HomeMy WebLinkAboutSLAS6705_PERMIT_RENEWAL_20190308Field 7Inactive
Field 6Inactive
Field 1
Field 3a Field 2 Field 4
Field 5Inactive
Field 3
Well
250 ft
200 ft
25 ft fromcenter of path for fieldsbordering path
SLAS-67-05
-
Source: 2010 NAIP Color Imagery, NCDA; site boundary, NC DENR Division of Waste Management.Map created by NC DENR Division of Waste Mangement, Compost and Land Application Branch for permitting purposes only.
500 0 500250 Feet
crc, Apr. 2016
SEPT G _"D PPl--'1 ATIO
OV JR SHEET
Site Operator: __ .,...._-:---:;::t--m __ f"\_� __ -,....:...::.J....:.J-=....::___:.....ry);;,...__e/ ti ) I e..SLAS Permit #:IJ Site Location: � -S�� d1 P a.a
(street address I e sde !I! latitude and longitude) \'n""', i ,J • } I ,t...,Number of acres permitted: __ Lf __ 7 ____ , _3 _________ _
Permitted application rate: __ _..;S�0=--1-, -=-tJ..:::.o...JiiO'----------
Crop( s ): Co4.,shd 6e-r�::C:c:t:e h)e.-s (��
Crop nitrogen requirement(s): c3. r T <SYl� / A-C...,-G y a S:
CERTIFICATION:
(pounds nitrogen per acre) 3 O a . .S-
"I certify, under penalty of law, that the pathogen requirements in (insert either 503.32 (c)(1) or 503.32 (c)(2)) and the vector attraction reduction requirements in (insert 503.33 (b)(9), 503.33 (b)(10) or 503.33 (b)(12)) have been met. This determination has been made under my direction and supervision in accordance
with the system designed to ensure that qualified personnel properly gather and evaluate the information used to determine that the pathogen requirements and
vector attraction reduction requirements have been met. I am aware that there are significant penalties for false certification including the possibility of fine and
�� 3/4�?olj (signature) (da )