760005_Rescission Request_20220908

RECEIVED
SEP 0 8 2022
Ramesh Ravella NO DEQIDWR
Program Manager Central Office
Animal Feeding Operations Program
Division of Water Resources
North Carolina Department of Environmental Quality
Raleigh, NC 27699-1636
RE: Request for Rescission of NCDEQ AFO Permit
Dear Mr. Ravella:
Kim S Griffin
7377 Overman Rd
Liberty, NC 27298
As the permittee, owner, and operator of the KLS Swine Farm, LLC in Randolph County, I am respectfully
requesting immediate rescission of the North Carolina DEQ Animal Feeding Operation (AFO) permit
corresponding to the following information:
- Facility: KLS Swine Farm, LLC
- Permittee: Kim S Griffin
- Permit #: 76-05
Closure of the waste storage ponds was completed on September 1, 2022. 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 [phone]. Thank you for your assistance.
Sincerely,
//./4;1 -SeW4
Kim S Griffin
CC: Rebecca Chandler; Winston 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: 14.LS SSW 1V12 Y1M LL G Facility No:1 h - 6OO5
Owner(s) Name: k MI92 rki (i ri n
Mailing Address: 13 1 I ape 2v f - iJ
Lib it
Phone No: S. 4
County: cv1 p1--)
Operation Description (remaining animals only):
'Please check this box if there will be no animals on this farm after lagoon closure. If there will still be animals on the site 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. § 143-215.1OB threshold?
Will other lagoons be in operation at this farm after this one closes?
How many lagoons are left in use on this farm?:
Yes o No 0
Yes o No V#
of the Water Quality Regional Operations Section staff in the
Division of Wa er Resources' I. . y1 t rt - lP 1yj Regional Office (see map on back) was
contacted on (date) for notification of the pending closure of this pond or lagoon. This notification was
at least 24 hours pr r to the start of closure, which began on ALA \ go2- t (date).
(Name) 12-LXCCCarder
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 (Ple. se P int):// 1 -.ORAC;C /t/
Signature: j / � Date: 9- J �� 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. (� PC34-D_-[ GJJ)C)1(\,
Name of Technical Specialist (Please Print):
Affiliation:
Address (
Signature:
PLC - 1 Nov 19, 2013
LAW Ablilb
4f y) "! • y ��4.4S..\\ (�Z
04010
telliPP:kiih,5 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 SEP 0 8 ZO2Z
NO DEQ/DWFi
Central Office
Ll �. Phone iRone ct9 0-)3
li No.: jor*".._
'IA, I2-2 Date: 6it ([ z