R Crouse
1231 Cedar Springs Road
Lexington, NC 27292
As the permittee, owner, and operator of the Crousedale Farm, LLC. in Davidson County, I am
respectfully requesting immediate rescission of the North Carolina DEQ Animal Feeding Operation
(AFO) permit corresponding to the following information:
- Facility: Crousedale Farm, LLC.
- Permittee: Leslie R Crouse
- Permit #: AWC290014
Closure of the waste storage ponds was completed on 7/1/22. Closure forms are included with this request
OR have been previously provided to DWR.
Please send confirmation of rescission of this permit to my home address provided above. I appreciate
your timely response to this matter. If there are any questions, additional information, or actions required
to fulfill this request, please contact me at - or 336-250-4288. Thank you for your assistance.
Sincerely,
Leslie R Crouse
Crousedale Farm, LLC.
cc: Rebecca Chandler; Winston-Salem Regional Office, NC DEQ

Animal Waste Storage Pond and Lagoon Closure Report Form
(Please type or print all information that does not require a signature)
General Information:
Name of Farm: Crousedale Farm, LLC.
Owner(s) Name: Leslie R Crouse
Mailing Address: 1231 Cedar Springs Rd,
Lexington, NC 27292
Facility No: AWC 290014
Phone No: gn' L ?J 9
County: Davidson
Operation Description (remaining animals only):
i Please check this box if there will be no animals on this farm after lagoon closure. If there will still be animals on the ste after
lagoon closure, please provide the following information on the animals that will remain.
Operation Description:
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Dairy No. of Animals
o Wean to Feeder o Layer o Milking
o Feeder to Finish o Non -Layer o Dry
o Farrow to Wean Type of Beef No. of Animals o Heifers
o Farrow to Feeder o Brood o Calves
o Farrow to Finish o Feeders
o Gilts o Stockers
o Boars Other Type of Livestock: Number of Animals:
Will the farm maintain a number of animals greater than the G.S. § 143-215.10B threshold? Yes o No o
Will other lagoons be in operation at this farm after this one closes? Yes o No &
How many lagoons are left in use on this farm?: None
(Name) Rebecca Chandler of the Water Quality Regional Operations Section staff in the Division of Water
Resources' Winston Salem Regional Office (see map on back) was contacted on 10/4/21 (date) for
notification of the pending closure of this pond or lagoon. This notification was at least 24 hours prior to the start of
closure, which began on 3/1/2022 (date).
I verify that the above information is correct and complete. I have followed a closure plan, which meets all NRCS
specifications and criteria. I realize that I will be subject to enforcement action per Article 21 of the North Carolina
General Statutes if I fail to properly close out the lagoon.
Name of Land Owner (Please Print): C rd u5 € CAP a 1 E'- Fi r yvi , L L C. b,j Leslie te b' ou s e
Signature: ec C 4.rr�a n': L :; .... �'.: r ki C-C e Date: 7 / 2 $ j? a 2 2—
The facility has followed a closure plan which meets all requirements set forth in the NRCS Technical Guide Standard
360. The following items were completed by the owner and 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): 7 o e r- + A . (A N b 1 Y) M" l t t l C r"
Affiliation:
b4V1,So tJ ,S vst Cb
Address (Agency): Of l6n/Ti 5 ► . �eX ti ff} Phone No.:V.21.4-2--
336-2Y-Z —Z9 8 /
Signature: �'� Date: ]/
Return within 15 days following completion of animal water storage pond or lagoon closure to:
N. C. Division of Water Resources
Animal Feeding Operations Branch RECEIVED
1636 Mail Service Center
Raleigh, NC 27699-1636
JUL 12 2022
PLC - 1 Nov 19, 2013
NC DEQ/DWR
Central Office