State of North Carolina Department of Environment and Natural Resources Division of Water Resources

State of North Carolina Department of Environment and Natural Resources Division of Water Resources Animal Waste Management Systems Request for Certificate of Coverage Facility Currently Covered by an Expiring State Non-Discharge Generil Permit On September 30, 2014, 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. Thearefore, all applications must be received by the Division of Water Resources by no later than April 1, 2014. Please do not leave any question unanswered. Please verify all information and make any necessa y corrections below. Application must be signed and dated by the Permittee. 1. Facility Number: 090102 and Certificate of Coverage Number: AWS090102 2. Facility Name: Neill Jackson Farm 3. Landowner's name (same as on the Waste Management Plan): Neill Jackson 4. Landowner's mailing address: 1646 S Elwell Ferrv Rd City/State: Council NC Zip: 284348618 Telephone Number (include area code): (910)669-2124 E-mail: njacksonlsintrstar.net *EVED/DENR/DWR APR 1 4 ZOU vllater Quality Operations Regional Section 5. Facility's physical address: 1646 1646 S Elwell Ferry Rd City: Council State: NC Zip: 28434 6. County where facility is located: Bladen 7. Farm Manager's name (f different than the Landowner): 8. Farm Manager's telephone number (include area code): 9. ntegrator's name (if there is not an integrator write "None"): Ernest Smith Farni nc 10. Operator in Charge (OC) name: Henry Jackson Telephone Number Cfto /yfe*? bic# 11. Lessee's name (if there is not a lessee write "None"): (/lh>h'<. 12. ndicate animal operation type and number:, Swine Wean to Finish Wean to Feeder 3204 Farrow to Finish Feeder to Finish 600 Farrow lo Wean Farrow to Feeder Boar/Stud Gilts Other Horses - Horses Horses - Other Cattle Dairy Calf Dairy Heifer Milk Cow Dry Cow Beef Stocker Calf Beef Feeder Beef Brood Cow Other Sheep - Sheep Sheep - Other Dry Poultry Non Laying Chickens Laying Chickens Turkeys Other Pullets Turkey Poults Wet Poultry Non Laying Pullet Layers FORM: RFNFWAL-STATF GENERAL 03/2014

Mail one (1) copy of the most recent Waste Utilization Plan (WUP) along with the field maps tor this facility with this completed and signed application as required by NC General Statures 143-215.10C(d) to the address below. The WUP must be signed by the owner and a certified technical specialist.. As a second option to mailing paper copies of the application package, you can scan and email one signed copy of the application and the WUP to: animapermits@ncdenr.goy attest that this application has been reviewed by me and is accurate and complete to the best of my loiowledge. 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: n accordance with NC General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false statement, representation, or certification m 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 Cine of not more than $10,000 or imprisonment of not more than 5 years, or both for a similar offense.) Printed Name of Signing Official (Landowner, or if multiple Landowners all landowners should sig^ f Landowner is a corporation, signature should be by a principal executive officer of the corporation): Name: f V -y/ ^dz-i» -t Title: Signature Date: Name: Title: Signature: Date: Name: Title: Signature: Date: THE COMPLETED APPLCATON SHOULD BE SENT TO THE FOLLOWNG NCDENR-DWR Animal Eeeding Operations Branch 1636 Mail Service Center Raleigh, North Carolina 27699-1636 ADDRESS: Telephone nnmber: (919) 807-6464 E-mail: animalpermits@ncdenr.gov FORM: RFNFWAL-STATF GFNFRAL 03/2014

JL WORKSHEET FOR CALCULATNG PAN AND TONS OF WASTE FROM COMBNATON SWNE OPERATONS ^ peved/denr/dvvr D e r a t i o n Code: 6 C o m b i n a t i o n Swine Farm APR 1 4 2014 PPLCATON METHOD: r r i g a t i o n ter Quality Regional 'perations Section Type O p e r a t i o n Number A n i m a l s Tons p e r Waste.ftjaimal PAN p e r an. JMBER OF WEAN TO FEEDER PGS: JMBER OF FEEDER TO F N S H HOGS: UMBER OF FARROW TO WEAN SOWS: UMBER OF FARROW TO FEEDER SOWS: UMBER OF FARROW TO F N S H SOWS: 3204 600.40 1.9 6.i 7.^ 19.9.48 2.3 5.4 6.5 26 TOTAL NUMBER ANMALS 3804 ONS OF WASTE PRODUCED PER YEAR: WEAN TO FEEDER: FEEDER TO F N S H :. r ^. FARROW TO WEAN: FARROW TO FEEDER: FARROW TO F N S H : 1281.6 t o n s 1140 t o n s 0 t o n s 0 t o n s 0 t o n s. '^OTAL WASTE: 2421.6 t o n s 'AN PRODUCED PER YEAR: 7,-i vc Z.G. WEAN TO:FEEDER: ' ^ FEEDER'2fo F N S H : " FARROW TO WEAN: FARROW TO FEEDER:- FARROW TO F N S H : 1537.92 l b s 1380 l b s 0 l b s 0 l b s 0 l b s -rv;. TOTAL PAN: 2917 WERAGE TONS OF WASTE PER ANMAL PER YEAR: 0.6364353 1 WERAGE PAN PRODUCED PER ANMAL PER YEAR: 0.7668243 51 73 SLUDGE PAN PRODUCED PER YEAR: BROADCAST 7 WEAN TO FEEDER: FEEDER TO F N S H : FARROW TO WEAN: FARROW TO FEEDER: FARROW TO F N S H :.243.504 l b s 222 l b s 0- l b s 0 l b s 0 l b s TOTAL SLUDGE PAN: 465.504 l b s AVERAGE SLUDGE PAN PER ANMAL PER YEAR: 0.122372239748

ANMAL WASTE UTLZATON PL^N Producer: Location: Telephone: Type Operation: Number of Animals: (Design Capacity) STORAGE STRUCTURE: APPLCATON METHOD; NEL JACKSON 164 6 ELWELL FERRY ROAD COUNCL NC 2 8434 % (910) 669-2124 Existing Combination Swine Par a 3804.00 swine rrigation The w a s t e f r o m y o u r a n i m a l f a c i l i t y must be l a n d a p p l i e d a t a s p e c i f i e d r a t e t o p r e v e n t p o l l u t i o n o f s u r f a c e w a t e r and/or g r o u n d w a t e r. The p l a n t n u t r i e n t s i n t h e a n i m a l w a s t e s h o u l d be used t o r e d u c e t h e amount o f c o m m e r c i a l f e r t i l i z e r r e q u i r e d f o r t h e c r o p s i n t h e f i e l d s w h e r e t h e w a s t e i s t o be a p p l i e d. T h i s w a s t e u t i l i z a t i o n p l a n u s e s n i t r o g e n as t h e l i m i t i n g n u t r i e n t. Waste s h o u l d be a n a l y z e d b e f o r e each a p p l i c a t i o n c y c l e. A n n u a l s o i l t e s t s a r e s t r o n g l y e n c o u r a g e d so t h a t a l l p l a n t n u t r i e n t s can be b a l a n c e d f o r r e a l i s t i c y i e l d s o f t h e c r o p t o be grown. S e v e r a l f a c t o r s a r e i m p o r t a n t i n i m p l e m e n t i n g y o u r w a s.1 t ^ u t i l i z s t i o n p l a n, i n o r d e r t o ' m a x i m i z e t h e f e r t i l i z e r v a l u e o f t h e v;aste and t o e n s u r e t h a t. i t i s ap»plied i n an e n v i r o n m e n t a l l y s a f e manner:., - 1. A l w a y s a p p l y w a s t e based on t h e needs o f t h e c r o p t o be ^ ' g r o w n and t h e n u t r i e n t c o n t e n t o f t h e w a s t e. Do n o t a p p l y.. more n i t r o g e n t h a n t h e c r o p can u t i l i z e. ^ j '2. S o i l - t y p e s a r e i m p o r t a n t as t h e y have d i f f e r e n t i n f i l t r a t i o n rates',- l e a c h i n g p o t e n t i a l s, c a t i o n exchange c a p a c i t i e s, and,t.. a v a i l a b l e w a t e r h o l d i n g c a p a c i t i e s. 3. N o r m a l l y w a s t e s h a l l be a p p l i e d t o l a n d e r o d i n g a t l e s s t h a n 5 t o n s p e r a c r e pe^_ y e a r. Waste may be a p p l i e d t o l a n d e r o d i n g a t 5 o r more t o n s p e r a c r e a n n u a l l y, b u t l e s s t h a n 10 t o n s p e r a c r ^ p e r y e a r p r o v i d i n g t h a t adequate f i l t e r s t r i p s a r e e s t a b l i s h e d. 4. Do n o t a p p l y w a s t e o n s a t u r a t e d s o i l s, w h e n ' i t i s r a i n i n g, o r when t h e s u r f a c e i s f r o z e n. E i t h e r o f t h e s e c o n d i t i o n s may r e s u l t i n r u n o f f t o s u r f a c e w a t e r s w h i c h i s n o t a l l o w e d u n d e r DWQ r e g u l a t i o n s. Page:

ANMAL WASTE UTLZATON PLAN TABLE 1: ACRES OWNED BY PRODUCER TRACT FELD SOL TYPE c CLASS- DETERMNNG PHASE CROP CODE APPLY METH YELD LBS AW N i PER AC C0r4M N PER AC o r RESD. N k-k ACRES * LBS ^ AW N USED APPLC TME 5368 1 NOA BP 5368-1 NOA SG END 4.6 230 10.5 2415 MAR-OCT f. 21 50^'' 10.5 529.2 S PT-M.bA 1 i 1 TOTAL 2944.2 - - n d i c a t e s t h a t t h i s f i e l d i s b e i n g o v e r s e e d e d (i,e. inte:...slanted) o r v / i n t e r a n n u a l s f o l l o v ; summer annuals::... NOTE; The a p p l i c a t o r i s c a u t i o n e d t h a t P and K may be p y e r a p p l i e d w h i l ^ D s m e e t i n g t h e N i r e q u i r e m e n t s. n, t h e f u t u r e / r e g u l a t i o n s mayclrequire f a r m e r s i n :.spme p a r t s o f N o r t h C a r o l i n a t o have a n u t r i e n t management planz-fchat a d d r e s s e s a l l n u t r i e n t s. T h i s p l a n o n l y a d d r e s s e s n i t r o g e n..

# ANMAL WASTE UTLZATON PLAN TABLE 2: ACRES WTH NOTARZED AGREEMENT OR LONG TERM LEASE (Agreement w i t h a d j a c e n t l a n d o w n e r s must be a t t a c h e d. ) ( R e q u i r e d o n l y i f o p e r a t o r does n o t own adequate l a n d. See r e q u i r e d s p e c i f i c a t i o n 2.) TRACT FELD SOL TYPE & CLASS- DETERMNNG PHASE CROP CODE APPLY METH YELD LBS AW N PER AC COMM N PER AC o r l E S D. N * * ACRES LBS AW N USED APPLC TME END TOTAL 0 n d i c a t e s t h a t t h i s f i e l d i s b e i n g o v e r s e e d e d ( i. ^. i n t e r p l a n t e d ) o r w i n t e r a n n u a l s f o l l o w summer a n n u a l s. n i n t e r p l a n t e d f i e l d s ( i. e. s m a l l g r a i n, et<i:, i n t e r s e e d e d i n b e r m u d a g r a s s ), f o r a g e must be removed t h r o u g h ' g r a z i n g, hay a n d / o r s i l a g e. Where g r a z i n g, p l a n t s s h o u l d be g r a z e d when t h e y r e a c h a h e i g h t o f. s i x t o n i n e i n c h e s. C a t b l e s h o u l d be removed when p l a n t s a r e g r a z e d t o a h e i g h t, a f - " f o u r i n c h e s.. n f i e l d s where s m a l l g r a i n, e t c, i s t o be removed for-.-hay o r s i l a g e, c a r e s h o u l d be e x e r c i s e d n o t t o l e t s m a l l g r a i n t o r e a c h m a t u r i t y ; / e s p e c i a l l y l a t e i n t h e s e a s o n ( i. e. A p r i l o r M a y ). S h a d i n g i m a y r e s u l t i f s m a l l g r a i n g e t s t o o h i g h apd t h i s w i l l d e f i n i t e l y i n t e r f e r e w i t h s t a n d o f b e r m u d a g r a s s. T h i s l o s s o f s t a n d. -. w i l l r e s u l t i n r e d u c e d y i e l d s and l e s s n i t r o g e n b e i n g u t i l i z e d. R a t h e r t h a n c u t t i n g s m a l l g r a i n f o r h a y o r s i l a g e j u s t b e f o r e h e a d i n g as i s t h e n o r m a l s i t u a t i o n, y o u a r e e n c o u r a g e d t o c u t t h e s m a l l g r a i n e a r l i e r. You may want t o c o n s i d e r h a r v e s t i n g h a y o r s i l a g e t w o t o t h r e e t i m e s d u r i n g t h e season, d e p e n d i n g on t i m e s m a l l g r a i n i s p l a n t e d i n t h e f a l l. The i d e a l t i m e t o i n t e r p l a n t s m a l l g r a i n, e t c, i s l a t e September o r e a r l y O c t o b e r. D r i l l i n g i s recommended o v e r b r o a d c a s t i n g. Bermudagrass s h o u l d be g r a z e d o r mowed t o a h e i g h t o f a b o u t t w o i n c h e s b e f o r e d r i l l i n g f o r b e s t r e s u l t s.

ANMAL WASTE UTLZATON P ** Acreage f i g u r e s may exceed t o t a l a c r e a g e i n f i e l d s due t o o v e r s e e d i n g. * l b s AW N ( a n i m a l w a s t e n i t r o g e n ) e q u a l s t o t a l r e q u i r e d n i t r o g e n l e s s a n y c o m m e r c i a l n i t r o g e n (COMM N) s u p p l i e d. The f o l l o w i n g l e g e n d e x p l a i n s t h e c r o p codes u s e d i n t a b l e s 1 and 2 above CROP CODE CROP UipiTS PER UNT BP SG HYBRD BERMUDAGRASS-PASTURE SMALL GRAN OVERSEEDED TONS 50 2.4 TOTALS FROM TABLES 1 AND 2 ACRES LBS AW N USED TABLE 1 10.5 2944.2 TABLE 2 0 0 TOTAL 10.5 2944.2,^,:*** BALANCE -2 7.2 yl" 'A. '''' ' *** T h i s ^#tiraber must be l e s s t h a n o r e q u a l t o 0 i n o r d e r t.p : : : : f u l l y u t i l i z e t h e a n i m p l. w a s t e N p r o d u c e d. Page: 5

ANMAL WASTE UTLZATON PLAN *** T h i s number must be l e s s t h a n o r e q u a l t o 0 i n o r d e r t o f u l l y u t i l i z e t h e a n i m a l w a s t e N produced. A c r e s shown i n each o f t h e p r e c e d i n g t a b l e s a r e c o n s i d e r e d t o be t h e u s a b l e a c r e s e x c l u d i n g r e q u i r e d b u f f e r s, f i l t e r s t r i p s a l o n g d i t c h e s, odd a r e a s u n a b l e t o be i r r i g a t e d, and p e r i m e t e r a r e a s n o t r e c e i v i n g f u l l a p p l i c a t i o n r a t e s due t o equipment l i m i t a t i o n s. A c t u a l t o t a l a c r e s i n t h e f i e l d s l i s t e d may, and most l i k e l y w i l l be, more t h a n t h e a c r e s shown i n t h e t a b l e s. See a t t a c h e d map s h o w i n g t h e f i e l d s t o be used f o r a n i m a l w a s t e. t t i e u t i l i z a t i o n o f APPLCATON OF WASTE BY RRGATON The i r r i g a t i o n a p p l i c a t i o n r a t e s h o u l d n o t exceed t h e i l i t a k e r a t e o f t h e s o i l a t t h e t i m e o f i r r i g a t i o n s u c h t h a t r u n o f f o r p o n d i n g o c c u r s. T h i s r a t e i s l i m i t e d by i n i t i a l s o i l m o i s t u r e c o n t e n t, s o i l s t r u c t u r e, s o i l t e x t u r e, w a t e r d r o p l e t s i z e, and o r g a n i c s o l i d s. The a p p l i c a t i o n amount s h o u l d n o t e x c e e d t h e a v a i l a b l e w a t e r h o l d i n g c a p a c i t y o f t h e s o i l a t t h e t i m e o f i r r i g a t i o n n o r s h o u l d t h e p l a n t a v a i l a b l e n i t r o g e n a p p l i e d exceed t h e n i t r o g e n needs o f t h e c r o p. ;. - f s u r f ace. i r r i g a t i o n i s t h e method o f l a n d a p p l i c a t i o n f o r t h i s p l a n, i t i s t h e r e s p o n s i b i l i t y o f t h e p r o d u c e r and i r r i g a t i o n d e s i g n e r " t o e n s u r e t h a t an i r r i g a t i o n s y s t e m i s i n s t a l l e d t o p r o p e r l y i r r i g a t e t h e a c r e s shown i n T a b l e s 1 and 2. F a i l U P e p t o a p p l y t h e recommended r a t e s - and amounts o f n i t r o g e n shown i n t h e - t a b l e s may make t h i s p l a n i n v a l i d. The f o l l o w i n g t a b l e i s p r o v i d e d as a g u i d e f o r e s t a b l i s h i n g a p p l i c a t i o n r a t e s and a m o u n t s. A p p l i c a t i o n Rate A p p l i e. Amount T r a c t F i e l d S o i l Type 1 Crop ( i n / h r ) ( i n c h e s ) 5368 1 NOA BP 0.5 *0.75 6 ~ 1 NOA SG 0.5 *0.75

ANMAL WASTF UTLZATON PLAN T h i s i s t h e maximum a p p l i c a t i o n amount a l l o w e d f o r t h e s o i l a s s u m i n g t h e amount o f n i t r o g e n a l l o w e d f o r t h e c r o p i s n o t o v e r a p p l i e d. n many s i t u a t i o n s, t h e a p p l i c a t i o n amount shown c a n n o t be a p p l i e d because o f t h e n i t r o g e n l i m i t a t i o n. The maximum a p p l i c a t i o n amount shown c a n be a p p l i e d u n d e r o p t i m u f n s o i l c o n d i t i o n s. Y o u r f a c i l i t y i s d e s i g n e d f o r 180.00 days o f t e m p o r a r y s t o r a g e and t h e t e m p o r a r y s t o r a g e must be removed on t h e a v e r a g e o f once e v e r y 6.00 months. n no i n s t a n c e s h o u l d t h e v o l u m e o f t h e w a s t e be s t o r e d i n y o u r s t r u c t u r e be v / i t h i n t h e 25 y e a r 24 h o u r s t o r m s t o r a g e o r one f o o t o f f r e e b o a r d e x c e p t i n t h e e v e n t o f t h e 2 5 y e a r 24 h o u r s t o r m. t i s t h e r e s p o n s i b i l i t y o f t h e p r o d u c e r and w a s t e a p p l i c a i o r t o e n s u r e t h a t t h e s p r e a d e r e q u i p m e n t i s o p e r a t e d p r o p e r l y t o a p p l y t h e c o r r e c t r a t e s t o t h e a c r e s shown i n T a b l e s 1 and 2. F a i l u r e t o a p p l y t h e recommended r a t e s and amounts o f n i t r o g e n shown i n the. t a b l e s may tpajce t h i s p l a n i n v a l i d. C c i i l y o u r t e c h n i c a l s p e c i a l i s t a f t e r, y o u r e c e i v e t h e w a s t e A n a l y s i s r e p o r t f o r a s s i s t a n c e i n d e t e r m i n i n g t h e amount o f w a s t e p e r.acre and t h e p r o p e r a p p l i c a t i o n r a t e p r i o r t o a p p l y i n g t h e w a s t e. t - NARRATVE OF OPERATON H. -e^^^xa-^ba Vzp 0 r - 4 ^ L V 4 L e ^ X AA.A-C>Va3 \ P^KUU^ -^o^ o^u.cu [i^^iyt-^ ^ A ^ ^ S ^. ^^^^^

ANMAL WASTE UTLZATON PLAN WASTE UTLZATON PLAN AGREEMENT Name o f Farm: Owner/Manager Agreement (we) u n d e r s t a n d and w i l l f o l l o w and i m p l e m e n t t h q s p e c i f i c a t i o n s and t h e o p e r a t i o n and m a i n t e n a n c e p r o c e d u r e s e s t a b l j i s h e d i n t h e a p p r o v e d a n i m a l waste u t i l i z a t i o n p l a n f o r t h e f a r m named above. (we) know t h a t any e x p a n s i o n t o t h e e x i s t i n g d e s i g n c a p a c i t y o f t h e w a s t e t r e a t m e n t and s t o r a g e s y s t e m o r c o n s t r u c t i o n l o f new f a c i l i t i e s w i l l r e q u i r e a new c e r t i f i c a t i o n t o be s u b m i t t e d t o t h e N o r t h C a r o l i n a D i v i s i o n o f W a t e r Q u a l i t y (NCDWQ) b e f o r e t h e new a n i m a l s a r e s t o c k e d. (we) a l s o u n d e r s t a n d t h a t t h e r e must be no d i s c h a r g e o f a n i m a l w a s t e f r o m t h i s s y s t e m t o s u r f a c e w a t e r s o f t h e s t a t e f r o m a s t o r m e v e n t l e s s s e v e r e t h a n t h e 2 5 - y e a r, 2 4 - h o u r s t o r m. The a p p r o v e d p l a n w i l l be f i l e d o n - s i t e a t t h e f a r m o f f i c e and a t t h e o f f i c e o f t h e l o c a l S o i l and W a t e r C o n s e r v a t i o n D i s t r i c t and w i l l be a v a i l a b l e f o r r e v i e w by NCDWQ upon r e q u e s t. Name of Facility Owner: NEL JACKSON (Please p r i n t ) Signature: V /. 'AV^^p.j? ^,^^>)c^--.^ Date: y^c^p Name of Manager (f different from owner): V Signature: Date: :y^ Name of Person Preparing Plan: (Please pxint)r.' Dean Morris Affiliation:USDA- NRCS h -. Phone No. 910-862 + 6! 36 7 ^.; ' v Address (Agency): 122 Ag. Service Ctr. Elizabethtown NC 28337 Signature: VoiyQ.^ Date: \^ ]m V Page: 11

ft b U.S. D E P A R T M E N T O F A G R C U L T U R E SOL CONSERVATON S E R V C E.. SOS-CPA-16 ^ f-t 2-81 CONSERVATON PLAN MAP Owner. County ~ ^ c i ^ ^ ^ Approximate acres 3^ Cooperating with_\3kfl^^ ia. Plan identification Assisted by /Ay^x^eA.Operator State Al C.Approximate scale rv..-- / " - Date 'S-ZO-^a 5gn '.Conservation District.Photo number,. USDA Soil Conservation Service istv:

2 vsi-c WA ) ;7 x 7 c' f : P YP o c» H" X,.*i : 4! (A ^, T -. : 7' - U t z f t G: 1.; f/ ' ' i ^\mr\ai:^"y < 0 to fo JG x' -4.16_ 1. 1. '^" < O N n > ' AJ o> ut w W -P : ) ) OA L_ C"- tof la -P. o ft ;-p v* i f 15 f&ii a n! ) i < om, A -^2 -V -0 ec <c r h 7 n 0 2 c.m m