090041_Application_20210504

RECEIVED
APR 3 0 2021
NC DELI/DWI
Central Office
Notification of Change of Ownership
Animal Waste Management Facility
(Please type or print all information that does not require a signature)
APPENDIX 2.2A
In accordance with the requirements of 15A NCAC 2H .0217(a)(1)(H)(xii) this form is official notification to the Division of
Water Quality (DWQ) of the transfer of ownership of an Animal Waste Management Facility. This form must be submitted
to DWQ no later than 60 days following the transfer of ownership.
General Information:
Name of Farm: Pork Partners Facility No: AWS _ 090041
Previous Owner(s) Name: Don Butler Phone No:
New Owner(s) Name: C4 Farms LLC Phone No: 910.874.4901
Mailing Address: PO Box 429, Bladenboro NC 28320
Farm Location: Latitude and Longitude: 34 563 148 / 78 804 171 County: Bladen
Please attach a copy of a county road map with location identified and describe below (Be specific: road names, directions,
milepost, etc.):
Operation Description:
Type of Swine No. of Animals Type of Poultry No. of Animals Type of Cattle No. of Animals
CWean to Feeder 7104 0 Layer 0 Dairy
❑ Feeder to Finish 0 Pullets 0 Beef
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish Other Type of Livestock: Number of Animals:
❑ Gilts
❑ Boars
Acreage Available for Application: 69.76 Required Acreage: 35.11
Number of Lagoons / Storage Ponds : 2 Total Capacity: Cubic Feet (ft3)
Owner / Manager Agreement
I (we) verify that all the above information is correct and will be updated upon changing. I (we) understand the operation and
maintenance procedures established in the Certified Animal Waste Management Plan (CAWMP) for the farm named above
and will implement these procedures. I (we) know that any modification or expansion to the existing design capacity of the
waste treatment and storage system or construction of new facilities will require a permit modification before the new animals
are stocked. I (we) understand that there must be no discharge of animal waste from the storage or application system to
surface waters of the state either directly through a man-made conveyance or from a storm event less severe than the 25-year,
24-hour storm and there must not be run-off from the application of animal waste. I (we) understand that this facility may be
covered by a State Non -Discharge Permit or a NPDES Permit and completion of this form authorizes the Division of Water
Quality to issue the required permit to the new land owner.
Name of Previous Land Owner:
Signature:
Name of New Land Own
Pork Partners/Don Butler
Date: 04/23/2021
Farms LLC/Jordan Carter
Signature: . - . Date: 04/23/2021
Name of A . na i different from owner):
Signature: Date:
Please sign and return this form to:
N. C. Division of Water Quality
Aquifer Protection Section
Animal Feeding Operations Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
November 1, 2004