520018_Compliance_20220919

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: Potters Hill Nursery #1 and # 2
Owner(s) Name: NC Real Estate Properties LLC
Mailing Address1627 Stonegate N. Sanford NC 27332 Phone No:
34.989086 / 77.685410
Facility No: 52-18
910-303-9423
County: Jones
O eration Description (remaining animals only):
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. of Animals Type of Poultry
_Type
Wean to Feeder 6400 0 Layer
0 Feeder to Finish ❑ Non -Layer
O Farrow to Wean _ Type of Beef
❑ Farrow to Feeder 0 Brood
0 Farrow to Finish ❑ Feeders
❑ Gilts 0 Stockers
❑ Boars Other Type of Livestock:
No of Animals Type of Dairy No. of Animals
0 Milking
O Dry
No. of Animals ❑ Heifers
0 Calves
Number of Animals:
Will the farm maintain a number of animals greater than the G.S. § 143-215.10B threshold?
Will other lagoons be in operation at this farm after this one closes?
How many lagoons are left in use on this farm?: 0
Yes No
Yes a No cY
(Name)Chad Coburn of the Water Quality Regional Operations Section staff in the Division of Water Resources'
WIRO Regional Office (see map on back) was contacted on 10/1/21 (date) for notification of the
pending closure of this pond or lagoon. This notification was at least 24 hours prior to the start of closure, which began
on 10/4/2021 (date).
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.
Name of Land Owner (Please Print): NC Real Estate Properties LLC //L
Signature: X �_� fbr NG �u e F fr`) Dates.L<x S.S/ ..t
The facility has followed a closure plan which meets all requirements set forth in the NRCS Technical Guide Standard
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. --�
Name of Technical Specialist (Please Print):
Affiliation: A-s .z-
Address (Agency):______Lr-J
Signature:
&net, e
Sox
o&L o2Sv ',hone No.: 25- 2 "" ?IC" —AG
Date: X S/f t-
Return within 15 days following completion of animal water storage pond or lagoon closure to:
N. C. Division of Water Resources
Animal Feeding Operations Branch
1636 Mail Service Center
Raleigh, NC 27699-1636
PLC - 1 Nov 19, 2013