630004_Report_20220311

RECEIVED
hR 11 2022
ATTACHMENT
NC DEGIIDWR
Central Office ANIMAL FACILITY ANNUAL REPORT FORM
Report for (previous) Calendar Year: 20 ` Today's Date:4a—
Certificate of Coverage or Permit Number.. S 1i County r v x re
Facility Name (as shown on Certificate of Coverage or Permit) ik<44 V d irl . .
Operator in Charge for this Facility Operator Certification #>C.p.�rC,
Facility's Integrator, if applicable: c\). CS. 41V,5. tp. t
Part I: Facility Information (As of December 31st of reportiti2: Year unless otherwise sbecifted):
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. ).lso, 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
Management Plan (CAWMP):
I
Fields or
Pulls/zbnes
Total Useable Acres approved in the CAWlv1P
01i?. • I
Acres
Total pounds of Plant Available Nitrogen (PAN) allowed to be land applied
annually by the CAWMP and the permit:
Li.���
'q
Lbs. PAN
r .,
LAGOON SUMMARY
Number of Permitted Lagoons
# Lagoons
Number of Permitted Lagoons with a sludge removal or management plan
per Permit Condition 111-22
..
#Lagoons
ANNUAL OPERATIONS SUMMARY•
(for all crops with windows that ended during.theprevious calendar:year.
Total number of Fields or Pulls on which land application occurred during
the year:
'; [ .,
4,1eds, or
r
Pulls/zones
Total Acres on which animal waste was applied
Acres
Total pounds of Plant Available
Nitrogen (PAN) applied during
the year for all application sites:
Permitted Animal Waste
'- tl
Lbs. PAN
.
Other Nutrient Sources (Mel Dry Litter) I
CoLbs.
PAN
SOIL SAMPLE SUMMARY ... .......... ..:. ..:..._..._:..
Total number of Fields or Pulls for which the.most recent soils. evaluation . i.
indicated a Soil P (P-indPZc) greater than 400 !
,r O
. Fielda or
/^^��
V
Pulls/zones
Total usable acres of Fields or Pulls for which the most recent soils I
evaluation indicated a Soil P.(-index) greater than 400
!,
Acres
1
AFOAR 4-12-2019

Swine
Wean to Finish
Wean to Feeder;
Farrow to Finish.
Feeder to Finish..
Farrow to Wean
Farrow to Feeder
Boar/Stud
Gilts
Other
• . • . • • •• • ; • •-• ;! L 41; b • .
BENIVICALVSg §VM1L4RY k — —
•
Estimated amount of t.ot4r4F:tuye, -litter ikrtdp,rocess wastewater sold or 1. Tons
.,........
........ .
1
given to other persons and taken.off site- duting keS'qr. • 1 'Gallons
PRODUCTION SUMMARY •
• t ep .; ik) e!.,
. •
Annual averate number of animals bytzp."-'0 at this:faelliq durinttbe reouylsxiar tft
•
Operation Type , i.11,,tcit.)
k„. mr.z 6
.• ...
vNumber 'of
•
ATTACHMENT A \
, . • : • • , •
• . :
tinerJ b10-1q boa • he :
- 41,;•,1;;v-i /1.22:323
C4ttle • ": ...................Dry Poultry - . Other
.Dairy„Calf
Dairy Heifer itin:111.k
'MilkCow
Dry. CoW,
Beef Stocker Calf
Beef Feeder ft
Beef Broad Co'/''''
Other
Non -Laying Chickens
PV14)91#9)FT,:gcr 7.c.)
:Turkeys
Turkey Pullet]: cv
Non -Laying
Layers • : •
•
H dies
•-•
14
• -§4eeP— 1419P
7;
.... Odle. ' •
.
, I I:1 :•:1 .:. '4 111/"I r:: '. '1'111111 V 4;..10‘-'41.1. *441)14 41 r-6 i 1 . V Z ii.04 i :1 1 ..,',..:;!: II: '' : ', •
Part II: Faciliir Sfaius`atesiond.foi_activii*Trithim.the:CalendarNear of renortiniyearLunlesa :
otherwise specified): ':(•:si.e\..1 /RAI 'j.'. kv1::.',41'1.7,.:';?-3'k(i' ..'i , ',::./,.i _
. . _... , ......k.15.1.'.'k. ::4,PP,,,,,,,,,,,,,,,,,,,,, f'.!.9.310, 19044:0 2.' •',":41- (•,y,,,`T'i.Kts'n 0-;-•;, .. ''.4:..• %i.j..''''.. ; '. .:
Directions; Checkbox next to the app.Toprk‘tisiwAS. )1:9Ti,54,94-4,..taP4 '.1v9.TC,I0C ,F1,,,siv.,2, .I4 ,`.`,N9", provide a
written description of any 'action' take taken' or pending to address the requirements facility to
compliance : ,
1. All "major changes,!! `.revisions,". at.Wiamencliments"-tp•the W1YER.' 4yere'inade: i:. '-i-1-'•17, ;-;'-(7-res-') No
according to requirements of Condition 1,4. -, , •.' .
• , , I 10-,„,,,YI ittiltiaA b5ii;r1t;*ri ..,1,:131),•:: A )tu:.;i', .:.: oi,,. :: •
.•-;---....-, --- -------,,,-. --ponds.-••,--4: :x..ti.tv.i.;.No
2. There were no freeboard exceedances in any lagoons or storage .;
,)3, , ,t L14 w.,44A9ruur4.194,,,,
3. There was no PAN application to ar;ty.Aelds or,crops at tl}is facility greater than No
the . , ,
levels specifiedln 'this facility's CAWNIY, ' wiu, ,;410pI
4. Sludge Surveys as required in Condition 11122 have beep completed, v -a.i., N,',:i''..;;P, ',:,, ,itz No
i .
5, For any tcmporgy,la5oon lowering eyeati,drawn..da%Tn,restrictions ;and. record ':. i::. ,:.1:.:::. ! '1:, ,. ' No
keeping requirements ,in Condition 1i,29 have been met, . ow, r,d1 .,,,,',E1,,, K,,_.,,,,,. : ei
6. Soils analysis were performed wiltniiie last :tfir7pe,yepKs,pps#9);Acid,Tepeiyipg,pira.,,l,„; . !v,.,-V,$,..,' ',No
waste.
. oq.k,ii.,:aii 1..t.1,i,qiqi (4,)bi...;•••-4 1.;...,.,.. , •,. ....5,,_, ,;;J• ;
•.' „ . . .
AFOAR 4-12-2019

ATTACHMENT A
All required monitoring and reporting were performed m accordance with,the facility's C es
permit during the past calendar year t . ' �,',
't rr.
Crops as specified in the CAWMP:were maintained dining,the past;calendar year onall
sites receiving animal waste and th4 crops grown were l arye ted and removed in
accordance with the facili 'ss permit. 1, ••
'`
No
No
•
Part III: Affirmation Statement,
�Jti 1'
"I affirm by my signature that this doc4imeni and all attachments were prepared under my direction or
supervision. The information submitted is, «p the best 'of n' knowledge and belief, true, accurate, and
complete: I am aware that there -are signifiaa`nt"penalties for submitting false information, including the
possibility of civil and criminal penalties." i , .y
1
•
.!. • f•
ermittee Name and.Title (type'`or. pentv.
eimittee
Signature of Operator in C
(if different from Permittee)
RECEIVED
MAR 11 2022,
NC DEQ/DWR
Central Office
ci q
l.+
AFOAR :4-12-2019