630004_Annual Report_20200417

RECENM
APR 1 i ' 2020 ATTACHMENT A
NC DEGUDWR ANIMAL FACILITY ANNUAL REPORT FORM
R *%NTdous) Calendar Year: 20Today's Date:
Certificate of Coverage or Permit Number County 420-1—e
Facility Name (as shown on Certificate of Coverage or Permit) Ire>,- A-g l A
I
Operator in Charge for this Facility _ Operator Certification # �7 G
Facility's Integrator, if applicable:
Part I: Facility Information (As of December 315t of reporting year unless otherwise specified):
Land application of animal waste as allowed by the above permit occurred during the past calendar year
YES NO. If NO, skip Part I and proceed to Part II and Part III. Also, if animal waste was
generated but not land applied, attach an explanation on how the animal w-date was managed/disposed.
1Z
CAWMP SUMMARY
Total number of application Fields or Pulls in the Certified Animal Waste
Fields or
%
Pulls/zones
Acres
Management Plan (CAWMP):
Total Useable Acres approved in the CAWMP
Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied
Lbs. PAN
annuallyb the CAWMP and the ermit:
LAGOON SUMMARY
Number of Permitted Lagoons
# Lagoons
Number of Permitted Lagoons with a sludge removal or management plan
O
#Lagoons
r Permit Condition III-22
ANNUAL OPERATIONS SUMMARY
for all crops with windows that ended during the previous calendar ear
Total number of Fields or Pulls on which land application occurred during
Fields or
e.
Pulls/zones
the year:
Total Acres on which animal waste was applied
Acres
Lbs. PAN
Total pounds of Plant Available
Permitted Animal Waste
Nitrogen (PAN) applied during
I
the year for all application sites:
Other Nutrient Sources (incl Dry Litter)
Lbs. PAN
SOIL SAMPLE SUMMARY
r
Total number of Fields or Pulls for which the most recent soils. evaluation Fields or
indicated a Soil P (P-index) greater than 400 Pulls/zones
EGEfVEt)f Fields or Pulls for which the most recent soils
evaluation indicated a Soil P -index ter than 400
O
Acres
APR 1 J 2020
1 AFOAR 4-12-2019
OPERATOR DE T C T ON PROGRAM

ATTACHMENT
BENIFICAL USE SUMMARY
Estimated amount of total manure, Etter and process wastewater sold or
given to other persons and taken off site during the year
J
Tons
Gallons
.PRODUCTION SUMMARY
Annual average number of animals bjjbyjt at this fticility, Au'r 'the,jit 4, U_s*.`y,'6kr'
Operation Type
�.Number of Animal
Swine
Cattle
Weah to Finish
'Dairy Calf
Wean to Feeder
Dairy Heifer
Farrow to Finish-
'Milk Cow
Feeder to Finish
Dry Cow
Farrow to Wean
Beef Stocker Calf
Farrow to Feeder
Beef Feeder. .
Boar/Stud
Beef Broad Cow'
Gilts
Other - ,
Other
Dry Poultr-y
Other TWes
Non -Laying Chickens
Horses
. g4Cbick= Lay.
in
Horses — Other.
Pullets
S heep, —. S hqep
Turkeys
Sheep- Other'.
-
Turkey Pullet;
Wet Poultiry
Non -Laying Pullet
Layers
Part H: Facility 1 Status ikest) ond-for acthlbrwithin the. Calendar year of reyortinwvear.�unless
otherwise sbecifieft
Directions: Check box next to the appropriatq.4pswpr,.f9r, each statementwere.the answer -is -"No' , provide a
written description of any action take taken 6�p`ending to address. the requirements and ret&fi'11ie facility to
compliance
,)
1. All "major changes," revisions," and •'amendments" A-WW to the Cwere made esNo
according to requirements of Condition 1.4.
2. There were no freeboard exceedances in any lagoons or storage ponds. No
3. There was no PAN application to any fields or crops at this facility greater than,.the_ o,es No
levels specified in this facility's CAWMT.
4. Sludge Surveys as req,4ired in Condition HI.22 have been completed. Yes, No
5. For any temporary lagoon lowering event, drawn down restrictions and record Yes,
N6
keeping requirements in Condition 11.29 have been met.
6. Soils analysis were performed within the last three ,years qn each field receiving,, animal.,,,,, Yes _`� No
waste.
2 AFOAR 4-12-2019

t ATTACHMENT A
7. All required monitoring and reporting were performed in accordance with.the facility's No
permit during the past calendar year. , „ % ,
8. Crops as specified in the CAWMP were maintained duning'the:past calendar year on all Yes No
sites receiving animal waste and the crops grown were harvested and removed in
accordance with the facility's permit.
Part III: Affirmation Statement, i
s".
"I affirm by my signature that this document and all attachments were prepared under my direction or
supervision. The information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant°penalties for submitting false information, including the
possibility of civil and criminal penalties."
�e or print',
Signature of Operator m Ch e
(if different from Permittee)
RECENW
APR 17 2020
AG DEC
DID .
-..:
Date
4.
Date
3 AFOAR 4-12-2019