670015_Application Attachment_20221221

AWS67001 5
Mortality Management Methods
Indicate which method(s) will be implemented.
When selecting multiple methods indicate a primary versus secondary option.
Methods other than those listed must be approved by the State Veterinarian.
Primary Secondary Routine Mortality
Burial three feet beneath the surface of the ground within 24 hours of knowledge of animal
death. The burial must be at least 300 feet from any flowing stream or public body of water
(G.S.106-403). The bottom of the burial pit should be at least one foot above the seasonal
high water table. Attach burial location map and plan.
Landfill at municipal solid waste facility permitted by NC DEQ under GS 15A NCAC
13B .0200.
U
Rendering at a rendering plant licensed under G.S. 106-168.7,
Complete incineration according to 02 NCAC 52C ,0102.
A composting system approved and permitted by the NC Department of Agriculture & Con-
sumer Services Veterinary Division (attach copy of permit). If compost is distributed off -farm,
additional requirements must be met and a permit is required from NC DEQ.
In the case of dead poultry only, placing in a disposal pit of a size and design approved by the
NC Department of Agriculture & Consumer Services (G.S. 106-549.70).
Any method which, in the professional opinion of the State Veterinarian, would make possible
the salvage of part of a dead animal's value without endangering human or animal health,
(Written approval by the State Veterinarian must be attached)_
Mass Mortality Plan
Mass mortality plans are required for farms covered by an NPDES permit. These plans are
also recommended for all animal operations. This plan outlines farm -specific mortality man-
agement methods to be used for mass mortality. The NCDA&CS Veterinary Division sup-
ports a variety of emergency mortality disposal options; contact the Division for guidance.
• A catastrophic mortality disposal plan is part of the facility's CAWMP and is activated
when numbers of dead animals exceed normal mortality rates as specified by the State
Veterinarian.
• Burial must be done in accordance with NC General Statutes and NCDA&CS Veterinary
Division regulations and guidance.
+ Mass burial sites are subject to additional permit conditions (refer to facility's animal
waste management system permit).
• In the event of imminent threat of a disease emergency, the State Veterinarian may enact
additional temporary procedures or measures for disposal according to G.S. 106-399.4.
Signature of Farm Owner/Manager
1 1-21-12—
Date
Signature of Technical Specialist Date

Animal Waste Management System Operator Designation Form
WPCSOCC
NCAC 15A 8F .0201
Facility/Farm Name: G.-4-1'
.-4-l t n -c-
Permit #: A W 5 4/ 00 1.5 Facility ID#: AL: - 1' County: On s I p W
Operator In Charge (OTC)
Name:
First
Cert Type / Number:
Signature:
Middle
Last
Rwq 16 z60rT
Jr, Sr, etc.
Work Phone: (q/' 0 ) 2 71- tey0
Date: 1_7 - 2--
"1 certify that 1 agree to my designation as the Operator in Charge for the facility noted. I understand and will abide by the rules and regulations
pertaining to the responsibilities set forth in 15A NCAC 08F .0203 and failing to do so can result in Disciplinary Actions by the Water
Pollution Control System Operators Certification Commission."
Back-up Operator In Charge (Back-up OIC) (Optional)
Name:
First
Cert Type / Number:
Middle
Signature:
"I certify that I agree to my designation as Back-up Operator in Charge for the facility noted. I understand and will abide by the rules and
regulations pertaining to the responsibilities set forth in 15A NCAC 08F .0203 and failing to do so can result in Disciplinary Actions by the
Water Pollution Control System Operators Certification Commission."
Last
Jr, Sr, err.
Work Phone: (
Date:
Owner/Perm.ittee Name: _ ✓ �^
Phone #: 40 L-71 - S l 0
Signature: Y
(Owner or authorized agent)
h, tl
Fax#: 1
Date: /2—? o-LL
Mail, fax or email the
original .to:
Mail or fax a copy to the
appropriate Regional Office:
1618 Mail Service Center, Raleigh, NC 27699-1618
Email: certadrnin(ncdenr.Lov
Asheville
2090 US Hwy 70
Swannanoa 28778
Fax: [phone]
Phone: [phone]
Washington
943 Washington Sq Mall
Washington 27889
Fax: [phone]
Phone: [phone]
Fayetteville
225 Green St
Suite 714
Fayetteville 28301-5043
Fax: [phone]
Phoen: 910.433.3300
Wilmington
127 Cardinal Dr
Wilmington 28405-2845
Fax: [phone]
Phone: [phone]
Fax: [phone]
Mooresville
610 E Center Ave
Suite 301
Mooresville 28115
Fax: [phone]
Phone: [phone]
Winston-Salem
450 W. Hanes Mall Rd
Winston-Salem 27105
Fax: [phone]
Phone: [phone]
(Retain a copy of this form for your records)
Raleigh
3800 Barrett Dr
Raleigh 27609
Fax: [phone]
Phone:[phone]
Revised 05•2015

DEVICES TO AUTOMATICALLY STOP IRRIGATION EVENTS
STATE GENERAL PERMITS
The State of North Carolina has issued State General Permits for animal facilities to operate in North Carolina. These
Permits meet both State and EPA requirements and provide coverage for the following types of facilities.
• AWG 100000 - Swine Facilities
• AWG200000 - Cattle Facilities
• AWG300000 - Poultry Facilities with a liquid waste management system
You have recently been issued a Certificate of Coverage (COC) to operate your animal facility under one of these General
Permits.
Condition 1I.24 of each of these Permits reads as follows:
The Permittee shall:
a. install, operate, and maintain devices on all irrigation pumps/equipment designed to automatically stop irrigation
activities during precipitation; or
b. commit to provide for the presence of the OIC, a designated backup 01C, or a person under the supervision of an
OIC or designated backup OIC at all times during the land application of waste so that in case of a precipitation
event, the irrigation activities will be stopped immediately. This commitment must be submitted in writing to the
Division on a farm supplied by, or approved by, the Division. [G.S. § 90A-47]
Installation of devices or submission of alternate documentation shall be completed within 12 months of the
issuance of the COC for this General Permit, The Permittee shall maintain such devices according to the
manufacturer's instructions and warranties. This Condition does not apply to manure spreaders or other equipment
pulled by manned vehicles. [1 SA NCAC 02T .0108(b)]
Please check the box below that indicates your commitment to do one of the following.
Within twelve (12) months of the effective date of a COC issued under this permit, I shall install, operate and maintain
devices on all irrigation pumps/equipment designed to automatically stop irrigation activities during precipitation.
This condition does not apply to manure spreaders or other equipment pulled by manned vehicles.
I will commit to provide for the presence of the Operator in Charge (OIC), the designated backup OIC, or a person
under the supervision of an OIC or backup OIC at all times during the land application of waste.
"I certify under penalty of law that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information,
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 fines and imprisonment for knowing
violations."
Facility Name
James Riley Pickett
Feeling Swine Farm AWS670015
Permit Number
Owner/Permittee Name and Title (type or rint)
Date
Signature of Ow /Permittee
Signature of Operator in Charge (if different from Permittee) Date
Mail to:
Animal Feeding Operations
1636 Mail Service Center
Raleigh, NC 27699-1636
DTASIE 1-22-2020