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HomeMy WebLinkAbout540032_OIC Designation Form_20240215State 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 snake any necessary corrections belorv. Application mast be signed and dated by the Permiftee. 1. Certificate Of Coverage Number: AWS540032 2. Facility Name: Top Stock Hog Farm 3. Permittee's Name (same as on the Waste Management Plan): Offspring Farms LLC 4. Permittee's Mailing Address: 239 Jonestown Rd City: Pink Hill State: NC Zip: 28572 Telephone Number: 252-361-2034 Ext. E-mail: Rod Smith <rds0312na hotmai1.com> 5. Facility's Physical Address: 4059 Vine Swamp Rd City: Kinston State: NC 6. County where Facility is located: Lenoir 7. Farm Manager's Name (if different from Landowner): Zip: 28504 8. Farm Manager's telephone number (include area code): 9. Integrator's Name (if there is not an Integrator, write "None"): M - rown LLC SMi f el d 10. Operator Name (OIC): Ste r or ter Phone No.: OIC #: 4509494 --' e4a sni;A Jr. w5t 361-ap3y Iflit5 11, Lessee's Name (if there is not a else , write ' None' ): 12. Indicate animal operation type and number: Current Permit: Operations Type Swine - Gilts Operation Tvnes: Swine Cattle Wean to Finish Dairy Calf Wean to Feeder Dairy Heifer Farrow to Finish Milk Cow Feeder to Finish Dry Cow Farrow to Wean Beef Stocker Calf Farrow to Feeder Beef Feeder Boar/Stud Beef Broad Cow Gilts Other Other Allowable Count 3,240 Dry Poultry Other Types Non Laying Chickens Horses - Horses Laying Chickens Horses - Other Pullets Sheep - Sheep Turkeys Sheep - Other Turkey Pullet Wet Poultry Non Laying Pullet 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 Name Structure 'type (Lagoon/Digester/ W SP) Estimated Date Built Liner'lype (Clay, Synthetic, Unknown) Capacity (Cubic Feet) Estimated Surface Area (Square Feet) Design Freeboard "Redline" (Inches) 1 Lagoon 3/31/1992 Full, clay 726,520.00 79,279.00 25.50 Submit one (1) copy of the Certified Animal Waste Management Plan (CAWMP) with this completed and signed application as required by NC General Statutes 143-215.1OC(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), sinned 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 143-215.613, 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): � (�� fJr Name (Print): (Ji'iC (iA L- l c/C4'!✓'lit e: t2tx'01 Signature: OQ` Date: ta"' 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