310772_Annual Report_20200601

RECEIVED
����N 1 2020 A'ITACI NT A
ANIMAL FACILITY ANi'�iJAL, REPORT FORM
?
Report for (previous) Calendar Year. ?A_j Central Office NC DEQIDWR Today's Date: q
Certificate of Coverage or Permit Number S % -1 County _ LL.A V�,
Facility Name (as shown on Certificate of Coverage or Permit) _ �1( ✓p & , C,
Operator in Charge for this Facility L= ryy l Qu PN Operator Certification # .2 1
Facility's Integrator, if applicable: y 4a _ Lc�
Part I: Feeility Information As of December 31st of reoortnyear }efed):=
Land application of animal waste as allowed by the above pennit occurred during the past calendar year
YES NO. If NO, skip Part I and proceed to Part H and Part III. Also, if animal waste was
generated but not land applied, attach an explanation on how the animal waste was managed/disposed.
CAVIW SUBMARY
Total number of application Fields or Pulls in the Certified Animal Waste
Fields or
Management Plan (CAWMP):
nes
i Total Useable Acres a Roved in the CAWAIP
Acres
Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied
Lbs PAN
annuall = b - the CAWMP and the permit
LAGOON Si AEM ARY
Number of Permitted. Lagoons;
l
ItLagoons
Number of Permitted Lagoons with a sludge removal or management plan
per Permit Condition M 22
#Lagoons
ANNUAL OPERATIONS SUA04ARY
ifor aH cro )s vAth windows that ended during the previous calendar rear)
j
f Total number of Fields or Pulls on which land application occurred during
Fields or
=PdWones
the year:
9 S-7
Ades
Total Acres on which animal waste was applied
Total pounds of Plant Available Permitted Animal Waste
3 O ) 3
Lbs. PAN
Nitrogen (PAN) applied during
- -
the year for all application sites: Other Nutrient Sources (incl Dry Litter)
{
Lbs. PAN
SOIL SAWnlY SUAHAARY
Total nuer of Fields or Pulls for which the most recent soils evaluation
-Fields or
indicated a Soil P (P-index) greater than 400 -^ —
- —
Pumones
Total usable acres of Fields or Pulls for which the most recent soils
indicated a Soil Y(P-index) g i e ater than 400
1
® � Acres �
AFOAR 4-12-2019
23

BENEFICIAL USE SUMMARY
Estimated amount of total manure, litter and process wastewater sold or
given to other persons and taken off site during the year
PRODUCTION SUAHAARY
Annual average number of animals by type at this faciliq during the
®
previous year
AT TACHN
Tons
Gallons
Operation Type
Number of Animal
�-2
q�
Swine
Wean to Finish
Wean to Feeder
Farrow to Finish
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Boar/Stud
Gilts
Other
Cattle
Dairy Calf
Dairy Heifer
Milk Cow
Dry Cow
Beef Stocker Calf
Beef Feeder
Beef Broad Cow
Other.
Dry Poultry
Non -Laying Chickens
Laying Chickens
Pullets
Turkeys
Turkey Pullet
Wet Poulf ry
Non -Laying Pullet
Layers
Other M's
Horses — Horses
Horses — Other
Sheep — Sheep
Sheep - Other
Part H: Facility Status (Respond for activity within the Calendar year of reporting year unless
otherwise specified):
[ENT A
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 L�1 Yes ❑ No
according to requirements of Condition 1.4.
2. There were no freeboard exceedances in any lagoons or storage ponds. E Yes ❑ No
3. There was no PAN application to any fields or crops at this facility greater than the RYes ❑ No
levels specified in this facility's CAWW.
4. Sludge Surveys as required in Condition U1.22 have been completed. Vyes
es El No
5. For any temporary lagoon lowering event, drawn down restrictions and record ❑ No
keeping requirements in Condition H.29 have been met.
6. Soils analysis were performed within the last three years on each field receiving animal C7 Yes ❑ No
waste.
2 AFOAR 4-12-2019

ATTACYRENT A
7. AR 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 CAWMP were maintained during the past calendar year on all WJ 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."
1, 14 VN-
Permittee Name and Title (type or print)
Signature
Signature of Operator in Charge
(if different from Permittee)
RECEIVED
JUN 01 2020
NC DEQ/DWR
contral Office
pwh.PV-
_jam--,�a
Date
Date
3 "OAR 4-12 2019