740038_Annual Report_20200417

RECEIVED
ATTACHMENT A
APR 17 M20
ANVAAL FACILITY ANNUAL REP.ORT FORM
NC DEQ/DWR
Report f.4"MMendar Year: 20 Today's Date: " A
Certificate of Coverage or Permit NumbeA us OD 3'r County P "
Facility Name (as shown on Certificate of Coverage or Permit) 50-M. waor4 - _ _ hoa,\3
Operator in Charge for this Facility CQ"j4t �"` operator Certaficatton #
Facility's Integrator, if applicable: J N4� f1 @ Pjs
OM-194-S'
Part I: Facility Information As of December 311 of re orting y-M jinlM o1herwile secs
Land� 'cation of animal waste as allowed by the above permit occurred during the past calendar year
/ YES No. If NO, skip PartI and proceed to Part Hand Part III. Also, if animal waste was
generated but not land applied, attach an explanation on how the animal waste was managed/disposed.
CAWMP SUMMARY
Total number of application Fields or Pulls in the Certified Animal Waste Fields or
Management Plan (CAWMP): Pulls/zones
Total Useable Acres a nroved in the CAWMP r' . y� Acres
Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied OQ 7/ Lbs. PAN
annually by the CA~ and the permit:
LAGOON SUbOdARY _ _
Number of Permitted Lagoons
# La Dons
Number of Permitted Lagoons with a sludge removal or management plan
# Lagoons
per Permit Condition lII 22
ANNUAL OPERATIONS SUMVIARY
(for all cro s with windows that ended during the revious calendar ear
Total number of Fields or Pulls on which land application occurred during
O
Fields or
the year
O
Pulls/zones
Total Acres on which animal waste was applied
S. 41.5"
Acres
Total pounds of Plant Available Permitted Animal Waste
31 f j
Lbs. PAN
Nitrogen (PAN) applied during
the year for all application sites: Other Nutrient Sources (incl. Dry Litter)
Q
Lbs. PAN
SOIL SAMPLE SUMMARY
Total number of Fields or Pulls for which the most recent soils evaluation
i>T
or
indicated a Soil P (P-index) greater than 400
es
Total usable acres of Fields or Pulls for which the most recent soils
6
evaluation indicated a Soil P (P-index) Greater than 400
l AFOAR 4-12-2019

ATTACHMENT A
BENMCAL USE SUMMARY
Estimated amount of total manure, litter and process wastewater sold or _
Tons
given to other persons and taken off site during the year Gallons
f
PRODUCTION SUI 04"Y
Annual avers ge number of animals M: tti a at this facility AaAnp the preViOUS ear
Operation Type Number of Animal
t i_ % i % t _R E 1
Spine Ca a Dry Pou_It a Other Tym
Wean to Finish Dairy Calf Non -Laying Chickens Horses — Horses
Wean to Feeder Dairy Heifer Laying Chickens Horses — Other
Sheep — Sheep
Farrow to Finish Milk Cow Pullets
Feeder to Finish Dry Cow Turkeys Sheep - Other
Farrow to Wean Beef Stocker Calf Turkey Pullet
Farrow to Feeder Beef Feeder
Boar/Stud Beef Broad Cow Wet Poultry
Gilts Other Non -Laying Pullet
Other Layer
Part II: Facili qStatus (Respond for acthiV within the Calendar year of KWorfte yME unless
otherwise s ecifed :
Directions: Check box next to the appropriate answer, for each statement were the answer is "No", provide a
written description of any action take taken or pending to address the requirements and return the facility to
compliance
1. All "major changes," "revisions," and "amendments" to the CAWMP were made Yes
❑ No
according to requirements of Condition I.4.
❑ No
2. There were no freeboard exceedances in any lagoons or storage ponds.9,/Yes
El
3. There was no PAN application to any fields or crops at this facility greater than the 1Q Yes
No
levels specified in this facility's CAWMP. ,_,/
Id Yes
El No
4. Sludge Surveys as required in Condition U1.22 have been completed.
VYes
5. For any temporary lagoon lowering event, drawn down restrictions and record
❑ No
keeping requirements in Condition U.29 have been met
❑
6. Soils analysis were performed within the last three years on each field receiving animal VrYes
No
waste.
2 AFOAR 4-12-2019

ATTA�M O ENT A
l�r
7. All required monitoring and reporting were performed in accordance with the facility's Yes ❑ No
permit during the past calendar year.
8. Crops as specified in the CAWIVIP were maintained during 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 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."
PernutteeName and Title (type
4_Signatm of Permittee
or print)
Signature of Operator in Charge
(if different from Permittee)
RECENE®
APR 17 2020
a A
D
]ate
AFOAR 412-2019