240076_Owner (Name Change)_20210201

Notification of Change of OWnership
Animal Waste Management Facility
(Please type or print all infomtation that does .not require a signature)
RECE►VE0
JAN 21 2021
CeQ/DWR
nttral Office
In accordance with the requirements of ISA NCAC 2T _1304(c) and ISA NC'AC 2T.i305(d) this form is official notification
to the Division of Water Resources (DWRI of the transfer of ownership of an Animal Waste Managcttieatt Facility_ This
form must be submitted to DWR no later than 60 days following the transfer of ownership.
General Information:
Previous Name of Farm: Stateiine Fen 1 &2
Previous tlwnet s) Name: Stateline Holdings LLC
New Owner(s) Na:
Tripe. S Watts. Far1't LLC
New Faun Marne (if applicable). Triple 8 Watts Farm
Mailing Address: 4020 M M lay Road
Facility No: 24 - 76
Phone No: [phone]
Phone No: _(91 0) 840-021 3
Clarendon. NC 28432
Farm Location. Latitude and Longitude: 34` 40' 29Sr!ler 43' Mel' Comm: Columbus
Please attach a copy off a county road map with location identified; and provide the location address and driving directions
below (Be ape iliic: road nanie .: directions, milepost, etc.): 4223 Old Dothan Road _ Tabor Ci , NC 28483E
Operation i eiintion:
Tape of 9tri w ;tin 0 Ailli talc Taps of Swirne ..1a Qf 2minols 7% of Cattle %o. afA+rur'rals
Irl Wean to Feeder CI Gills ,_ 13 Dairy
D Weannto Finish 0 Roars 0 Beef
lit Feeder to Finnish 7,54e
0 Farrow to Wean
Tape of Poultry No. of
CI Farrow to Feeder 01..ay-er
l7 Farrow to Finish Q Pullets
Other Type ofLivestock: Number ofAnimaf .
Acreage Available for Application: 65.00 t - Required Acreage: 50.00
Number of Lagoons t Storage Ponds: Total Capacity; 1.484.807 Cubic Feet (f13)
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Owner/Manager Agreement
1(v :) verify that all the above informadon is correct and milli be updated upon changing. I (we) understand the operation and
maintenance procedures established in the Ccuified Animal Waste Management Place (CAWMP) for the farm named above
and will implement these procedures 1(we) know that any modification or expansion to the existing design capacity or the
waste treatment and storage system or construction of new facilities will require a permit modification before the new
saint* are •stocked. 1 (we) understand thaatthere must- be no discharge of animal waste from the storage or application
stem to sure waters of the state either directly through a man-made conveyance or from a worm event less severe than
the 25-year, 2 ur storm and there roustnot be nm-off front 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 Resources to issue the required permit bo the new land owner.
Name of Pr'evious Land owner: Stateline Holdings. LLC by Kyle Cox
Signature_ Date: _ ri
Name of New Land ner: Triple 8 Watts Farm LLC by Brent Watts
Signature: c—.r%Date• !_ 2/—
Name
orMaanager (if ditTerent from owner):
Siatrare: Dates
Please sign and return this form to:
Animal Feeding Operations
N. C. Division of Water Resources
Water- Quality Regional Operations Section
1636 Mail Service Center
Rate gh. NC 27699-t636
June 12, 201i