490016_Remission (Request)_20200407

RECEIVED
03/26/2020 APR 0 7 2020
NC DEQ/DWR
Central Office
Subject: Waste Pond Closure
Mr. Sutton,
Please follow the instructions below to finalize your Waste Pond Closure.
1. Please fill in the section in the middle of the form with the name of
the person you contacted from Water Quality Regional Operations,
NCDWR. Our local contact was James Bealle, now is Michael
Meilinger, [phone] out of Mooresville. If you haven't
contacted him to date, please do as soon as possible. You were
supposed to contact him prior to closing the pond. If they do ask, you
can have Michael contact me to verify the waste was completely
removed and agronomically applied according to plan and sludge
plan — I have that information and you probably have that plan as
well. Also, my enclosed dated certification photos are evidence. If
you did contact him and aren't sure of the date, the date on the photo
titled "Bare Soil after sludge removal" is the likely date.
2. Sign the form at the orange dot — it is already dated.
3. Mail the form to:
NC Division of Water Resources
Animal Feeding Operations Branch
1636 Mail Service Center
Raleigh, NC 27699-1636
am also enclosing a copy for you to keep as records.
Sincerely,.
J' Pr post, NRCS SSC

Animal Waste Storage Pond and Lagoon Closure Report Form
(Please type or print all information that does not require a signature)
General Information:
Name of Farm: Fred Sutton Farm Facility No: 49 -16
Owner(s) Name: Frederick Sutton
Mailing Address: 492 Old Miller Rd. Statesville NC 28625
Phone No: [phone]
County: Iredell
Operation Description (remaining animals onK):
o Please check this box if there will be no animals on this farm after lagoon closure. If there will still be animals on the site after
lagoon closure, please provide the following information on the animals that will remain.
Operation Description:
Type of Swine No. bfAnimals
o Wean to Feeder
o Feeder to Finish
o Farrow to Wean
o Farrow to Feeder
o Farrow to Finish
o Gilts
Type of Poultry No. of Animals
Type of Dairy
o Layer
o Milking
o Non -Layer
o Dry
Type of Beef No. of Animals
o Heifers
o Brood
o Calves
o Feeders
o Stockers
No. of Animals
o Boars Other Type of Livestock: Number ofAnimals: o
Will the farm maintain a number of animals greater than the G.S. § 143-215.1 OB threshold? Yes o No X
Will other lagoons be in operation at this farm after this one closes?
How many lagoons are left in use on this farm?: None
3�y
r
P
f
Yes o No X
nnn
(Name) V " l a 0 `r C� Q E Ile- of the Water Quality Regional Operations Section staff in the
Division of Water Resources' M , . /r.' Regional Office (see map on back) was
contacted on N " (date) for notification of the pending closure of this pond or lagoon. This notification was7
at least 24 hours prior to the start of closure, which began on K v J 4rx 0 t R, (date). V
I verify that the above information is correct and complete. I have followed a closure plan, which meets all NRCS
specifications and criteria. I realize that I will be subject to enforcement action per Article 21 of the North Carolina
General Statutes if I fail to properly close out the lagoon. P
Name of Land OwW (Please Print): Frederick
Signature: 1.�� �. IctiDate: 03�z61Za2O
The facility has followed a closure plan which meets all requirements set forth in the NRCS Technical Guide Standard o
360. The following items were completed by the owner and verified by me: all waste liquids and sludges have been
removed and land applied at agronomic rate, all input pipes have been removed, all slopes have been stabilized as
necessary, and vegetation established on all disturbed areas. c
S
Name of Technical Specialist (Please Print):Jim Propst, NRCS SSC
r
Affiliation: USDA-NRCS
Address (Agency):4 Bristol Dr. Statesville, NC 28677 Phone No.:[phone]
VC 3�26�ZA 2O
Signature: � Date: d J �
Return within 15 days following completion of animal water storage pond or lagoon closure to: 6�
RECEIVE® N. C. Division of Water Resources
Animal Feeding Operations Branch
APR 0 7 2020 1636 Mail Service Center GN
Raleigh, NC 27699-1636
PLC -I Nov 19, 13
P

USDA
Conservation Practice Certification Form
NC—CPA-09
08/17
Use this Conservation Planning Assistance Form to document practice Construction & Certification (C&C) for all conservation planning
activities implemented under the technical supervision of an employee with the appropriate ECS and/or ENG Job Approval Authority (JAA).
Completed practices are to be checked against the planned specifications and associated Statements of Work (SOW) to ensure the planned
practice purpose has been achieved meeting applicable NRCS practice standard criteria and planning criteria treatment threshold for any
NRCS assisted activities. Final field inspection or check-out documentation will become part of the client's case file, along with ALL other
supporting data from previous planning, layout, or documenting records. When an employee determines the practice "Meets NRCS
Standards and Specifications", it implies the conservation practice or system meets applicable NRCS practice standard criteria as well as
other applicable technical and/or program requirements. All conservation practices will be certified and documented according to Title 450,
General Manual GM Part 407 and the applicable conservation practice SOW.
'A•T A —General Information
Client Name: Frederick Sutton Program Type: EQIP Agreement Number:74453219IMN
N RCS Administrative Area: 1 County: IREDELL Team Number:5.
_ _
Tract Number(s): 10465 ❑ Or refer to the attached Practice Certification Map(s)
PART B — Practice Certification Information
B(I). Conservation Practice(s) Applied & Field Certified
CIN Practice Name Practice Applied Meets MRCS Standards Field Inspection Field Inspection
Code Amount/Extent and Specifications? By Date
1
Waste Facility Closure
360
1 No.
Q Yes ❑ No
Jim Propst, NRCS SSC
03/24/2020
.❑ Yes ❑ No
❑ Yes No
Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
_
❑ Yes ❑ No
❑ Yes ❑ Na
Required Technical Documentation
Note -ALL required practice installation/certification documentation, as specified in GM 450 Part 407, conservation practice SOW "Check
Out -Deliverables", applicable jobsheet(s), approval letters, digital images, and/or practice certification maps*, must be attached to this form.
*Practice Certification Map(s) will include the installed practice location(s), Tracts) & Field number(s), standard practice symbols, and the
amount/extent of practice(s) certified.
Applicable Job Sheet(s) Certified Applicable Checklist(s) Certified Practice Certification Digital Image(s)
X Yes ❑ N/A I © Yes ❑ N/A 0 Yes
Applicable Approval Letter(s) from Individual with JAA " Practice Certification Map(s) Progress Report Completed
Yes 0 N/A ❑■ Yes a Yes
•ART C- Certification of Compliance with Plans and Specifications
101 Practice(s) meets NRCS Conservation Practice Standards and Specifications as identified in Part B(I).
❑ Practice(s) does NOT meet NRCS Conservation Practice Standards and Specifications as identified in Part B(I).
State reason(s) for practice(s) NOT meeting NRCS Standards and Specifications. If practice is a component or part of a system, then Part D-
Review of Technical Certification, will not be completed until all practices comprised by the system meet NRCS standards and specifications.
PART D— Review of Technical Certification
I acknowledge and attest that the conservation practices meeting NRCS Standards and Specifications listed in Section
B(I) of this form, have been certified by an individual with the appropriate JAA level or by a Registered TSP. I hereby
certify that the information and statements contained in this form are true and the best of my knowledge.
Digitally signed by JAMES
JAMES PROPST'PROPST SSC Team 5 03/26/2020
l
Date: 2020.03.2613:1524-04'00' Ann A r �0L0
1 L
Signature Title Date
NC DEQ/DWR Page 1 of 1
Clear Forrn Central office

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