860010_Application_20230412 (2)

Animal Waste Management Plan Certification
(Please type or print all information that does not require a signature)
[Existing,>or New or Expanded (please circle one)
General Information: Permit No: AWC8610
Name of Farm: KooBa Farms Facility No: _86 -- 10
Owner(s) Name: KooBa Farms, LLC
Mailing Address:1719 PeM Tew Mill Road, Roseboro NC 28382
Farm Location:
Latitude and Longitude: _36 _30
Phone No:704-682-2560
County Farm is located in: Surry
_05 / _80_ 43_ _15_ Integrator:
Please attach a copy of a county road map with location identified and describe below (Be specific: road
names, directions, milepost, etc.): Exit 6 off HWY 74W, N on HWY 89N, Left on Pine Ridge, Farm on
Right
Operation Description:
Type of Swine No. ofAnimalc
o Wean to Feeder
o Feeder to Finish
o Farrow to Wean
o Farrow to Feeder
o Farrow to Finish
o Gilts
o Boars
Type of Poultry No. of Animals
o Layer
o Non -Layer
Type of Beef No. of Animals
o Brood
o Feeders
o Stockers
Other Type gfLivestock:
Type of Dairy No. of Animals
o Milking
o Dry
o Heifers 800
o Calves 200
Number ofAnimals:
Expanding Operation Only
Previous Design Capacity: Additional Design Capaci • Total Design Capacity:
Acreage Available for Application: 365.1 Required Acreage: 88
Number of waste structures: _2 Total Capacity: _187,839 Cubic Feet (ft3)
Are subsurface drains present on the farm: YES or(E)
r NO (please circle one)
If YES: are subsurface drains present in the area of the waste structures (please circle one or both as applicable)
Owner / Manager Agreement
I (we) verify that all the above information is correct and will be updated upon changing. I (we) understand the operation and
maintenance procedures established in the approved animal waste management plan for the farm named above and will
implement these procedures. I (we) know that any expansion to the existing design capacity of the waste treatment and
storage system or construction of new facilities will require a permit application and a new certification to be submitted to the
Division of Water Resources (DWR) and permit approval received before the new animals are stocked. T (we) understand that
there must be no discharge of animal waste from the storage system to surface waters of the state unless specifically allowed
under a permit from DWR and there must not be run-off from the application of animal waste. I (we) understand that run-off
of pollutants from lounging and heavy use areas must be minimized using technical standards developed by the USDA -
Natural Resources Conservation. Service (NKCS). The approved plan will be filed at the farm and at the DWR Regional
Office and the office of the local Soil and Water Conservation District (SWCD). I (we) know that any modification must be
approved by a technical specialist and submitted to the DWR Regional Office and local SWCD and required approvals
received from DWR prior to implementation_ A change in farm ownership requires a permit application to be sent to DWR
along with a new certification (if the approved plan is changed).
Name of Land Owner:
Signature• Date: O 4 -1 I Qw-3 ,
Name of Manager if different from owner):
Signature:
AWC - September 18, 2006
Date:

Technical Specialist Certification
L As a technical specialist designated by the North Carolina Soil and Water Conservation Commission pursuant to 15A
NCAC 6H .0104, I certify that the animal waste management system for the farm named above has an animal waste
management plan that meets or exceeds standards and specifications of the Division of Water Resources as specified in 15A
NCAC 2T .1300 (formerly 2H .0217) and the USDA -Natural Resources Conservation Service and/or the North Carolina Soil
and Water Conservation Commission pursuant to 15A NCAC 2T .1300 (formerly 2H .0217) and 15A NCAC 6F .0101-.0105.
The following elements are included in the plan as applicable. While each category designates a technical specialist who
may sign each certification (SD, SI, WUP, RC, 1), the technical specialist should only certify parts for which they are
technically competent.
IL Certification of Design
A) Collection, Storage, Treatment System
Check the appropriate box
w" Existing facility without retrofit (SD or WUP)
Storage volume is adequate for operation capacity; storage capability consistent with waste utilization
requirements.
o New, expanded or retrofitted facility (SD)
Animal waste storage and treatment structures, such as but not limited to collection systems, lagoons and ponds,
have been designed to meet or exceed the minimum standards and specifications.
Name of Technical Specialist (Please Print):Michael Shepherd
Affiliation NCDA&CS DSWC
Date Work Completed: 4/11/2023
Address (Agency): 212 W Jones S Raleigh NC 27699 Phone No.:336-940-8901
Signature: Date: %' /(-- 2 ` Z- 3
B) Land Application Site (WUP)
The plan provides for minimum separations (buffers); adequate amount of land for waste utilization; chosen crop is suitable
for waste management; and the hydraulic and nutrient loading rates are appropriate for the site and receiving crop.
Name of Technical Specialist (Please Print): Michael Shepherd
Affiliation NCDA&CS DSWC Date Work Completed: 4/11/2023
Address (Agency): 6 W ones St Ralle'gh/NC 27699
Signature:L/�y�
C) Runoff Controls from Exterior Lots
Check the appropriate box
o Facility without exterior lots (SD or WUP or RC)
This facility does not contain any exterior lots.
Phone No.:336-940-8901
Date: q-1/- ;? 02.3
o Facility with exterior lots (RC)
Methods to minimize the run off of pollutants from lounging and heavy use areas have been designed m
accordance with technical standards developed by MRCS.
Name of Technical Specialist (Please Print):
Affiliation Date Work Completed:
Address (Agency): Phone No.:
Signature: _ Date:
AWC - September 18, 2006

D). Application and Handling Equipment
Check the appropriate box
,u, Existing or expanding facility with existingwaste aste application equipment (WUP or I)
Animal waste application equipment specified in the plan has been either field calibrated or evaluated in
accordance with existing design charts and tables and is able to apply waste as necessary to accommodate the
waste management plan: (existing application equipment can cover the area required by the plan at rates not to
exceed either the specified hydraulic or nutrient loading rates, a schedule for timing of applications has been
established; required buffers can be maintained and calibration and adjustment guidance are contained as part of
the plan).
New, expanded, or existing facility without existing waste application equipment for spray irrigation (I)
Animal waste application equipment specified in the plan has been designed to apply waste as necessary to
accommodate the waste management plan; (proposed application equipment can cover the area required by the
plan at rates not to excccd either the specified hydraulic or nutrient loading rates; a schedule for timing of
applications has been established; required buffers can be maintained; calibration and adjustment guidance are
contained as part of the plan).
New, expanded, or existing facility without existing waste application equipment for land spreading not using
gray irrigation. (WUP or I)
Animal waste application equipment specified in the plan has been selected to apply waste as necessary to
accommodate the waste management plan; (proposed application equipment can cover the area required by the
plan at rates not to exceed either the specified hydraulic or nutrient loading rates; a schedule for timing of
applications has been established; required buffers can be maintained; calibration and adjustment guidance are
contained as part of the plan).
Name of Technical Specialist (Please Print): Michael Shepherd
Affiliation NCDA&CS DSWC Date Work Completed: 4/11/2023
Address (Agency): 212,E W Jones S Raleigh NC 27699 Phone No.:336-940-8901
Signature: Date:
E) Odor Control, Insect Control Mortality Management and Emergency Action Plan (SD,
SI, WUP, RC or D
The waste management plan for this facility includes a Waste Management Odor Control Checklist, an Insect Control
Checklist, a Mortality Management Checklist and an Emergency Action Plan. Sources of both odors and insects
have been evaluated with respect to this site and Best Management Practices to Minimize Odors and Best
Management Practices to Control Insects have been selected and included in the waste management plan. Both the
Mortality Management Plan and the Emergency Action Plan are complete and can be implemented by this facility.
Name of Technical Specialist (Please Print): Michael Shepherd
Affiliation NCDA&CS DSWC Date Work Completed: 4/11/2023
Address (1
Signature:
Phone No.:336-940-8901
Date: /° 3
F) Written Notice of New or Expanding Swine Farm
The following signature block is only to be used for new or expanding swine farms that begin construction after June
21, 1996. If the facility was built before June 21,1996, when was it constructed or last expanded
I (we) certify that I (we) have attempted to contact by certified mail all adjoining property owners and all property owners
who own property located across a public road, street, or highway from this new or expanding swine farm. The notice was in
compliance with the requirements of NCGS 106-805. A copy of the notice and a list of the property owners notified are
attached.
Name of Land Owner:
Signature.
Name of Manager (if different from owner):
Date;
Signature: Date:
AWC - September 18, 2006 3

III. Certification of Installation
A) Collection, Storage, Treatment Installation
New, expanded or retrofitted facility (SI)
Animal waste storage and treatment structures, such as but not limited to lagoons and ponds, have been installed in
accordance with the approved plan to meet or exceed the minimum standards and specifications.
For existing facilities without retrofits, no certification is necessary.
Name of Technical Specialist (Please Print):
Affiliation Date Work Completed:
Address (Agency
Signature:
B) Land Application Site (WUP)
Phone No.:
The cropping system is in place on all land as specified in the animal waste management plan.
Name of Technical Specialist (Please Print):
Affiliation Date Work Completed:
Address (Agency):
Signature:
Date:
No.:
C) Runoff Controls from Exterior Lots (RC)
Facility with exterior lots
Methods to minimize the run off of pollutants from lounging and heavy use areas have been installed as specified
in the plan.
For facilities without exterior lots, no certification is necessary.
Name of Technical Specialist (Please Print):
Affiliation Date Work Completed:
Address (Agency): Phone No.:
Signature: Date:
D) Application and Handling Equipment Installation (WUP or I)
0 Animal waste application and handling equipment specified in the plan is on site and ready for use; calibration
and adjustment materials have been provided to the owners and are contained as part of the plan.
o Animal waste application and handling equipment specified in the plan has not been installed but the owner
has proposed leasing or third party application and has provided a signed contract; equipment specified in the
contract agrees with the requirements of the plan; required buffers can be maintained; calibration and
adjustment guidance have been provided to the owners and are contained as part of the plan.
Name of Technical Specialist (Please Print):
Affiliation Date Work Completed:
Address (Agency):
Signature:
AWC - September 18, 2006 4
Phone No.:

E) Odor Control, Insect Control and Mortality Management (SD, SI, WUP, RC or I)
Methods to control odors and insects as specified in the Plan have been installed and are operational. The
mortality management system as specified in the Plan has also been installed and is operational.
Name of Technical Specialist (Please Print):
Affiliation Date Work Completed:
Address (Agency):__
Phone No.:
Signature: Date:
Please return the completed form to the Division of Water Resources at the following address:
Department of Environment and Natural Resources
Division of Water Resources
Animal Feeding Operations Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
Please also remember to submit a copy of this form along with the complete Animal Waste
Management Plan to the DWR Regional Office and the local Soil and Water Conservation
District Office and to keep a copy in your files with your Animal Waste Management Plan.
AWC - September 18, 2006