WQ0043923_Application_20221031

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Animal Feeding Operations Permit Application Form
(THIS FORM MAYBE PHOTOCOPIED FOR USE AS AN ORIGINAL)
Distribution of Animal Waste Residual Solids
This application is intended for facilities which distribute materials which have been processed with animal
waste solids with no domestic sewage contribution.
1. GENERAL INFORMATION
1.1 Application date:
1.2 Applicant's name (please specify the name of the corporation, individual, etc.):
1.3 Print owner's or signing official's name and title (the person legally responsible for the facility and its compliance):
1.4 Mailing address:
City: State: Zip:
Telephone number: ( ) Fax: ( )
E-mail:
1.5 Fee submitted: $ [Major, $180 if>3,000 dry ton/year; Minor, $60 if < 3,000 dry ton/year]
1.6 Specify the process facility's owner classification: ❑ private ❑ federal ❑ state ❑ local government
1.7 Specify the source of the animal waste product: ❑ poultry ❑ swine ❑ cattle ❑ other (explain)
1.8 Specify how these residuals will be distributed: ❑ sold or given away in bags or other containers ❑ lawn (bulk)
❑ home garden (bulk) ❑ other (explain)
1.9 Estimated volume of waste product to be processed annually: dry tons/year
1.10Physical address of animal waste generating facility:
City: State: Zip:
1.11 Physical address of animal waste process facility:
City: State: Zip:
1.12 County where animal waste process facility is located (if in North Carolina):
1.13 Latitude:
Longitude: of animal waste process facility
1.14 Are new facilities to be constructed in North Carolina? ❑ yes ❑ no. If "yes", please include three (3) sets of plans and
specifications with the application for approval.
2. PERMIT INFORMATION
2.1 Application No. (to be completed by DWR):
2.2 Specify the application type: ❑ new ❑ renewal ❑ modification renewal ❑ with modification
For renewals, complete all sections included in the application. The engineering signature and seal are not required for
renewals, or if there is not any construction involved with the subject project.
2.3 If this application is being submitted as a renewal or modification of an existing permit, list the existing permit number:
and its issue date:
FORM: DARS 04/2020 Page 1 of 5

3. CHEMICAL POLLUTANT INFORMATION
3.1 Please complete a chemical analysis of each residual material. Each analysis must include the parameters listed in the table
below as well as any other known or suspected contaminants of concern. Animal waste residuals cannot be sold or given
away if the concentration of any pollutant in the residuals exceeds any of the Ceiling Concentrations specified in the table
below on a dry -weight basis (mg/kg). Fill out the pollutant concentrations of the residuals in the table below (attach all lab
analyses):
Pollutant
Pollutant Concentration
dry weight (mg/kg)
Pollutant Ceiling Concentration
dry weight (mg/kg)
Copper
1500
Zinc
2800
3.2 Were any pilot or bench -scale studies performed on the residual material? ❑ yes ❑ no. If "yes", please provide the
results of those studies, including the approximate fertilizer equivalent of the material.
4. PATHOGEN REDUCTION INFORMATION
In accordance with 15A NCAC 02T .1310, animal waste residuals shall be monitored for the density of fecal coliform or
Salmonella sp. Bacteria at the time the residuals are used or disposed, or at the time they are prepared for sale or giving away
for land application. Sampling results must demonstrate compliance with pathogen limit in either Part A or Part B below
(please submit all lab analyses, test results, and calculations). Please check which of the following applies to the subject
residual:
Part A ❑ A fecal coliform density less than 1000 Most Probable Number per gram of total dry solids
Part B ❑ A Salmonella sp. density less than 3 Most Probable Number per 4 grams of total dry solids
Part C Please select the method used to achieve compliance with respect to pathogen limit requirements.
❑ Alkaline treatment — the pH of the residuals is raised to greater than 12 for at least 72 hours. During this time, the
temperature of the residuals should be greater than 52° C for at least 12 hours. In addition, after the 72-hour period,
the residuals shall; be air-dried to greater than 50% total solids.
❑ Composting — using either the within -vessel or static aerated pile composting methods, the temperature of the
residuals are raised to 55° C or higher for three days. Using the windrow composting method, the residuals are
raised to 55° C or higher for fifteen days. During the high temperature period, there will be a minimum of five
turnings of the windrow.
❑ Heat Drying — residuals are dried by direct or indirect contact with hot gases to reduce the moisture content of the
residuals to 10% or lower. Either the temperature of the gas in contact with the residuals exceeds 80° C or the wet
bulb temperature of the gas in contact with the residuals, when the residuals leave the dryer, exceeds 80° C.
❑ Heat Treatment — liquid residuals are heated to a temperature of 180° C or higher for thirty minutes.
❑ Pasteurization — the temperature of the residuals is maintained at 70° C or higher for at least thirty minutes.
❑ Other — please describe in detail.
FORM: DARS 04/2020 Page 2 of 5

5. PROCESS INFORMATION
5.1 Please provide a brief narrative concerning materials handling and processing, including the following:
a. How will the animal waste product be handled and transported from where they are produced to where they will be
treated?
b. Where will the animal waste residuals be stored until processing?
c. How will the animal waste be treated and what will be the duration of treatment of the animal waste product? Provide
detailed description and all necessary calculations, designs, site maps, and supporting documentation
d. Where will the final product be stored?
e. How will leachate collection from the raw product storage, treatment facility, and finished product storage be handled?
f. How long will the final product be stored before being distributed?
g. How will the final product be distributed (packaging), if applicable?
5.2 Please provide a sampling and monitoring plan that describes how the animal waste residuals will comply with Sections 3
and 4 of this application. [15A NCAC 02T .1310 (b)]
5.3 Please attach a marketability statement detailing destinations and approximate amounts of the final product to be
distributed. [15A NCAC 02T .1310 (b)]
5.4 Please provide either a label, which shall be affixed to the bagged processed animal waste residual, or an information
sheet, which shall be provided to the person who receives the processed animal waste residual. The label or information
sheet shall contain, at a minimum, the following information [15A NCAC 02T .1310 (b)] :
a. The name and address of the person who prepared the animal waste residual that is sold or given away in a bag or
other container for application to the land.
b. A statement that application of the animal waste residual to the land is prohibited except in accordance with the
instructions on the label or information sheet.
c. A statement that animal waste residuals must be applied at agronomic rates and recommended rates for intended uses.
d. A statement that the animal waste residuals shall not be applied to any site that is flooded, frozen, or snow-covered.
e. A statement that adequate procedures shall be provided to prevent surface runoff from carrying any disposed or stored
animal waste residuals into any surface waters.
f. A statement which identifies that this material shall be prevented from entering any public or private water supply
source (including wells) and any stream, lake, or river.
g.
The pollutant concentrations for the pollutants listed in Section 3 above measured to be in the animal waste residual.
h. The nitrogen and phosphorus concentration in the animal waste residual.
FORM: DARS 04/2020 Page 3 of 5

6. PROFFESSIONAL ENGINEER'S CERTIFICATION
NOTE: Engineer's Certification is required only for construction of new treatment and/or storage facilities to be
located in North Carolina.
Name of engineering firm:
Mailing address:
City: State: Zip:
Telephone: ( ) Fax: ( )
E-mail:
I, , attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I further attest that, to the best of my
knowledge, the proposed design has been prepared in accordance with the applicable regulations. Although certain portions of
this submittal package may have been developed by other professionals, inclusion of these materials under my signature and
seal signifies that I have reviewed the material and have judged it to be consistent with the approved design.
North Carolina Professional Engineer's seal, signature, and date:
7. APPLICANT'S CERTIFICATION (include a designation letter if signing for the Permittee)
I, , attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all required parts of
this application are not completed and that, if all required supporting information and attachments are not included, this
application package will be returned to me as incomplete.
Signature:
PLEASE SUBMIT THE COMPLETED APPLICATION PACKAGE, ALL SUPPORTING INFORMATION AND MATERIALS,
AND ANY PLANS AND SPECIFICATIONS TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
ANIMAL FEEDING OPERATIONS PROGRAM
1636 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1636
TELEPHONE NUMBER: [phone]
ELECTRONIC SUBMISSION IS ENCOURAGED. EMAIL TO [e-mail]
FORM: DARS 04/2020
Page 4 of 5

DIVISION OF WATER RESOURCES REGIONAL OFFICES (4/2020)
Asheville Regional WQROS Supervisor
2090 U.S. Highway 70
Swannanoa, NC 28778
[phone]
Fax [phone]
Avery Macon
Buncombe Madison
Burke McDowell
Caldwell Mitchell
Cherokee Polk
Clay Rutherford
Graham Swain
Haywood Transylvania
Henderson Yancey
Jackson
Fayetteville Regional WQROS
225 Green Street, Suite 714
Fayetteville, NC 28301-5094
[phone]
Fax [phone]
Anson Moore
Bladen Richmond
Cumberland Robeson
Harnett Sampson
Hoke Scotland
Montgomery
Washington Regional WQROS Supervisor
943 Washington Square Mall
Washington, NC 27889
[phone]
Fax [phone]
Beaufort Jones
Bertie Lenoir
Camden Martin
Chowan Pamlico
Craven Pasquotank
Currituck Perquimans
Dare Pitt
Gates Tyrell
Greene Washington
Hertford Wayne
Hyde
SupervisorMooresville Regional WQROS Supervisor
610 East Center Avenue
Mooresville, NC 28115
[phone]
Fax [phone]
Alexander
Cabarrus
Catawba
Cleveland
Gaston
Iredell
Winston-Salem Regional WQROS Supervisor
450 Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Phone [phone]
Fax [phone]
Alamance Rockingham
Alleghany Randolph
Ashe Stokes
Caswell Surry
Davidson Watauga
Davie Wilkes
Forsyth Yadkin
Guilford
Lincoln
Mecklenburg
Rowan
Stanly
Union
Raleigh Regional WQROS Supervisor
1628 Mail Service Center
Raleigh, NC 27699-1628
[phone]
Fax [phone]
Chatham
Durham
Edgecombe
Franklin
Granville
Halifax
Johnston
Lee
Nash
Northampton
Orange
Person
Vance
Wake
Warren
Wilson
Wilmington Region WQROS Supervisor
127 Cardinal Drive Extension
Wilmington, NC 28405-3845
[phone]
Fax [phone]
Brunswick
Carteret
Columbus
Duplin
New Hanover
Onslow
Pender
FORM: DARS 04/2020 Page 5 of 5