820326_Complete File - Historical_20020902 (2)

myrk N'v CME/(4CL(7.,)Ly/ ik_c4v(41.
}� u v notification of Change of Ownership
p
Animal ZVVaste Management Facility
(Please type or print all information that does not require a signature)
Ir. accordance- ui:th the requirements of 15A NCAC 2H .0217(a)(I)(H)(xii) this form i5 official notification to the D
water Quality rDw Division of
y . Q) of the transfer of ownership of an Animal Waste Management Facility. This form must bc submitted to
DWQ no later than 60 days folfowino the transfer of ownership.
General information:
Narnc of Farm:
Previous Owner (s) Name:
I /
r m-4 t- h L .
New Own_r'(s) Name: R , Y -eY )--et :.
Maiiin_ Address: ?.O i D X \ ! ti , c i < < r,
Tarn; Locerinr:: Latitude and Longitude:
Facility No: �Z ,�Zb
No:
Phone No: /4 /ell 53 2- - =/ 7 2
Phone No: /S ids S 3 a
County:
Please attach a copy of a county road map with location. identified and describe below (Be specific: road natncs, direotionS.
milepost. etc.): bc; �/ / u'� `� - - ✓PIIS j✓i r G f S
Operation Description:
Tvp f. of Swine No. of Animals Type of Poultry No. of Animal's e Tv of Daip
D Vr Into Feeder J Pe. rl' No. of Animal:
,
�%: =e" l0 Finish ; Lc'c _ :J Milking
+
Non -Lave: D Dry.
. arrow to Fear, z r-f Type of Beef No. of Animals D Hei,e,
'i` �S
u Farrow to Feeder Brood D Calves
_J Farrow to Finish Feeders
::1 Gilts =t Stockers
1 Boars Other Type of Livestock: Number of Animals':
Acreage Avalaoie for Application.: Required Acreage: .S/-
Num. be; of Lagoons Storage Ponds : To Cap:ciry: Z�9j 0.2i) Cubic Feet (ft')
Sx;;u g uxwax m ex ar;xf s;;s*irxx
Owner / Manager Agreement
1 (we) .verify tuaa: all the above inroTation is eorreci andupdated upon chars in. 1 (we) the operation and
a w111 bc Lt.l:3t..0 v v ( � ti%C:C-5::.^.^
mair,tcnancc procedures established in the approved a-imal waste management plan, for the faun nam:d above and will
implement these procedures. 1 (we) know that any expansion to tr,e existing dcsisrn capacity of trc waste treatment and storage.
system, or construction of new facilities will require a near certification to he suhrni4cd to the DWQ before the new anir.ials are
stc^kcd. I (wc)understand that must be no discharge of anirnal was,- from, inc storage or application v r
ye. u ''pit �~`-` r '� ation system to surface
water ci cr directly through a men -made cv' _, r
waters of the state L^ cony an.... or from a scorn) event IcsS Severe thar. the 25-year. 24-npur
storm End there. rni_ts: not be run-off from the application of animal waste. 1 (wc) understand that run-off of pollutants from
lean_,:1;.-: and heavy use areas :nust bc minimized usinc technical standards developed by the Natural Resources Conservation
Service. : ; c approved plat; will be fled at the farm and a: the of5ce of the local Soil ar.d Water ,vat w, Conservation District. I (wc)
kllO that any rnodifi ation mustapproved by .,:.-,i_•,t li
.)' � � be a„p,o ... a a..:.:.. ..a., specialist ai,d $u[7rniiled to the Soil and �'ai:'r Consc-yatior,
:s�i:t prior to ht'.It'.l_rricni : on.. A change hr. ,and owner::hip requires K'rittcn notification to DWQ or a new ccrtifi;aticn (If
the approved plan is changed) within 60 days of a t tie transfer. -
Name of New 1 > l Af�
Land Owner : P ��t✓
J
Six hat
Name of ,'tr1ara,cr (if ch
Si_natur e:
Please sign and return this fore. tu:
Date;
Date:
NC Division of Water Quaii:v
Non -Discharge Compliance S Enforcement Unit
1617 Mail Service Center
Raleigh, '.0 27ti99-161 i -
_lull 1C, 2000
ZOO, +3C 0N> e
: NO��