090125_Application_20240401

State 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: AWS090125
2. Facility Name: Billy E Bordeaux Farm
3. Permittee's Name(same as on the Waste Management Plan): Douglas A Bordeaux
4. Permittee's Mailing Address: 112 Sweet Home Church Rd
City: Elizabethtown State: NC Zip: 28337-6140
Telephone Number: 910-874-1477 Ext. E-mail: dbordeaux&u ec.rr.com: vmbordeaux8(kec.rr.com
5. Facility's Physical Address: 2690 Sweet Home Church Rd
City: Elizabethtown State: NC Zip: 28337
6. County where Facility is located: Bladen
7. Farm Manager's Name(if different from Landowner): Douglas A Bordeaux
8. Farm Manager's telephone number(include area code): 910-874-1477 Ext.
9. Integrator's Name(if there is not an Integrator,write"None"): (MWhy-Brown LLC,
10. Operator Name(OIC): Douglas A.Bordeaux Phone No.: OIC#: 17945
11. Lessee's Name(if there is not a Lessee,write"None"):
12. Indicate animal operation type and number:
Current Permit: Operations Type Allowable Count
Swine-Feeder to Finish 3,672
Operation Types:
Swine Cattle Dry Poultry Other Types
Wean to Finish Dairy Calf Non Laying Chickens Horses-Horses
Wean to Feeder Dairy Heifer Laying Chickens Horses-Other
Farrow to Finish Milk Cow Pullets Sheep-Sheep
Feeder to Finish Dry Cow Turkeys Sheep-Other
Farrow to Wean Beef Stocker Calf Turkey Pullet
Farrow to Feeder Beef Feeder
Boar/Stud Beef Broad Cow Wet Poultry
Gilts Other Non Laying Pullet
Other Layers

13. Waste Treatment Lagoons,Digesters and Waste Storage Ponds(WSP): (Fill/Verify the following information.
Make all necessary corrections and provide missing data.)
Structure Type Estimated Liner Type Estimated Design Freeboard
Structure (Lagoon/Digester/ Date (Clay,Synthetic, Capacity Surface Area "Redline"
Name WSP) Built Unknown) (Cubic Feet) (Square Feet) (Inches)
1 Lagoon 8/31/1994 Full,clay 864,360.00 110,400.00 WaN 19
-t: 19.00
104,544.00
Submit one (1) copy of the Certified Animal Waste Management Plan (CAWMP) with this completed and signed
application as required by NC General Statutes 143-215.10C(d), either by mailing to the address below or sending it via
email to the email address below.
The CAWMP must include the following components:
1. The most recent Waste Utilization Plan(WUP),signed by the owner and a certified technical specialist,containing:
a. The method by which waste is applied to the disposal fields(e.g.irrigation,injection,etc.)
b. A map of every field used for land application(for example:irrigation map)
c. The soil series present on every land application field
d. The crops grown on every land application field
e. The Realistic Yield Expectation(RYE)for every crop shown in the WUP
f. The maximum PAN to be applied to every land application field
g. The waste application windows for every crop utilized in the WUP
h. The required NRCS Standard specifications
2.A site map/schematic
3. Emergency Action Plan
4.Insect Control Checklist with chosen best management practices noted
5. Odor Control Checklist with chosen best management practices noted
6.Mortality Control Checklist with selected method noted-Use the enclosed updated Mortality Control Checklist
7.Lagoon/storage pond capacity documentation(design,calculations,etc.) Please be sure the above table is
accurate and complete. Also provide any site evaluations,wetland determinations,or hazard classifications that may be
applicable to your facility.
8. Operation and Maintenance Plan
If your CAWMP includes any components not shown on this list,please include the additional components with your submittal.
(e.g.composting,digesters,solids separators,sludge drying system,waste transfers,etc.)
I attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that,
if all required parts of this application are not completed and that if all required supporting information and attachments are not
included,this application package will be returned to me as incomplete.

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): Title: �9 m�iAlt'
Signature: Date: > 2 l 2 d Z
Name(Print): Title: _
Signature: Date:
Name(Print): Title:
Signature: Date:
THE COMPLETED APPLICATION SHOULD BE SENT TO THE FOLLOWING ADDRESS:
E-mail: [e-mail]
NCDEQ-DWR
Animal Feeding Operations Program
1636 Mail Service Center
Raleigh,North Carolina 27699-1636

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Nutrient Management Plan For Animal Waste Utilization
07-29-2005
This plan has been prepared for: This plan has been developed by:
Billy Bordeaux Finishing Robert Dean Morris
Billy Bordeaux NRCS/Bladen SWCD
112 Sweet Home Church 122 Agriculture Service Center
Road
Elizabethtown, NC 28337 Elizabethtown, NC 28337
[phone] 910-862-3179 Ext. 3
Developer Signature
Type of Plan: Nitrogen Only with Manure Only
Owner/Manager/Producer Agreement
I (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 anima]
waste management that are included with this plan.
Signature(ownef) Date
��--
ignature(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: ��j
Techi+Pical Specialist Signature Date
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528573 Database Version 3.1 Date Printed: 07-29-2005 Cover Page 1

Nutrients applied in accordance with this plan will be supplied from the following
source(s):
Commercial Fertilizer is not included in this plan.
S7 Swine Feeder-Finish Lagoon Liquid waste generated 3,403,944 gals/year by a 3,672
animal Swine Finishing Lagoon Liquid operation. This production facility has waste
storage capacities of approximately 180 days.
Estimated Pounds of Plant Available Nitrogen Generated per Year
Broadcast 7840
Incorporated 13464
Injected 14828
Irrigated 8522
Max.Avail. Actual PAN PAN Surplus/ Actual Volume Volume Surplus/
PAN(lbs) * Applied(lbs) Deficit(lbs) Applied(Gallons) Deficit(Gallons)
Year 1 8,522 8939 -417 3,570,764 -166,820
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Note: In source ID,S means standard source,U means user defined source.
*Max.Available PAN is calculated on the basis of the actual application method(s)identified in the plan for this source.
528573 Database Version 3.1 Date Printed: 07-29-2005 Source Page Page 1 of 1

The table shown below provides a summary of the crops or rotations included in this plan for each field. Realistic Yield estimates
are also provided for each crop in the plan. In addition,the Leaching Index for each field is shown,where available.
Planned Crops Summary
Total Useable Leaching
Tract Field Acres Acres Index(LI) Soil Series Crop Sequence RYE
1625 4 2.50 1.19 N/A Torhunta Hybrid Bermudagrass Pasture 5.0 Tons
Small Grain Overseed 1.0 Tons
1625 4bro 1.31 1.31 N/A Torhunta Hybrid Bermudagrass Pasture 5.0 Tons
Small Grain Overseed 1.0 Tons
1625 5&6bro 5.50 1.75 N/A Cape Fear Hybrid Bermudagrass Pasture 3.5 Tons
Small Grain Overseed 1.0 Tons
1625 5,6 5.50 3.06 N/A Cape Fear Hybrid Bermudagrass Pasture 3.5 Tons
Small Grain Overseed 1.0 Tons
1625 7&8bro 13.00 2.35 N/A Ocilla Hybrid Bermudagrass Pasture 5.0 Ton.:
Small Grain Overseed 1.0 Tons
1625 7,8 13.00 9.15 N/A Ocilla Hybrid Bermudagrass Pasture 5.0 Tons
Small Grain Overseed 1.0 Tons
1625 9&10bro 19.50 5.63 N/A Ocilla Small Grain Overseed 1.0 Tons
Hybrid Bermudagrass Hay 5.0 Tons
1625 9,10 19.50 13.87 N/A Ocilla Small Grain Overseed 1.0 Tons
Hybrid Bermudagrass Hay 5.0 Tons
PLAN TOTALS: 79.81 38.31
LI Potential Leaching Technical Guidance
2 Low potential to contribute to soluble None
nutrient leaching below the root zone.
>-2& Moderate potential to contribute to soluble Nutrient Management(590)should be planned.
nutrient leaching below the root zone.
<= 10
High potential to contribute to soluble Nutrient Management(590)should be planned. Other conservation practices that improve the soils
nutrient leaching below the root zone. available water holding capacity and improve nutrient use efficiency should be considered.
> 10 Examples are Cover Crops(340)to scavenge nutrients,Sod-Based Rotations(328),Long-Term
No-Till(778),and edge-of-field practices such as Filter Strips(393)and Riparian Forest Buffers
(391).
528573 Database Version 3.1 Date Printed 7/29/2005
� PCS Page Page 1 of 1
NOTE: Symbol*means user entered data.

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The Irrigation Application Factors for each field in this plan are shown in the following table. Infiltration rate varies with soils. If
applying waste nutrients through an irrigation system,you must apply at a rate that will not result in runoff. This table provides the
maximum application rate per hour that may be applied to each field selected to receive wastewater. It also lists the maximum
application amount that each field may receive in any one application event.
Irrigation Application Factors
Application Rate Application Amount
Tract Field Soil Series (inchesthour) (inches)
1625 4 Torhunta 0.45 1.0
1625 4bro Torhunta 0.45 1.0
1625 5&6bro Cape Fear 0.40 1.0
1625 5,6 Cape Fear 0.40 1.0
1625 7&8bro Ocilla 0.50 1.0
1625 7,8 Ocilla 0.50 1.0
1625 9&10bro Ocilla 0.50 1.0
1625 9,10 Ocilla 0.50 1.0
528573 Database Version 3.1 Date Printed 7/29/2005 IAF Page Page 1 of 1
NOTE: Symbol*means user entered data.

The following Lagoon Sludge Nitrogen Utilization table provides an estimate of the number of acres needed for sludge
utilization for the indicated accumulation period. These estimates are based on average nitrogen concentrations for each source,
the number of animals in the facility and the plant available nitrogen application rates shown in the second column.
Lagoon sludge contains nutrients and organic matter remaining after treatment and application of the effluent. At clean out,this
material must be utilized for crop production and applied at agronomic rates. In most cases,the priority nutrient is nitrogen but
other nutrients including phosphorous,copper and zinc can also be limiting. Since nutrient levels are generally very high,
application of sludge must be carefully applied.
Sites must first be evaluated for their suitability for sludge application. Ideally,effluent spray fields should not be used for
sludge application. If this is not possible,care should be taken not to load effluent application fields with high amounts of
copper and zinc so that additional effluent cannot be applied. On sites vulnerable to surface water moving to streams and lakes,
phosphorous is a concern. Soils containing very high phosphorous levels may also be a concern.
Lagoon Sludge Nitrogen Utilization Table
Maximum Maximum Sludge
Crop PA-N Rate Application Rate Minimum Acres Minimum Acres Minimum Acres
lb/ac 1000 gal/ac 5 Years Accumulation 10 Years Accumulation 15 Years Accumulation
Swine Feeder-Finish Lagoon Sludge-Standard
Cam 120 bu 150 13.16 46.03 92.07 138.10
Hay 6 ton R.Y.E. 300 26.32 23.02 46.03 69.05
Soybean 40 bu 160 14.04 43.16 86.31 129.47
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528573 Database Version 3.1 Date Printed: 07-29-2005 Sludge Page Page 1 of

The Available Waste Storage Capacity table provides an estimate of the number of days of storage capacity available
at the end of each month of the plan. Available storage capacity is calculated as the design storage capacity in days
minus the number of days of net storage volume accumulated. The start date is a value entered by the user and is
defined as the date prior to applying nutrients to the first crop in the plan at which storage volume in the lagoon or
holding pond is equal to zero.
Available storage capacity should be greater than or equal to zero and less than or equal to the design storage
capacity of the facility. If the available storage capacity is greater than the design storage capacity,this indicates that
the plan calls for the application of nutrients that have not yet accumulated. If available storage capacity is negative,
the estimated volume of accumulated waste exceeds the design storage volume of the structure. Either of these
situations indicates that the planned application interval in the waste utilization plan is inconsistent with the
structure's temporary storage capacity.
Available Waste Storage Capacity
Source Name Swine Feeder-Finish Lagoon Liquid Design Storage Capacity(Days)
Start Date 9/1 180
Plan Year Month Available Storage Capacity(Days)
1 1 93
1 2 81
1 3 110
1 4 140
1 5 169
1 6 180
1 7 180
1 8 149
1 9 119
1 10 104
1 11 90
1 12 75
*Available Storage Capacity is calculated as of the end of each month.
-------------------------------------------------------------------------------------------------------------------------- Page g Page 528573 Database Version 3.1 Date Printed: 07-29-2005 Capacitye 1 of 1

Required Specifications For Animal Waste Management
1. Animal waste shall not reach surface waters of the state by runoff, drift,
manmade conveyances, direct application, or direct discharge during operation
or land application.Any discharge of waste that reaches surface water is
prohibited.
2. There must be documentation in the design folder that the producer either owns
or has an agreement for use of adequate land on which to properly apply the
waste.If the producer does not own adequate land to properly dispose of the
waste, he/she shall provide evidence of an agreement with a landowner, who is
within a reasonable proximity, allowing him/her the use of the land for waste
application.It is the responsibility of the owner of the waste production facility to
secure an update of the Nutrient Management Plan when there is a change in the
operation, increase in the number of animals, method of application, receiving
crop type, or available land.
3. Animal waste shall be applied to meet,but not exceed, the nitrogen needs for
realistic crop yields based upon soil type, available.moisture, historical data,
climatic conditions, and level of management, unless there are regulations that
restrict the rate of applications for other nutrients.
4. Animal waste shall be applied to land eroding less than 5 tons per acre per year.
Waste may be applied to land eroding at more than 5 tons per acre per year but
less than 10 tons per acre per year provided grass filter strips are installed where
runoff leaves the field (see USDA, NRCS Field Office Technical Guide Standard
393 -Filter Strips).
5. Odors can be reduced by injecting the waste or by disking after waste application.
Waste should not be applied when there is danger of drift from the land
application field.
6. When animal waste is to be applied on acres subject to flooding,waste will be soil
incorporated on conventionally tilled cropland.When waste is applied to
conservation tilled crops or grassland, the waste may be broadcast provided the
application does not occur during a season prone to flooding (see "Weather and
Climate in North Carolina" for guidance).
7. Liquid waste shall be applied at rates not to exceed the soil infiltration rate such
that runoff does not occur offsite or to surface waters and in a method which does
not cause drift from the site during application. No ponding should occur in order
to control odor and flies.
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528573 Database Version 3.1 Date Printed:7/29/2005 Specification Page 1

8. Animal waste shall not be applied to saturated soils, during rainfall events, or
when the soil surface is frozen.
9. Animal waste shall be applied on actively growing crops in such a manner that
the crop is not covered with waste to a depth that would inhibit growth. The
potential for salt damage from animal waste should also be considered.
10. Nutrients from waste shall not be applied in fall or winter for spring planted
crops on soils with a high potential for leaching. Waste/nutrient loading rates on
these soils should be held to a minimum and a suitable winter cover crop planted
to take up released nutrients. Waste shall not be applied more than 30 days prior
to planting of the crop or forages breaking dormancy.
11. Any new swine facility sited on or after October 1, 1995 shall comply with the
following: The outer perimeter of the land area onto which waste is applied from
a lagoon that is a component of a swine farm shall be at least 50 feet from any
residential property boundary and canal.Animal waste, other than swine waste
from facilities sited on or after October 1, 1995, shall not be applied closer that 25
feet to perennial waters.
12. Animal waste shall not be applied closer than 100 feet to wells.
13. Animal waste shall not be applied closer than 200 feet of dwellings other than
those owned by the landowner.
14. Waste shall be applied in a manner not to reach other property and public
right-of-ways.
15. Animal waste shall not be discharged into surface waters, drainageways, or
wetlands by a discharge or by over-spraying. Animal waste may be applied to
prior converted cropland provided the fields have been approved as a land
application site by a "technical specialist". Animal waste shall not be applied on
grassed waterways that discharge directly into water courses, and on other
grassed waterways, waste shall be applied at agronomic rates in a manner that
causes no runoff or drift from the site.
16. Domestic and industrial waste from washdown facilities, showers, toilets, sinks,
etc., shall not be discharged into the animal waste management system.
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528573 Database Version 3.1 Date Printed: 7/29/2005 Specification Page 2

17. A protective cover of appropriate vegetation will be established on all disturbed
areas (lagoon embankments,berms,pipe runs, etc.). Areas shall be fenced, as
necessary, to protect the vegetation. Vegetation such as trees, shrubs, and other
woody species, etc., are limited to areas where considered appropriate. Lagoon
areas should be kept mowed and accessible. Berms and structures should be
inspected regularly for evidence of erosion, leakage, or discharge.
18. If animal production at the facility is to be suspended or terminated, the owner is
responsible for obtaining and implementing a "closure plan" which will eliminate
the possibility of an illegal discharge,pollution, and erosion.
19. Waste handling structures,piping, pumps, reels, etc., should be inspected on a
regular basis to prevent breakdowns, leaks, and spills. A regular maintenance
checklist should be kept on site.
20. Animal waste can be used in a rotation that includes vegetables and other crops
for direct human consumption. However,if animal waste is used on crops for
direct human consumption, it should only be applied pre-plant with no further
applications of animal waste during the crop season.
21. Highly visible markers shall be installed to mark the top and bottom elevations of
the temporary storage (pumping volume) of all waste treatment lagoons.
Pumping shall be managed to maintain the liquid level between the markers. A
marker will be required to mark the maximum storage volume for waste storage
ponds.
22. Waste shall be tested within 60 days of utilization and soil shall be tested at least
annually at crop sites where waste products are applied. Nitrogen shall be the
rate-determining nutrient, unless other restrictions require waste to be applied
based on other nutrients, resulting in a lower application rate than a nitrogen
based rate. Zinc and copper levels in-the soils shall be monitored and alternative
crop sites shall be used when these metals approach excessive levels. pH shall be
adjusted and maintained for optimum crop production. Soil and waste analysis
records shall be kept for a minimum of five years. Poultry dry waste application
records shall be maintained for a minimum of three years.
Waste application records for all other waste shall be maintained for five (5)
years.
23. Dead animals will be disposed of in.a manner that meets North Carolina
regulations.
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528573 Database Version 3.1 Date Printed: 7/29/2005 Specification Page 3

Crop Notes
The following crop note applies to field(s): 9&1Obro, 9,10
Bermudagrass Coastal Plain,Mineral Soil,Moderately Well Drained,
Adaptation:Well-adapted.
In the Coastal Plain,hybrid bermudagrass sprigs can be planted Mar. 1 to Mar. 31.Cover sprigs 1"to 3"
deep (1.5"optimal). Sprigs should be planted quickly after digging and not allowed to dry in sun and
wind.For Coastal and Tifton 78 plant at least 10 bu/ac in 3'rows,spaced 2' to 3' in the row. Generally a
rate of 30 bu/ac is satisfactory to produce full groundcover in one or two years under good growing
conditions. Tifton 44 spreads slowly, so use at least 40 bu/ac in 1.5' to 2' rows spaced 1' to 1.5' in row.
For broadcast/disked-in sprigs use about 60 bu/ac. Soil test for the amounts of lime,phosphorus,
potassium and micronutrients to apply preplant and for annual maintenance.Apply 60 to 100 lb/ac N in
the establishment year in split applications in April and July.For established stands apply 180 to 240
lb/ac N annually in split applications,usually in April and following the first and second hay cuts.
Reduce N rates by 25%for grazing. Refer to NCSU Technical Bulletin 305 Production and Utilization
of Pastures and Forages in North Carolina for more information or consult your regional agronomist or
extension agent for assistance.
The following crop note applies to field(s): 5&6bro, 5,6
Small Grain: Coastal Plain, Organic Soils
In the Coastal Plain, oats and barley should be planted from October 15-October 30; and rye from
October 15-November 20. For barley,plant 22 seed/drill row foot and increase the seeding rate by 5% for
each week seeding is delayed beyond the optimum time. See the seeding rates table for applicable
seeding rate modifications in the current NCSU "Small Grain Production Guide". Also, increase the
initial seeding rate by at least 10%when planting no-till. Oats should be planted at 2 bushels/acre and
rye at 1-1 1/2 bushels/acre.Plant all these small grains at 1-1 1/2" deep.Adequate depth control is
essential.Review the NCSU Official Variety"green book" and information from private companies to
select a high yielding variety with the characteristics needed for your area and conditions.Apply no more
than 30 lbs/acre N at planting.Phosphorus and potash recommended by a soil test can also be applied at
this time.The remaining N should be applied during the months of February-March.
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528573 Database Version 3.1 Date Printed: 07-29-2005 Crop Note Page Page 1 of 3

The following crop note applies to field(s): 4,4bro
Small Grain: Coastal Plain,Organic Soils
In the Coastal Plain,oats and barley should be planted from October 15-October 30; and rye from
October 15-November 20.For barley,plant 22 seed/drill row foot and increase the seeding rate by 5%for
each week seeding is delayed beyond the optimum time. See the seeding rates table for applicable
seeding rate modifications in the current NCSU"Small Grain Production Guide". Also,increase the
initial seeding rate by at least 10%when planting no-till. Oats should be planted at 2 bushels/acre and
rye at 1-1 1/2 bushels/acre.Plant all these small grains at 1-1 1/2" deep. Adequate depth control is
essential.Review the NCSU Official Variety"green book"and information from private companies to
select a high yielding variety with the characteristics needed for your area and conditions.Apply no more
than 30 lbs/acre N at planting.Phosphorus and potash recommended by a soil test can also be applied at
this time. The remaining N should be applied during the months of February-March.
The following crop note applies to field(s): 7&8bro,7,8, 9&1Obro, 9,10
Small Grain: CP,Mineral Soil,medium leachable
In the Coastal Plain,oats and barley should be planted from October 15-October 30; and rye from
October 15-November 20.For barley,plant 22 seed/drill row foot and increase the seeding rate by 5%for
each week seeding is delayed beyond the optimum time. See the seeding rates table for applicable
seeding rate modifications in the current NCSU"Small Grain Production Guide". Also,increase the
initial seeding rate by at least 10%when planting no-till. Oats should be planted at 2 bushels/acre and
rye at 1-1 1/2.bushels/acre.Plant all these small grains at 1-1 1/2" deep. Adequate depth control is
essential.Review the NCSU Official Variety"green book" and information from private companies to
select a high yielding variety with the characteristics needed for your area and conditions.Apply no more
than 30 lbs/acre N at planting.Phosphorus and potash recommended by a soil test can also be applied at
this time.The remaining N should be applied during the months of February-March.
The following crop note applies to field(s): 5&6bro, 5,6
Bermudagrass: Coastal Plain, Organic Soil
Adaptation: Not adapted.
The following crop note applies to field(s): 4,4bro
Bermudagrass: Coastal Plain, Organic Soil
Adaptation:Not adapted.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
528573 Database Version 3.1 Date Printed: 07-29-2005 Crop Note Page Page 2 of 3

The following crop note applies to field(s): 7&8bro, 7,8
Bermudagrass: CP,Mineral Soil,Moderately Well Drained.
Adaptation: Well-adapted.
In the Coastal Plain,hybrid bermudagrass sprigs can be planted Mar. 1 to Mar. 31. Cover sprigs 1"to 3"
deep (1.5"optimal). Sprigs should be planted quickly after digging and not allowed to dry in sun and
wind.For Coastal and Tifton 78 plant at least 10 bu/ac in 3'rows, spaced 2' to 3' in the row. Generally a
rate of 30 bu/ac is satisfactory to produce full groundcover in one or two years under good growing
conditions.Tifton 44 spreads slowly, so use at least 40 bu/ac in 1.5' to 2'rows spaced 1' to 1.5' in row.
For broadcast/disked-in sprigs use about 60 bu/ac. Soil test for the amounts of lime,phosphorus,
potassium and micronutrients to apply preplant and for annual maintenance.Apply 60 to 100 lb/ac N in
the establishment year in split applications in April and July.For established stands apply 180 to 240
lb/ac N annually in split applications,usually in April and following the first and second hay cuts.
Reduce N rates by 25%for grazing. Refer to NCSU Technical Bulletin 305 Production and Utilization
of Pastures and Forages in North Carolina for more information or consult your regional agronomist or
extension agent for assistance.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
52s573 Database Version 3.1 Date Printed: 07-29-2005 Crop Note Page Page 3 of 3

EMERGENCY ACTION PLAN
PHONE NUMBERS
DWQ 910-486-1541
EMERGENCY MANAGEMENT SYSTEM 911
SWCD 910-862-6936
NRCS 9j0-862-6936
This plan will be implemented in the event that wastes from
your operation are leaking, overflowing, or running off
site. - You should not wait until wastes reach surface waters
or leave your property .to consider that you have a problem. .
You should make every effort to ensure that this does not
happen. This plan should be posted in an accessible
location for all employees at the facility. The following
are some action items you should take.
1. Stop the release of wastes. Depending on the
situation, this may or may not be possible. Suggested
responses to some possible problems are listed below.
A. Lagoon overflow-possible solutions are:
a. Add soil to berm to increase elevation of dam.
b. Pump wastes to fields at an acceptable rate.
C. Stop all flows to the lagoon immediately.
d. Call a pumping contractor.
e. Make sure no surface water is entering lagoon.
B: Runoff from waste application field-actions
include:
a. Immediately stop waste application.
b. Create a temporary diversion to contain waste.
C. Incorporate waste to reduce runoff.
d. Evaluate and eliminate the reason(s) that
caused the runoff.
e. Evaluate the application rates for the fields
where runoff occurred.
C: Leakage from the waste pipes and sprinklers-action
include:
a. Stop recycle pump.
b. Stop irrigation pump.
C. Close valves to eliminate further discharge.

d. Repair all leaks prior to restarting pumps.
D: Leakage from flush systems, houses, solid
separators-action include:
a. Stop recycle pump.
b. Stop irrigation pump.
C. Make sure no siphon occurs.
d. Stop all flows in the house, flush systems, or
solid separators.
e. Repair all leaks prior to restarting pumps.
E: Leakage from base or sidewall of lagoon. often
this is seepage as opposed to flowing leaks-
possible action:
a. Dig a small well or ditch to catch all seepage,
put in a submersible pump, and pump back to
lagoon.
b. If holes are caused by burrowing animals, trap
or remove animals and fill holes and compact
with a clay type soil.
C. Have a professional evaluate the condition of
the side walls and lagoon bottom as soon as
possible.
2 . Assess the extent of the spill and note any obvious
damages.
a. Did the waste reach any surface waters?
b. Approximately how much was released and for what
duration?
C. Any damage noted, such as employee injury, fish
kills, or property damage?
d. Did the spill leave the property?
e. Does the spill have the potential to reach surface
waters?
f. Could a future rain event cause the spill to reach
surface waters?
g. Are potable water wells in danger (either on or off
of the property) ?
h. How much reached surface waters?
3 : Contact appropriate agencies.
a. During normal business hours, call your DWQ
(Division of Water Quality) .regional office; Phone
910-486-1541• After hours, emergency number: 919-
733-3942 . Your phone call should include: your
name, facility, telephone number, the details of

the incident from item 2 above, the exact location
of the facility, the location or direction of
movement of the spill, weather and wind conditions.
The corrective measures that have been under taken.
and the seriousness of the situation.
b. If spill leaves property or enters surface waters,
call local EMS Phone number 911.
C. Instruct EMS to contact local Health Department.
d. Contact CES, phone number 910-862-4591 , local SWCD
office phone number 910-862-6936 , and local NRCS
office for advice/technical assistance phone number
.910-862-6936_
4: If none of the above works call 911 or the Sheriff's
Department and explain your problem to them and ask r
that person to contact the proper agencies for you.
: t 5 : Contact the contractor of your choice to begin repair
of problem to minimize off-site damage.
a. Contractors Name:
b. Contractors Address:
C. Contractors Phone:
6: Contact the technical specialist who certified the
lagoon (NRCS, Consulting Engineer, etc. )
a. Name•
b. Phone:
7 : Implement procedures as advised by DWQ and technical
assistance agencies to rectify the damage, repair the
system, and reassess the waste management plan to keep
problems with release of wastes from happening again.
r
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INSECT CONTROL CHECKLIST FOR ANIMAL OPERATIONS
Source Cause BMP's to Minimize Odor Site Specific Practices
(Liquid Systems)
Flush Gutters Accumulation of solids ush system is designed and operated
sufficiently to remove accumulated
solids from gutters as designed.
() Remove bridging of accumulated solids at
discharge
Lagoons and Pits Crusted Solids ( aintain lagoons, settling basins and
pits where pest breeding is apparent to
minimize the crusting of solids to a depth
of no more than 6-a inches over more than
30%of surface.
Excessive Vegetative Decaying vegetation (j),ldaintain vegetative control along banks of
Growth lagoons and other impoundments to prevent
accumulation of decaying vegetative matter
along water's edge on impoundment's perimeter.
(Dry Systems)
Feeders Feed Spillage () Design, operate and maintain feed systems(e.g_
bunkers and troughs) to minimize the accumulation
of decaying wastage.
{) Clean up spillage on a routine basis(e.g.7-10 day
interval during summer; 15-30 day interval during winter).
Feed Storage Accumulations of feed residues {) Reduce moisture accumulation within and around
immediate perimeter of feed storage areas by
insuring drainage away from site and/or providing
adequate containment(e.g., covered bin for
brewer's grain and similar high moisture grain
products).
() Inspect for and remove or break up accumulated
solids in filter strips around feed storage as needed.
Animal Holding Areas Accumulations of animal wastes () Eliminate low area that trap moisture along fences
and feed wastage and other locations where waste accumulates and
and disturbance by animals is minimal.
() Maintain fence rows and filter strips around animal
holding areas to minimize accumulations of wastes
(i.e.inspect for and remove or break up accumulated
solids as needed).
.MIC—November 11. 1996

Dry Manure Handling Accumulations of animal wastes () Remove spillage on a routine basis(e.g.7-10 day
Systems interval during summer, 1 S-30 days interval during
winter) where manure is loaded for land application
or disposal.
() Provide for adequate drainage around manure stockvies.
() Inspect for and remove or break up aceunvAated wastau
in.filter stripes around stockpiles and manure handling
areas as needed.
The issues checked 4 j pertain to this operation. The landownerintegramr agrees to use sound judgment in applying
insect control measures as practical.
I certify the aforementioned insect control Best Management Practices have been reviewed with me.
(Landowner Signature)
For more information contectthe Cooperative Extension Service,Department of Entomology. Box 7613,.North Carolina State University, Raleigh, NC
Z7695-7613.
AMIC—!November 11, 1996

q- 125 version—Nmrember 26,2M
r ►� �ordecr . Mortality Management Methods
Indicate which method(s)Wil be implemented.
Farm When selecting mutiiple methods indicate a primary versus secondary option.
Methods bther than those listed must be approved by the State Veterfnadan.
Primary Secondary Routine Mortality
a 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 beat 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 1 SA NCAC
13B .0200.
Rendering at a rendering plant licensed under G.S.105-168.7.
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.
(—"1 In the case of dead poultry only,placing in a disposal pit of a size and design approved by the
J� NC Department of Agriculture&Consumer Services(G.S.106-549.70).
❑ �'""1 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 CAVVMP 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. 106-399A
sl
Si';nature of Farm Owner/Mang r Date
Signathe of Technical Specialist r Date

Operator:BILLY BORDEAUX County: BLADEN Date: 08/31/94
Distance to nearest residence (other than owner): 1500.0 feet
1. AVERAGE LIVE WEIGHT (ALW)
0 sows (farrow to finish) x 1417 lbs. = 0 lbs
0 sows (farrow to feeder) x 522 lbs. = 0 lbs
3672 head (finishing only) x 135 lbs. = 495720 lbs
0 sows (farrow to wean) x 433 lbs. = 0 lbs
- 0 head (wean to feeder) x 30 lbs. = 0 lbs
Describe other 0
Total Average Live Weight = 495720 lbs
2. MINIMUM REQUIRED TREATMENT VOLUME OF LAGOON
Volume = 495720 lbs. ALW x Treatment Volume(CF)/lb. ALW
Treatment Volume(CF)/lb. ALW = 1 CF/lb. ALW
Volume = 495720 cubic feet
3. STORAGE VOLUME FOR SLUDGE ACCUMULATION
Volume = 0.0 cubic feet
4. TOTAL DESIGNED VOLUME
Inside top length (feet) 480.0
Inside top width (feet) - - 230.0
Top of dike elevation (feet) 101.3
Bottom of lagoon elevation (feet)- 90,3
Freeboard (feet) -- 1.0
Side slopes (inside lagoon) 3.0 : 1
Total design volume using prismoidal formula
SS/END] SS/END2 SS/SIDE] SS/SIDE2 LENGTH WIDTH DEPTH
3-0 3.0 3.0 3.0 474.0 224.0 10.0
AREA OF TOP
LENGTH * WIDTH =
474.0 224.0 106176 (AREA OF TOP)
AREA OF BOTTOM
LENGTH * WIDTH =
414.0 164.0 67896 (AREA OF BOTTOM)
AREA OF MIDSECTION
LENGTH WIDTH * 4
444.0 194.0 344544 (AREA OFJKIDSECTION * 4)
CU. FT. _ [AREA TOP + (4*AREA MIDSECTION) + AREA BOTTOM] * DEPTH/6
106176.0 344544.0 67896.0 1.7
Total Designed Volume Available = 364360 CU. FT.

�r
r'
5. TEMPORARY STORAGE REQUIRED
DRAINAGE AREA:
Lagoon (top of dike)
Length '* Width =
480.0 230.0 110400.0 square feet
Buildings (roof and lot water)
0.0 square feet Describe this area.
TOTAL DA 110400.0 square feet
Desi A temporary storage period to be 180 days.
5A. Volume of waste produced
Feces & urine production in gal./day per 135 lb. ALW 1.37
Volume = 495720 lbs. ALW/135 lbs. ALW '� 1.37 gal/day 180 days
Volume = 905515 gals. or 121058.2 cubic feet
5B. Volume of wash water
This is the amount of fresh water used for washing floors or volume
of fresh water used for a flush system. Flush systems that recirculate
the lagoon water are accounted for in 5A.
Volume = 3304.0 gallons/day '' 180 days storage/7.48 gallons
Volume = 79508.0 cubic feet per CF
5C. Volume of rainfall in excess of evaporation
Use period of time when rainfall exceeds evaporation by largest amount.
180 days excess rainfall = 7.0 inches
Volume = 7.0 in 't DA / 12 inches per foot
Volume = 64400.0 cubic feet

5D. Volume of 25 year - 24 hour storm
Volume = 7.3 inches / 12 inches per foot DA
Volume = 66700.0 cubic feet
TOTAL REQUIRED TEMPORARY STORAGE
5A. 121058 cubic feet
51B. 79508 cubic feet
5C: 64400 cubic feet
5D. 66700 cubic feet
TOTAL 331666 cubic feet
6. SUMMARY
Temporary storage period - -- ——) 180 days
Rainfall in excess of evaporation--- - ) 7.0 inches
25 year - 24 hour rainfall -- -__ ) 7.3 inches
Freeboard - - -- --) 1.0 feet
Side slopes -- -) 3.0 : 1
Inside top length - --) 480.0 feet
Inside top width ----- -- ) 230.0 feet
Top of dike elevation ) 101.3 feet
Bottom of lagoon elevation ) 90.3 feet
Total required Yolume - ) 82738b cu. ft.
Actual design volume- - --_ - - - ) 864360 cu. ft.
Seasonal high watertable elevation (SHWT)=) 96.5 feet
Stop pumping elev.— ----) 96.8 feet
Must be ) or = to the SHWT elev.= -) 96.5 feet
Must be ) or = to min. req. treatment el.=) 96.3 feet
Required minimum treatment volume- ) 495720 cu. ft.
Volume at stop pumping elevation- - -_=) 522484 cu. ft.
Start pumping elev.— -- -) 99.6 fleet
Must be at bottom of freeboard & 25 yr. rainfall
Actual volume less 25 yr.- 24 hr. rainfall=) 797660 cu. ft.
Volume at start pumping elevation - _ - -_) 791059 cu. ft.
Required volume to be pumped -----) 264966 cu. ft.
Actual volume planned to be pumped - -_) 268575 cu. ft.
Min. thickness of soil liner when required=) 1.6 feet
7. DESIGNED BY. APPROVED 8Y:
DATE: DATE:
NOTE: SEE ATTACHED WASTE UTILIZATION PLAN
COMMENTS-

7
SHEET 1 OF 2
OPERATION AND MAINTENANCE PLAN
This lagoon is designed for waste treatment (permanent storage) and
180 days of temporary storage. The time required for the planned
fluid level (permanent and temporary storage) to be reached may vary
due to site conditions, weather, flushing operations, and the amount
of fresh water added to the system.
The designed temporary storage consists of 180 days storage for:
(1) waste from animals and (2) excess rainfall after evaporation. Also
included is storage for the 25 year — 24 hour storm for the location.
The volume of waste generated from a given number of animals will be
fairly constant throughout the year and from year to year, but excess
rainfall will vary from year to year. The 25 year rainfall will not
be a factor to consider in an annual pumping cycle, but this storage
volume must always be available.
A maximum elevation is determined in each design to begin
pumping and this is usually the outlet invert of pipe(s) from
building(s) . If the outlet pipe is not ihstalled at the elevation to
begin pumping, a permanent marker must be installed at this elevation
to indicate when pumping should begin. An elevation must be established
to stop pumping to maintain lagoon treatment depth.
Pumping can be started or stopped at any time between these two
elevations for operating convenience as site conditions permit, such as
weather, soils, crop, and equipment in order to apply waste without
runoff or leaching.
Land application of waste water is recognized as an acceptable
method of disposal. Methods of application include solid set,
center pivot, guns, and traveling gun irrigation. Care should be
taken when applying waste to prevent damage to crops.
The following items are to be carried out:
1. It is strongly recommended that the treatment lagoon be pre—
charged to 112 its capacity to prevent excessive odors during
start—up. Pre—charging reduces the concentration of the initial
waste entering the lagoon thereby reducing odors. Solids should be
covered with effluent at all times. When precharging is complete,
flush buildings with recycled lagoon liquid. Fresh water should not
be used for flushing after initial filling.
2. The attached waste utilization plan shall be followed. This
plan recommends sampling and testing of waste (see attachment)
before land application.
3. Begin temporary storage pump—out of the lagoon when fluid level
reaches the elevation 99.6 as marked by permanent marker. Stop pump—
out when the fluid level reaches elevation 96.8 . This temporary
storage, less 25 yr— 24 hr storm, contains 264966 cubic feet or
1981947 gallons.

SHEET 2 OF 2
4. The recommended maximum amount to apply per irrigation is
one (1) inch and the recommended maximum application rate is 0.3
inch per hour. Refer to the waste utilization plan for further details.
L
5. Keep vegetation on the embankment and areas adjacent to the
lagoon mowed annually. Vegetation should be fertilized as needed
to maintain a vigorous stand.
6. Repair any eroded areas or areas damaged by rodents and
establish in vegetation.
7. All surface runoff is to be diverted from the lagoon to stable
outlets.
8. Keep a minimum of 25 feet of grass vegetated buffer around
waste utilization fields adjacent to perennial streams. Waste will
not be applied in open ditches. Do not pump within 200 feet of a
residence or within 100 feet of a well. Waste shall be applied in a
manner not to reach other property and public right-of-ways.
9. The-.Clean Water Act of 1977 prohibits the discharge of
pollutants into waters of the United States. The Department of
Environment, Health, and Natural Resources, Division of Environ-
mental Management, has the responsibility for enforcing this law.

ROY COOPER
Governor f
4
ELIZABETH S.BISER
Secretary
RICHARD E.ROGERS,JR. NORTH CAROLINA ptECENED
Director Environmental Quality
February 12,2024 MAR 2 6 2024
Douglas A Bordeaux
Billy E Bordeaux Farm
IDWR
112 Sweet Home Church Rd C Central
Office
Elizabethtown,NC 28337-6140 Central® ���
Subject: Application for Renewal of Coverage for Expiring State General Permit
Dear Permittee:
Your facility is currently approved for operation under one of the Animal Waste Operation State Non-Discharge General Permits,
which expire on September 30, 2024. In order to ensure your continued coverage under the State Non-Discharge General
Permits you must submit an application for permit coverage to the Division of Water Resources (DWR)by April 3,2024.
Enclosed you will find a 'Request for Certificate of Coverage for Facility Currently Covered by an Expiring State
Non-Discharge General Permit."The application form must be completed signed by the Permittee,and returned to the DWR by
Apri13.2024.
Mailing Address: NCDEQ-DWR
Animal Feeding Operations Program
1636 Mail Service Center
Raleigh,North Carolina 27699 1636
Email:animal.gperationsna,deq.nc.gov
phone:[phone]
Please note that you must include one (1) copy of the Certified Animal Waste Management Plan (CAWMP) with the
completed and signed application form. A list of items included in the CAWMP can be found on page 2 of the renewal
application form.
Failure to request renewal of your coverage under a general permit within the time period specified may result in a civil penalty.
Operation of your facility without coverage under a valid general permit would constitute a violation of NC G.S. § 143-215.1
and could result in assessments of civil penalties of up to$25,000 per day.
Copies of the animal waste operation State Non-Discharge General Permits are available at
www.deq.nc.gov/animalpernuts2024.General permits can be requested by writing to the address above.
If you have any questions about the State Non-Discharge General Permits,the enclosed application,or any related matter please
feel free to contact the Animal Feeding Operations Branch staff at 919-707-9129.
Sincerely,
Michael Pjetraj,Deputy Director
Division of Water Resources
Enclosures: Request for Certificate of Coverage for Facilit+y Currently Covered by an Expirinc State Non-Discharge
General Permit
NorthCararmaDeparmentofEm-itanme taiQnr"ity DirbionofWatsr$egaarces
.^ L— 512 North Sarisirur+c Street 1634 Mail Sm-keCeaNr RaWFA NorthCarn9iffi 2'f4WIG36
919 7079129

State 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: AWS090125
2. Facility Name: Billy E Bordeaux Farm
3. Permittee's Name(same as on the Waste Management Plan): Douglas A Bordeaux
4. Permittee's Mailing Address: 112 Sweet Home Church Rd
City: Elizabethtown State: NC Zip: 28337-6140
Telephone Number: 910-874-1477 Ext. E-mail: dbordeaux8rec.rr.com:[e-mail]
5. Facility's Physical Address: 2690 Sweet Home Church Rd
City: Elizabethtown State: NC Zip: 28337
6. County where Facility is located: Bladen
7. Farm Manager's Name(if different from Landowner): Douglas A Bordeaux
g, Farm Manager's telephone number(include area code): 910-874-1477 Ext.
9. Integrator's Name(if there is not an Integrator,write"None"): Mumb,,-Brown LLC
10. Operator Name(OIC): Douglas A.Bordeaux Phone No.: OIC#: 17945
11. Lessee's Name(if there is not a Lessee,write"None"):
12. Indicate animal operation type and number:
Current Permit: Operations Type Allowable Count
Swine-Feeder to Finish 3,672
Operation Types:
Swine Cattle Dry Poultry Other Types
Wean to Finish Dairy Calf Non Laying Chickens Horses-Horses
Wean to Feeder Dairy Heifer Laying Chickens Horses-Other
Farrow to Finish Milk Cow Pullets Sheep-Sheep
Feeder to Finish Dry Cow Turkeys Sheep-Other
Farrow to Wean Beef Stocker Calf Turkey Pullet
Farrow to Feeder Beef Feeder
Boar/Stud Beef Broad Cow Wet Poultry
Gilts Other Non Laying Pullet
Other Layers

13. Waste Treatment Lagoons,Digesters and Waste Storage Ponds(WSP): (Fill/Verify the following information.
Make all necessary corrections and provide missing data.)
Structure Type Estimated Liner Type Estimated Design Freeboard
Structure (Lagoon/Digester/ Date (Clay,Synthetic, Capacity Surface Area 'Redline"
Name WSP) Built Unknown) (Cubic Feet) (Square Feet) (Inches)
1 Lagoon 8/31/1994 Full,clay 864,360.00 110,400.00 19.30
1 Lagoon 19.00
1 Lagoon 104,544.00
Submit one (1) copy of the Certified Animal Waste Management Plan (CAWMP) with this completed and signed
application as required by NC General Statutes 143-215.10C(d), either by mailing to the address below or sending it via
email to the email address below.
The CAWMP must include the following components:
1. The most recent Waste Utilization Plan(WUP),signed b% the owner and a certified technical specialist,containing:
a. The method by which waste is applied to the disposal fields(e.g.irrigation,injection,etc.)
b. A map of every field used for land application(for example:irrigation map)
c. The soil series present on every land application field
d. The crops grown on every land application field
e. The Realistic Yield Expectation(RYE)for every crop shown in the WUP
f. The maximum PAN to be applied to every land application field
g. The waste application windows for every crop utilized in the WUP
h. The required NRCS Standard specifications
2. A site map/schematic
3. Emergency Action Plan
4. Insect Control Checklist with chosen best management practices noted
5. Odor Control Checklist with chosen best management practices noted
6. Mortality Control Checklist with selected method noted-Use the enclosed updated Mortality Control Checklist
7. Lagoon/storage pond capacity documentation(design,calculations,etc.) Please be sure the above table is
accurate and complete. Also provide any site evaluations,wetland determinations,or hazard classifications that may be
applicable to your facility.
8. Operation and Maintenance Plan
If your CAWMP includes any components not shown on this list,please include the additional components with your submittal.
(e.g. composting,digesters,solids separators,sludge drying system,waste transfers,etc.)
I attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that,
if all required parts of this application are not completed and that if all required supporting information and attachments are not
included,this application package will be returned to me as incomplete.

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): i. �.�� `�����JG Title: n`e-'r— r
Signature: Date:
Name(Print): Title:
Signature: Date:
Name(Print): Title:
Signature: Date:
THE COMPLETED APPLICATION SHOULD BE SENT TO THE FOLLOWING ADDRESS:
E-mail: [e-mail]
NCDEQ-DWR
Animal Feeding Operations Program
1636 Mail Service Center
Raleigh,North Carolina 27699-1636