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HomeMy WebLinkAbout540087_oic_20240219State of North Carolina Department of Environmental Quality Division of Water Resources Animal Waste Management Systems Request for Certification of Coverage Facility Currently covered by an Expiring Sate Non -Discharge General Permit On September 30, 2024, the North Carolina State Non -Discharge General Permits for Animal Waste Management Systems will expire. As required by these permits, facilities that have been issued Certificates of Coverage to operate under these State Non -Discharge General Permits must apply for renewal at least 180 days prior to their expiration date. Therefore, all applications must be received by the Division of Water Resources by no later than April 3, 2024. Please do not leave any question unanswered. Please verify all information and make any necessary corrections below. Application must be signed and dated by the Permittee. 1. Certificate Of Coverage Number: AWS540087 2. Facility Name: Lenoir Swine Breeders Inc 3. Permittee's Name (same as on the Waste Management Plan): James Pollock 4. Permittee's Mailing Address: 2307 Hwy City: Kinston x 0 Telephone Number: - xt. State: NC E-mail: jimmvpollock a,suddenlink.net 5. Facility's Physical Address: 1167 Bland Howell Rd Zip: 28504 City: Kinston State: NC Zip: 28504 6. County where Facility is located: Lenoir 7. Farm Manager's Name (if different from Landowner): James Pollock 8. Farm Manager's telephone number (include area code): _- _ _ _ -_ ____, 9. Integrator's Name if there is not an Integrator, write "None" ar g (� g )� � f 10. Operator Name (OIC): Y� _ _ _ OIC #: -q� a Pone No.: 11. Lessee's Name (if there is not a Lessee, write "None"). ruv, ca" " 12. Indicate animal operation type and number: Current Permit: Operations Type Swine - Farrow to Wean Operation Tvnes: Swine Wean to Finish Wean to Feeder Farrow to Finish Feeder to Finish Farrow to Wean Farrow to Feeder Boar/Stud Gilts Other Cattle Dairy Calf Dairy Heifer Milk Cow Dry Cow Beef Stocker Calf Beef Feeder Beef Broad Cow Other Allowable Count 550 Dry Poultry Non Laying Chickens Laying Chickens Pullets Turkeys Turkey Pullet Wet Poultry Non Laying Pullet Layers Other Types Horses - Horses Horses - Other Sheep- Sheep Sheep - Other Note: In accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification in any application may be subject to civil penalties up to $25,000 per violation. (18 U.S.C. Section 1001 provides a punishment by a fine of not more than $10,000 or imprisonment of not more than 5 years, or both for a similar offense.) Print the Name of the Permittee/Landowner/Signing Official and Sign below. (If multiple Landowners exist, all landowners should sign. If Landowner is a corporation, signature should be by a principal executive officer of the corporation): Name (Print): _.y= Title: Signature: Date:, Name (Print): Signature: Name (Print): Signature: Title: Date: Title: Date: THE COMPLETED APPLICATION SHOULD BE SENT TO THE FOLLOWING ADDRESS: E-mail: animal.operations@deq.nc.gov NCDEQ-DWR Animal Feeding Operations Program 1636 Mail Service Center Raleigh, North Carolina 27699-1636 MIM; ; � Lenoir Swine Breeders Inc John Cumin Howard 1373 Davis Mill Rd Deep Run, NC 28525 252-568-4204 I'llillillil III's 7 111111 1 11111111111 Ill 11 �rkl JTM 211T �!11, !,l 1111 i i OUR"= MM � Eve H. Honeycutt N C Cooperative Extension Lenoir County Center 1791 Hwy 11155 Kinston, NC 28504 MAE Owner/Manager/Producer Agreement 1(we) understand and agree to the specifications and the operation and maintenance procedures established in this nutrient management plan which includes an animal waste utilization plan for the, farm named above. I have read and understand the , Required Specifications concerning animal waste management that are included with this, plan. Signature (owner) Date Signature (manager or producer) Date This plan meets the minimum standards and specifications of the U.S. Department of Agriculture - Natural Resources Conservation Service or the standard of practices adopted by the Soil and Water Conservation Commission. Plan Approved By: Y-chnica&�- i g�n`a t u . re- Date 148515 Database Version 4.1 Date Printed: 06-13-2018 Cover Page 1