NCG060133_Name Ownership Change Form_20180226

•
Division of Energy, Mineral & Land Resources FOR AGENCY USE ONLY
Date Received
(or) Certificate of Coverage
Land Quality Section/Stormwater Permitting Year I Month Day
NC®ENR
National Pollutant Discharge Elimination System
NO CAROLINA DEPaarNENT of
ENVIRONMENT ANO N ­RESOURCES
PERMIT NAME/OWNERSHIP CHANGE FORM
I. Please enter the permit number for which the change is requested.
NPDES Permit
(or) Certificate of Coverage
ININ ;C; 1$'11011
N' I C 1 ;G 10 1 6 10 1 1 13 1 3
H. Permit status prior to requested change.
a. Permit issued to (company name):
Southern States Cooperative, Inc.
b. Person legally responsible for permit:
Jim Moore
First MI Last
prccE i!ED
Vice President
n5 26
Title
PO Box 26234
�,Np QUAUN
Permit Holder Mailing Address
[OR-
PERMITTING
Richmond VA 23260
STORMWATER
City State Zip
( 804 ) 281-1000 ( )
Phone Fax
c. Facility name (discharge):
Southern States Coop - Cleveland Feed Mill
d. Facility address:
9150 Statesville Blvd
Address
Cleveland NC 27013
City State Zip
e. Facility contact person:
Glen Fisher ( 704) 278-2941
First / MI /Last Phone
III. Please provide the following for the requested change (revised permit).
a. Request for change is a result of:
0 Change in ownership of the facility
0 Name change of the facility or owner
If other please explain:
b. Permit issued to (company name):
Cargill, Incorporated
c. Person legally responsible for permit:
Susan Haas
First MI Last
Global Business Operational Leader
Title
15407 McGinty Road West
Permit Holder Mailing Address
Wayzata MN 55391
City State Zip
( 800 ) 227-4455 [e-mail]
Phone E-mail Address
d. Facility name (discharge)
e. Facility address:
f. Facility contact person:
Cargill Feed & Nutrition Barber
9150 Statesville Blvd
Address
Cleveland NC 27013
City State Zip
Glen Fisher
First MI Last
( 704) 278-2941 Glen [e-mail]
Phone E-mail Address
IV. Permit contact information (if different from the person legally responsible for the permit)
Revised Jan 27, 2014

NPDES PERMIT NAME/OWNERSHIP CHANGE FORM
Page 2 of 2
Permit contact: Sherrie Suttles
First MI Last
EHS Lead, North America
Title
2400 Industrial Drive
Mailing Address
Sidney OH 45365
City State Zip
( 937 ) 205-4153 Sherrie [e-mail]
Phone E-mail Address
V Will the permitted facility continue to conduct the same industrial activities conducted prior
to this ownership or name change?
0 Yes
❑ No (please explain)
VI. Required Items: THIS APPLICATION WILL BE RETURNED UNPROCESSED IF ITEMS
ARE INCOMPLETE OR MISSING:
❑� This completed application is required for both name change and/or ownership change
requests.
❑E Legal documentation of the transfer of ownership (such as relevant pages of a contract deed,
or a bill of sale) is required for an ownership change request. Articles of incorporation are
not sufficient for an ownership change.
The certifications below must be completed and signed by both the permit holder prior to the change, and
the new applicant in the case of an ownership change request. For a name change request, the signed
Applicant's Certification is sufficient.
PERMITTEE CERTIFICATION (Permit holder prior to ownership change):
I, , attest that this application for a name/ownership change has been reviewed 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 is not included, this
application package will be returned as incomplete.
Signature
Date
APPLICANT CERTIFICATION
1, Susan Haas , attest that this application for a name/ownership change has been reviewed 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 is not included, this
applicat' ackagew Freturnn�edas incomplete.
oda
Signature Date
PLEASE SEND THE COMPLETE APPLICATION PACKAGE TO:
Division of Energy, Mineral and Land Resources
Stormwater Permitting Program
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Revised Jan 27, 2014

MAP IS/RTP-AR S/P JU/IN L/IN I C/C I PARTJ INT This certifies that there are no delinquent ad valorem real estate taxes, which the
270 1 1 037 1 1 1 1 1 1 22 Rowan County Tax Collector is charged with collecting, that are a lien on:
Rowan County Assessor's office Property Identification Number 270 037
This is not a certification that the Rowan County Property Identification Number
matches this Deed description.
Record and return to: Tonya Parnell CWR 09-25-2017 11:55:24
Rowan Co. Tax Collections Manager Clerk Date/Time
First American Title Insurance Company Type: CONSOLIDATED REAL PROPERTY
801 Nicollet Mall, Suite 1900 Recorded: 9/25/2017 12:07:40 PM
Minneapolis, MN 55402 Fee Amt: $26.00 Page 1 of 5
Attn: Kathy Estenson Revenue Tax: $0.00
Nes-8' zzs<3 Ptis Rowan, NC
J. E. Brindle Register of Deeds
Prepared by:
Christina J. Fulham
Ropes & Gray LLP
800 Boylston Street
Boston, MA 02199-3600
SPECIAL WARRANTY DEED
THIS SPECIAL WARRANTY DEET) is made effective as of , 2017
by and between Southern States Cooperative, Incorporated, a Virginia corporation, with a
principal mailing address of 6606 West Broad Street, Richmond, VA 23230 (hereinafter "Grantor"),
and Cargill, Incorporated, a Delaware corporation, with a principal mailing address of 15407
McGinty Road West, Wayzata, MN 55391 (hereinafter "Grantee").
Grantor, in consideration of the sum of One and no/100 Dollar ($1.00) and other good and
valuable consideration, to it paid by Grantee, the receipt of which is hereby acknowledged, conveys,
confirms and warrants to Grantee, its successors and assigns, the following described real estate in
Rowan County, North Carolina, more particularly described in Exhibit (attached hereto and made
apart hereof) (the "Pro e "), together with all hereditaments and appurtenances belonging thereto
and all improvements and buildings thereon, subject to those exceptions set forth in Exhibit B
(attached hereto and made a part hereof) and to the extent they lawfully affect the Property. (the
"Permitted Encumbrances").
Said Property having been previously conveyed to Grantor by instruments recorded in
Book 623, Page 911, and Book 1028, Page 218 of the Rowan County Recorder's Office.
AND Grantor hereby covenants with Grantee, and its successors in interest, that Grantor
holds the Property by title in fee simple; that it has good and lawful authority to sell and convey the
same; that the Property is free and clear of all liens and encumbrances whatsoever, except for the
Permitted Encumbrances; and Grantor covenants to WARRANT and DEFEND the Property against
the lawful claims of all persons whomsoever claiming by, through or under Grantor, except for
those matters which are Permitted Encumbrances, but against no others.
[SIGNATURE PAGE FOLLOWS]
Parcel ID No. 270037
submitted electronically by "First American NCS Minneapolis"
6489Cin compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the Rowan County Register of Deeds.
:ook: 1296 Page: 945 Page 1 of 5

Executed under seal as of the date first set forth above.
SOUTHERN STATES COOPERATIVE,
INCORPORATED, a Virginia corporation
By:
_ 91��a �-
Name: I moo' e1 -r`
Title: SEc,Pei�
STATE OF _ ,l/,Q�iN�i9 )
`/ :SS
COUNTY OF 14'�/Ri �o )
I certify that the following person personally appeared before me this day, acknowledging to me
that he/she signed the foregoing document: Q 4 L. Aea2E-Tw ,c 5' uY eww
[insert name of principal].—,a7b'6 C'oo�E V5
Date: eg�- /� , 2017
otary Public:
My commission expires:
[affix Notarial Seal]
Emestine C. White
Commonwealth of Vrglnia
Notary Public
Commission No. 270780//��
�'•^ My Commissibn Expires 12f3 A
Prepared by:
Christina J. Fulham
Ropes & Gray LLP
Prudential Tower
800 Boylston Street
Boston MA 02199-3600
Signature Page to Cleveland NC Deed
3ook. 1296 Page- 945 Page 2 of 5

Exhibit A
Legal Description
LYING AND BEING IN CLEVELAND TOWNSHIP, ROWAN COUNTY, N. C., AND BEING
THAT TRACT OF LAND FORMERLY KNOWN AS THE JEROME LAIL PROPERTY
LYING ON THE WESTERN SIDE OF NORTH CAROLINA MIDLAND RAILROAD AND
ON THE NORTHERN SIDE OF U. S. HIGHWAY NO. 70 AND BEING ADJACENT TO THE
PROPERTY OF CLYDE WALLER, MRS. ALLIE NAIL, AND WILLIAM AND GEORGE
KEASLER ON THE WEST AND ADJACENT TO THE NORTH CAROLINA MIDLAND
RAILROAD ON THE EAST AND BEING MORE FULLY DESCRIBED AS FOLLOWS:
BEGINNING AT A NAIL IN A BOTTLE CAP LOCATED IN THE CENTER LINE OF THE
NORTH CAROLINA MIDLAND RAILROAD AT THE POINT WHERE SAID RAILROAD
CENTER LINE INTERSECTS THE NORTHERN RIGHT-OF-WAY LINE OF U. S.
HIGHWAY NO. 70 AND RUNS THENCE ALONG THE CENTER LINE OF THE NORTH
CAROLINA MIDLAND RAILROAD AND ALONG THE CENTER LINE OF THE SPUR
TRACK RUNNING FROM THE NORTH CAROLINA MIDLAND RAILROAD TO THE
WESTERN NORTH CAROLINA RAILROAD IN TEN COURSES AS FOLLOWS: (1) NORTH
11-52 EAST 335.6 FEET TO A NAIL IN A CAP; (2) NORTH 11-59 EAST 1054 FEET TO THE
POINT OF THE SWITCH ON THE SPUR LINE; (3) NORTH 5-49 EAST 200 FEET TO A
POINT; (4) NORTH 0-49 WEST 123.8 FEET TO A POINT OF THE SWITCH; (5) NORTH 7-
27 WEST 200 FEET; (6) NORTH 19-45 WEST 200 FEET; (7) NORTH 30-06 WEST 200 FEET
TO A NAIL IN A CAP; (8) NORTH 39-42 WEST 200 FEET TO A POINT; (9) NORTH 50-53
WEST 200 FEET TO A POINT; AND (10) NORTH 59-49 WEST 62.9 FEET TO A NAIL IN A
CAP; THENCE ALONG THE LINES OF WILLIAM AND GEORGE KEASLER AND MRS.
ALLIE NAIL, SOUTH 6-00 WEST (PASSING AN IRON STAKE AT 82.5 FEET) 1515.39
FEET TO A LARGE POPLAR TREE SIX INCHES IN DIAMETER WHICH HAS A NAIL IN
A CAP ON THE NORTH SIDE OF THE TREE IN ITS CENTER LINE; THENCE ALONG
THE LINE OF CLYDE S. WALLER, SOUTH 3-58 WEST 927.78 FEET TO AN IRON IN THE
CENTER LINE OF THE BRANCH, THIS POINT ALSO BEING IN THE NORTHERN
RIGHT-OF-WAY LINE OF U. S. HIGHWAY NO. 70; THENCE ALONG THE NORTHERN
RIGHT-OF-WAY LINE OF U. S. HIGHWAY NO. 70, SOUTH 74-52 EAST 463.44 FEET TO
THE POINT OF BEGINNING, CONTAINING A TOTAL ACREAGE OF 29.58 ACRES AND
AN ACREAGE LYING OUTSIDE OF THE RIGHT-OF-WAY LINE OF THE NORTH
CAROLINA MIDLAND RAILROAD AND THE SPUR TRACK OF 26.4 ACRES.
THE FOREGOING TRACT IS SHOWN ON A MAP ENTITLED "MAP PREPARED FOR J. P.
LAIL" BY HUDSON AND ALMOND, REGISTERED SURVEYORS,
THE FOREGOING PROPERTY IS SUBJECT TO THE RIGHT-OF-WAY OF THE NORTH
CAROLINA MIDLAND RAILROAD AND THE WESTERN NORTH CAROLINA
RAILROAD.
LESS AND EXCEPT:
RIGHT OF WAY LEFT
64890325_1
3ook- 1296 Page; 945 Page 3 of 5
A-1

POINT OF BEGINNING BEING A POINT IN THE WEST LINE OF THE UNDERSIGNED,
AND BEING N. 0642-30 E., 110.38 FEET FROM A POINT IN THE CENTERLINE OF -L2-,
STA. 152+00; THENCE TO A POINT ON A BEARING OF S. 78-30-30 E., A DISTANCE OF
417.8 FEET (127.36 METERS); THENCE TO A POINT ON A BEARING OF S. 08-15-30 W.,
A DISTANCE OF 27.0 FEET (8.24 METERS); THENCE TO A POINT ON A BEARING OF N.
78-30-30 W., A DISTANCE OF 414.1 FEET (126.21 METERS); THENCE TO A POINT ON A
BEARING OF N. 00-21-30 E., A DISTANCE OF 27.5 FEET (8.39 METERS); RETURNING
TO THE POINT AND PLACE OF BEGINNING.
For Grantor's title see General Warranty Deed of FCX, Inc. dated February 17, 1986 and recorded
in Book 623, Page 911 with the Register of Deeds, Rowan County, North Carolina; see also Deed
for Highway Right of Way to Department of Transportation, an agency of the State of North
Carolina, dated September 7, 2004 and recorded with said Deeds in Book 1028, Page 218.
648903251 A-2
Book: 1296 Page: 945 Page 4 of 5

Exhibit B
Permitted Encumbrances
1. Taxes and assessments not yet due and owing in the year 2017 and subsequent years.
2. Right(s) of way to Department of Transportation, an agency of the State of North Carolina
recorded in Book 1028, Page 218, Rowan County Registry.
3. Terms, provisions, covenants, conditions, easements and restrictions as provided in Right
of Way of North Carolina Midland Railroad and Western North Carolina Railroad contained in
Deed, recorded in Book 623, Page 911, Rowan County Registry.
4. Easement Deed by Court Order in Settlement of Landowner Action to" Qwest
Communications Company, LLC recorded in Book 1222, Page 882, Rowan County Registry.
5. Easement to Duke Energy Carolinas, LLC, a North Carolina limited liability company
recorded in Book 1266, Page 168, Rowan County Registry.
64890325_1
'ook. 1296 Page. 945 Page 5 of 5