820417_Certification Form_20200813

Animal Waste Management Plan Certification
(Please type or print all information that does not require a signature)
�Existin or New or Expanded (please circle one)
General Information:
Name of Farm:
Owner(s) Name:
Mailing Address:
r-ao
QRtsrAGE Rnl5, Xnlc.
po. Sox 938 C/lvrasi NC Z83Z9
Permit No: 4Ws8aZ0ti %
Facility No:
Phone No: 9/0. CM. 577/
Farm Location: County Farm is located in: S4•4? So id
Latitude and Longitude: 3'i • 5! 1 Don / 78 a 29 07" Integrator: PaeSTRGE Amps, .VJc.
Please attach a copy of a county road map with location identified and describe below (Be specific: road
names, directions, milepost, etc.): non me rrounecsloN o.P Zoykisl SRID&C £G! 4 /11SDAyvlels
eao<s2oaos, Go Soon! At 3.f times, Pam Is oN TNe £IolFr,
Operation Description:
Type of Swine No. of Animals
o Wean to Feeder
o Feeder to Finish
• Farrow to Wean
o Farrow to Feeder
o Farrow to Finish
o Gilts
o Boars
agog
Type of Poulny No. of Animals Type of Dairy No. of Animals
o Layer
o Non -Layer
Type of Beef No. of Animals
o Brood
o Feeders
o Stockers
Other Type of Livestock:
o Milking
o Dry
o Heifers
o Calves
Number of Animals:
Expanding Operation Only
Previous Design Capacity: Additional Design Capacity:
Total Design Capacity:
Acreage Available for Application: 4)9.2.
Number of waste structures:
Are subsurface drains present on the farm: YES or
Required Acreage: S.3• 0
Total Capacity: I 808, 3 3 4 Cubic Feet (ft3)
(please circle one)
If YES: are subsurface drains present in the area of the waste structures (please circle one or both as applicable)
Owner / Manager Agreement
I (we) verify that all the above information is correct and will be updated upon changing. I (we) understand the operation and
maintenance procedures established in the approved animal waste management plan for the farm named above and will
implement these procedures. I (we) know that any expansion to the existing design capacity of the waste treatment and storage
system or construction of new facilities will require a permit application and a new certification to be submitted to the Division
of Water Resources (DWR) and permit approval received before the new animals are stocked. I (we) understand that there must
be no discharge of animal waste from the storage system to surface waters of the state unless specifically allowed under a permit
from DWR and there must not be run-off from the application of animal waste. I (we) understand that run-off of pollutants
from lounging and heavy use areas must be minimized using technical standards developed by the USDA -Natural Resources
Conservation Service (NRCS). The approved plan will be filed at the farm and at the DWR Regional Office and the office of
the local Soil and Water Conservation District (SWCD). I (we) know that any modification must be approved by a technical
specialist and submitted to the DWR Regional Office and local SWCD and required approvals received from DWR prior to
implementation. A change in farm ownership requires a permit application to be sent to DWR along with a new certification
(if the approved plan is changed).
Name of Land Owner: PBESTAG Rats, INC..
Signature: a A / jrt itu4*ye (fami,. c. Date: 8i11izo&o
Name of Manager (if different from owner):
Signature: Date:
AWC - June 18, 2020 1

Technical Specialist Certification
L As a technical specialist designated by the North Carolina Soil and Water Conservation Commission pursuant to 15A
NCAC 6H .0104, I certify that the animal waste management system for the farm named above has an animal waste
management plan that meets or exceeds standards and specifications of the Division of Water Resources as specified in 15A
NCAC 2T .1300 (formerly 2H .0217) and the USDA -Natural Resources Conservation Service and/or the North Carolina Soil
and Water Conservation Commission pursuant to 15A NCAC 2T .1300 (formerly 2H .0217) and 15A NCAC 6F .0101-.0105.
The following elements are included in the plan as applicable. While each category designates a technical specialist who may
sign each certification (SD, SI, WUP, RC, I), the technical specialist should only certify parts for which they are technically
competent.
IL Certification of Design
A) Collection, Storage, Treatment System
Check the appropriate box
• Existing facility without retrofit (SD or WUP)
Storage volume is adequate for operation capacity; storage capability consistent with waste utilization requirements.
o New, expanded or retrofitted facility (SD)
Animal waste storage and treatment structures, such as but not limited to collection systems, lagoons and ponds,
have been designed to meet or exceed the minimum standards and specifications.
Name of Technical Specialist (Please Print): Ra41),4 L. - Al. t 4KEFo0 T
Affiliation pgE574G6 gems, Tilt. Date Work Completed:
Address (Agency): Q.O. Sox 93$ Cli�rral,Nc 22129 Phone No.: 9/D•C9a•5771
Signature: /r. ,�/ Date: 0 )13) 2020
B) Land Application Site (WUP)
The plan provides for minimum separations (buffers); adequate amount of land for waste utilization; chosen crop is suitable
for waste management; and the hydraulic and nutrient loading rates are appropriate for the site and receiving crop.
Name of Technical Specialist (Please Print): RA�IAAe� 111. &4QEFbD t
Affiliation P2eST4C6 ,4,eMf, Sic.. Date Work Completed:
Address (Agency): P0. $o% wdin�g C/„rnit me 2HZ9 Phone No.: 9/O. 592 • S77/
s Signature: tV 1. „V Date: 8//42oto
C) Runoff Controls from Exterior Lots
Check the appropriate box
• Facility without exterior Lots (SD or WUP or RC)
This facility does not contain any exterior lots.
o Facility with exterior lots (RC)
Methods to minimize the run off of pollutants from lounging and heavy use areas have been designed in
accordance with technical standards developed by NRCS.
Name of Technical Specialist (Please Print): F4,40,4.I— 4. B'sq.wFeof
Affiliation Pest rotoe MKg1S, Ink . Date Work Completed:
Address (Agency): P. 0. $oy. 1/3$ amp), nl t, ttit 9 Phone No.: 9/0 • S94. 5771
Signature: ;Ef�r f- r• �� Date: 8/13)2020
AW C - June 18, 2020 2

D). Application and Handling Equipment
Check the appropriate box
♦ Existing or expanding facility with existing waste application equipment (WUP or I)
Animal waste application equipment specified in the plan has been either field calibrated or evaluated in accordance
with existing design charts and tables and is able to apply waste as necessary to accommodate the waste management
plan: (existing application equipment can cover the area required by the plan at rates not to exceed either the specified
hydraulic or nutrient loading rates, a schedule for timing of applications has been established; required buffers can
be maintained and calibration and adjustment guidance are contained as part of the plan).
o New, expanded, or existing facility without existing waste a wlication equipment for spray irrigation. (I)
Animal waste application equipment specified in the plan has been designed to apply waste as necessary to
accommodate the waste management plan; (proposed application equipment can cover the area required by the plan
at rates not to exceed either the specified hydraulic or nutrient loading rates; a schedule for timing of applications
has been established; required buffers can be maintained; calibration and adjustment guidance are contained as part
of the plan).
o New, expanded, or existing facility without existing waste application equipment for land spreading not using spray
irrigation. (WUP or I)
Animal waste application equipment specified in the plan has been selected to apply waste as necessary to
accommodate the waste management plan; (proposed application equipment can cover the area required by the plan
at rates not to exceed either the specified hydraulic or nutrient loading rates; a schedule for timing of applications
has been established; required buffers can be maintained; calibration and adjustment guidance are contained as part
of the plan).
Name of Technical Specialist (Please Print): 14n1tt. 4. rinel<oatT
Affiliation Pt&BSTA46 ORRMS, =nit. Date Work Completed:
Address (Agency): pa go% 1/38 �NzBN AIL Z�329 Phone No.: 9/0 592.5'771
Signature: e N Date: 8/13/2020
E) Odor Control, Insect Control, Mortality Management and Emergency Action Plan (SD,
SI, WUP, RC or I)
The waste management plan for this facility includes a Waste Management Odor Control Checklist, an Insect Control
Checklist, a Mortality Management Checklist and an Emergency Action Plan. Sources of both odors and insects have
been evaluated with respect to this site and Best Management Practices to Minimize Odors and Best Management
Practices to Control Insects have been selected and included in the waste management plan. Both the Mortality
Management Plan and the Emergency Action Plan are complete and can be implemented by this facility.
Name of Technical Specialist (Please Print): FA4Mil, Pi. 4E6007"
Affiliation ?RESTAGE „q/tats, 4,c • Date Work Completed:
Address (Agency): PO. Bo% 959 anwJAlt- 0329 PhoneNo.: PP•S92• S77/
Signature: itfra /i Date: 9/15/2020
F) Written Notice of New or Expanding Swine Farm
The following signature block is only to be used for new or expanding swine farms that begin construction after June
21, 1996. If the facility was built before June 21, 1996, when was it constructed or last expanded
I (we) certify that I (we) have attempted to contact by certified mail all adjoining property owners and all property owners
who own property located across a public road, street, or highway from this new or expanding swine farm. The notice was in
compliance with the requirements of NCGS 106-805. A copy of the notice and a list of the property owners notified are
attached.
Name of Land Owner:
Signature: Date:
Name of Manager (if different from owner):
AWC - June 18, 2020 3

Signature: Date:
III. Certification of Installation
A) Collection, Storage, Treatment Installation
New, expanded or retrofitted facility (SI)
Animal waste storage and treatment structures, such as but not limited to lagoons and ponds, have been installed in
accordance with the approved plan to meet or exceed the minimum standards and specifications.
For existing facilities without retrofits, no certification is necessary.
Name of Technical Specialist (Please Print):
Affiliation Date Work Completed:
Address (Agency): Phone No.:
Signature: Date:
B) Land Application Site (WUP)
The cropping system is in place on all land as specified in the animal waste management plan.
Name of Technical Specialist (Please Print): RM40AL1. N. & fier0o'f
Affiliation PgESTzoc gistSt Ztc.. Date Work Completed:
Address (Agency): pa to N38 amid A/C.- #3Z1 Phone No.: 9/0 •594.117/
Signature: 4t 4(i Date: 9/i,Jz020
C) Runoff Controls from Exterior Lots (RC)
Facility with exterior lots
Methods to minimize the run off of pollutants from lounging and heavy use areas have been installed as specified in
the plan.
For facilities without exterior lots, no certification is necessary.
Name of Technical Specialist (Please Print):
Affiliation Date Work Completed:
Address (Agency): Phone No.:
Signature: Date:
D) Application and Handling Equipment Installation (WUP or I)
• Animal waste application and handling equipment specified in the plan is on site and ready for use; calibration
and adjustment materials have been provided to the owners and are contained as part of the plan.
o Animal waste application and handling equipment specified in the plan has not been installed but the owner has
proposed leasing or third party application and has provided a signed contract; equipment specified in the
contract agrees with the requirements of the plan; required buffers can be maintained; calibration and adjustment
guidance have been provided to the owners and are contained as part of the plan.
Name of Technical Specialist (Please Print): KA JOALL
Affiliation Ignn7*0E AAinst X. Date Work Completed:
Address (Agency): �./p.o, sox ill; chime;,dG 24329 Phone No.: 9/0 ° 592 • 5771
AWC - June 18, 2020 7f A✓ar- 4 B1I3'2oi0
4- a4amor

E) Odor Control, Insect Control and Mortality Management (SD, SI, WUP, RC or I)
Methods to control odors and insects as specified in the Plan have been installed and are operational. The mortality
management system as specified in the Plan has also been installed and is operational.
Name of Technical Specialist (Please Print): RA4o4L-t. fit FARE i oe7
Affiliation f l:b'I7Rogent S� Zilc. Date Work Completed:
Address (Agency): Q•0. tot3 and/at Z8729 Phone No.: 9/o • 59.2. 577/
Signature: /1/. ,C2/ Date: b/13i2ozo
Please return the completed form to the Division of Water Resources at the following address:
Department of Environmental Quality
Division of Water Resources
Animal Feeding Operations
1636 Mail Service Center
Raleigh, NC 27699-1636
Please also remember to submit a copy of this form along with the complete Animal Waste
Management Plan to the DWR Regional Office and the local Soil and Water Conservation District
Office and to keep a copy in your files with your Animal Waste Management Plan.
AWC - June 18, 2020 6

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