Form Dhec 3580 - Standard Application Form For New Or Expanding Agricultural Animal Facilities (Other Than Swine)

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Standard Application Form for
New or Expanding Agricultural Animal Facilities
(other than swine)
Please Type or Print
Section 1 – FACILITY INFORMATION
DATE
FACILITY NUMBER
ND
NEW
OR EXPANDING
FACILITY
IF EXPANDING: PERMIT NUMBER
DATE ISSUED
FARM NAME
COUNTY
COMMUNITY
LOCATION
IS THIS FARM PLANNING TO BE A CONTRACT GROWER WITH AN INTEGRATOR? o YES or
o NO
NAME OF INTEGRATOR
Section 2 – CONTACT INFORMATION
PERMIT APPLICANT
ADDRESS
PHONE NUMBER (WORK)
(HOME)
(CELL/BEEPER)
PERMIT APPLICANT'S EMAIL ADDRESS
ARE YOU THE PROPERTY OWNER OF RECORD? o YES or
o NO
IF NO, PROVIDE INFORMATION:
PROPERTY OWNER OF RECORD
ADDRESS
PHONE NUMBER (WORK)
(HOME)
(CELL/BEEPER)
OPERATOR’S NAME
ADDRESS
PHONE NUMBER (WORK)
(HOME)
(CELL/BEEPER)
OPERATOR'S EMAIL ADDRESS
PLAN PREPARER
TITLE/SC REGISTRATION NUMBER
ADDRESS
PHONE NUMBER (WORK)
(FAX)
(CELL/BEEPER)
PLAN PREPARER'S EMAIL ADDRESS
Section 3 – ANIMAL TYPES & NUMBERS
AVERAGE ANIMAL LIVE WEIGHT = average exit weight + average entry weight = (________) + (________) = ___________ pounds
2
2
Type(s) of
Maximum
Normal Produc-
Total Manure (tons/
Manure to
Additional Scraped
Acres for Land Ap-
Animals
# of Animals
tion Live Weight
yr or gal/yr)
Treatment
Solids or Compost
plication
(at any one time)
(pounds)
System
SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
DHEC 3580 (03/2016)

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