Form Dhec 3580 - Standard Application Form For New Or Expanding Agricultural Animal Facilities (Other Than Swine) Page 4

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APPLICATION INSTRUCTIONS - Agricultural Animal Facility Permit

Purpose: This form must be completed as part of an application package submitted for DHEC approval of proposed NEW or EXPANDING

agricultural animal facilities. The required items should be checked to ensure that a complete administrative package has been submitted. If

a complete administrative package is not submitted, the entire project may be returned.

Item-by-Item Instructions: Section 1 - Facility Information. Date: Enter the date of application. Facility Number: Leave blank, Department

staff will assign a facility number. New or Expanding Facility: If this application is for an existing facility that has previously obtained an agricultural

animal facility permit from DHEC, then indicate by checking EXPANSION or NEW if a new facility is being proposed. If an Expansion, provide

the following: Permit Number; Provide the permit number for the permitted facility, and Date Issued; Provide the date on which DHEC issued the

permit. Farm Name: Give the name of the proposed agricultural animal facility. County: Give the county in which the proposed facility is to be

located. Community: Give the name of the community in which the proposed facility is to be located. Location: Give directions to the proposed

facility from the nearest town or state road. Integrator Information: Circle YES or NO to indicate whether this farm will be under contract with

an integrator or integrating company. Provide the Name of the Integrator for this facility.

Section 2 - Contact Information. Permit Applicant: Enter the name, address and phone numbers for the person who is applying for the

permit. Circle YES or NO to indicate whether the permit applicant is the property owner of record. Property Owner of Record: Enter the name,

address and phone number of the person who legally owns the property on which the proposed agricultural animal facility is to be located.

Operator: Enter the name, address and phone number of the person who will be responsible for the daily operation of the proposed facility.

Plan Preparer: Enter the name of the plan preparer. Title/SC Registration Number: Enter the title and SC registration number (if applicable)

of the person responsible for the design of the Animal Facility Management plan. Address, Phone Number: Enter the business address and

phone numbers for the plan preparer.

Section 3 – Animal Types & Numbers. Average Animal Live Weight: Calculate the average weight of one animal unit by taking the average

exit weight plus the average entry weight and divide by two. Type of Animal Operation: Indicate the type of animal proposed to be grown at this

facility (i.e. dairy, turkey, broiler, etc....). Maximum # of Animals (at any one time): Indicate the maximum number of each type of animal at the

facility at any one time. Normal Production Animal Live Weight (lbs): The maximum number of animals at the facility at any one time multiplied

by the average animal live weight of those animals. Total Manure Produced (tons/year or gal/year): The total amount of manure produced

by the animals in the span of one year. This amount should be represented in tons per year for dry manure and in gallons per year for wet

manure. Manure to Treatment System: Provide the amount of manure or wastewater that is conveyed to a treatment system (if applicable).

Additional Scraped Solids or Compost: Provide the amount of manure or solids that may be scraped at the barn, rather than conveyed to the

treatment system. Or provide the amount of compost produced at a facility (if applicable). Acres for Land Application: The value here should

be the number of acres available, that you would like to designate as manure utilization areas.

Section 4 – Manure Handling & Treatment. Manure Handling: Circle DRY or WET to indicate the type of manure handling for this operation.

Treatment Proposed: Describe the type of manure treatment being proposed at the facility. Land Application: Circle YES or NO to indicate

whether the manure will be land applied. Owner of Manure Utilization Areas: Circle YES or NO to indicate whether the permit applicant owns

all of the manure utilization areas. If the applicant does not own all of the manure utilization areas, then owner information must be provided

for each manure utilization area in the Animal Facility Management Plan. Manure Broker: Circle YES or NO to indicate whether a manure

broker will be used for contract disposal of the manure from this facility and provide the name of the broker to be used (if applicable). Treatment

Technology: Circle YES or NO to indicate whether innovative and alternative technology is being proposed for this facility. Exceptional Quality

Compost: Circle YES or NO to indicate whether you are applying for the manure treated at your facility to qualify as exceptional quality compost

(must meet product quality standards outlined in Part 300 of R.61-43). Number of Groundwater Monitoring Wells: Provide the number of

groundwater monitoring wells that are proposed for this facility. Volume of Lagoon or Storage Pond: Provide the volume area of the proposed

lagoon or storage pond. If more than one lagoon or storage pond is utilized, please provide the volume of each structure separately. Number

of Houses: Indicate the number of existing and proposed houses that will be located on this property (All houses located on the same property

tract must be considered one facility). Trained Manure Manager: Circle YES or NO to indicate whether the operator of the proposed facility

has attended the certified manure manager’s training and certification class conducted by Clemson Extension Service. Indicate the date on

which the certification or training was obtained.

Section 5 – Facility Separation Distances. Separation Distances: This table outlines the required setbacks for the barns, lagoons, manure

storage ponds or manure treatment systems. Enter the actual separation distance for the proposed facility in the appropriate spaces.

Section 6 – Manure Utilization Area Information. This table outlines the required setbacks for manure utilization areas. Enter field identification

information, tract number, field number, and the actual separation distances for each manure application field in the appropriate spaces. Make

copies of this section if you need additional tables for the field information.

Section 7 – Permit Application Submittal Requirements. Check each item that is being submitted as a part of this application. All items

under Section 7 should be submitted to DHEC for review. In accordance with the Environmental Protection Fee Reg. 61-30, an application

fee is required for submitting an Application for agricultural animal facilities. There is a requirement that DHEC meet certain time frames when

processing permit applications. The “DHEC Time” is not the total time but rather it is the time that DHEC spends working on an application after

a complete package is received. “DHEC Time” does not include the time an applicant takes to supply any information that may be requested

by DHEC. The fees and time frames are as follows:

Agricultural Permit Application Fees

Facility Type

DHEC Time

Fee

Animal Facilities with wet manure handling ............................................................ 120 days .............................................. $240

Animal Facilities with dry manure handling ............................................................ 90 days ................................................ $165

Note: Please make CHECKS payable to SC DHEC/Bureau of Finance.

Regulation R61-30 also authorizes DHEC to assess annual environmental operating permit fees for certain permits. All new facilities must

submit payment for the first years operating fee before the permit to construct is issued. The operating fee is $150 per year for animal

facilities with wet manure handling operations and $75 per year for animal facilities with dry manure handling operations.

Section 8 – Certification. For this section, please read the certification statements and have the appropriate person(s) sign the certification.

DHEC Processing Procedures:

Two (2) copies of the submittal package are submitted to DHEC. After Permitting, DHEC files the original in the main project file, located in

DHEC’s central office. DHEC sends a copy of the approved package to the appropriate EQC Region Office.

DHEC 3580 (03/2016)