Form Dhec 3580 - Standard Application Form For New Or Expanding Agricultural Animal Facilities (Other Than Swine) Page 3
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4MANURE UTILIZATION AREA TABLE CONTINUED
SEPARATION DISTANCES:
Tract #
Field #
POTABLE WELL
200 ft
WATERS OF THE STATE
LOCATED DOWNSLOPE
100 ft*
EPHEMERAL & INTERMIT.
STREAMS DOWNSLOPE
100 ft*
DITCHES DOWNSLOPE
50 ft
RESIDENCE
300 ft**
* Reduced to 75 ft for incorporated manure, and 50 ft for injection or incorporation within 24 hours.
**If method of application is injection or immediate incorporation, then manure may be spread to the property line. All residence setbacks may be
reduced by consent of the owner of the residence.
Section 7 – PERMIT APPLICATION SUBMITTAL REQUIREMENTS
SUBMITTAL PACKAGE SHOULD INCLUDE 2 COPIES OF THE FOLLOWING ITEMS (CHECK EACH ONE SUBMITTED):
____ 1. ORIGINAL APPLICATION (and 1 copy of the original)
____ 2. ANIMAL FACILITY MANAGEMENT PLAN
a. Animal Manure Management System Description
b. Design Calculations and Construction Details for treatment/storage structure, including exact location and design information.
c. Concentration of Manure Constituents
d. Crop Management Plan (including contracts for each field not owned by the applicant, field owner’s name and contact
information)
e. Type of Waste Transport/Spreading Equipment (if applicable)
f. Spray Application System Specifications and Details (if applicable)
g. Manure Utilization Area Information and Maps
h. Soils Information (maps & descriptions)
i. Location maps (showing facility, treatment/storage structure, and all fields)
j. Copy of Tax Map (identifying all adjoining property owners within 1320 feet of the facility with names & addresses)
k. 100 year floodplain locations (facility may not be located in the 100-year floodplain)
____ 3. GROUNDWATER MONITORING WELL PROGRAM & DETAILS (if applicable)
____ 4. ODOR ABATEMENT PLAN
____ 5. VECTOR ABATEMENT PLAN
____ 6. PRIMARY METHOD OF DEAD ANIMAL DISPOSAL______________________________________________________
____ 7. ALTERNATIVE METHOD OF DEAD ANIMAL DISPOSAL FOR EXCESSIVE MORTALITY: _________________________
____ 8. CONTRACTS FOR CONTRACT DISPOSAL OF DEAD ANIMALS OR MANURE (if applicable)
____ 9. SOIL MONITORING PLAN
____10. PLANS & SPECIFICATIONS FOR ALL OTHER TREATMENT OR STORAGE STRUCTURES (composter, stacking shed, etc...)
____11. NOTICES OF INTENT FROM ALL PROPERTY OWNERS WITHIN 1320 FEET OF THE FOOTPRINT OF THE FACILITY
____12. EMERGENCY PLAN
____13. WRITTEN CONSENT FOR WAIVING OR REDUCING SETBACKS (if applicable)
____14. ALTERNATIVE TECHNOLOGY PROPOSAL (if applicable):
Specifications, and a detailed report including purpose and expected benefits.
____15. APPLICATION FEE: See instructions on the back of this page for amount.
____16. ANNUAL OPERATING FEE: See instructions for amount (first year’s fee must be submitted before permit is issued).
Section 8 - CERTIFICATION
I HEREBY CERTIFY THAT ALL OPERATIONS, MAINTENANCE AND ASSOCIATED ACTIVITY PERTAINING TO THIS SITE SHALL BE ACCOM-
PLISHED PURSUANT TO AND IN KEEPING WITH THE TERMS AND CONDITIONS OF THE APPROVED PLANS. I HAVE READ THIS APPLICA-
TION AND AGREE TO THE REQUIREMENTS AND CONDITIONS THAT ARE CONTAINED WITHIN. THE INFORMATION SUBMITTED IS, TO THE
BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, AND COMPLETE. I HEREBY GRANT AUTHORIZATION TO THE DEPARTMENT
OF HEALTH AND ENVIRONMENTAL CONTROL THE RIGHT OF ACCESS TO THE SITE AT ALL REASONABLE HOURS FOR THE PURPOSE OF
SAMPLING AND ON SITE INSPECTIONS.
__________________________________________________
_______________________________________________
Printed Name /Owner or Leasee
Signature/Owner or Leasee
I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THAT THE DESIGN IS CONSISTENT WITH THE REQUIREMENTS
OF TITLE 48, CHAPTER 1 OF THE 1987 SC CODE OF LAWS, AND PURSUANT REGULATION 61-43 AND APPROPRIATE NRCS STANDARDS.
___________________________________________________
_______________________________________
Printed Name/Plan Preparer
Signature/Plan Preparer
DHEC 3580 (03/2016)
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