MHC000100_Application_20220204

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Registration Form for Manure Hauler Operations
The Division of Water Resources (Division) amended its rules for "Waste Not Discharged to Surface Waters"
on September 1, 2006. Among the changes was the addition of registration and reporting requirements for
manure hauler operations. A manure hauler is defined as any person who accepts or purchases animal waste
and land applies the animal waste on land not covered by the generator's permit. In accordance with 15A
NCAC 02T .1403(a)(2), any manure hauler that land -applies a total of more than one hundred (100) tons of
animal waste per calendar year must register with the Division by September 1, 2007. Any new manure hauler
operation that will exceed the 100-ton threshold must register with the Division prior to accepting or purchasing
manure.
Please provide all of the following information in clear print:
1. Name of manure hauler:
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2. Manure hauler company/organization, (if applicable): / l
3. Mailing Address: /6��1 /�J''1i� 9f / / 0��-/
City, State: E//eii 0)-0, /1' C, Zip: d c/6
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Telephone: (f)63 ) 4/5-2-92 'S' E-Mail:
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4. Amount of animal waste land -applied: [400 - 750 tons/year ❑ > 750 tons/year
5. Counties/States from which manure is received:
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6. Counties/States where manure is land -applied: / 4 M -e -r% d mil/ 2
I hereby certify that the above information is correct and that I have read and understand the requirements for
manure haulers contained in NCAC 02T .1400. I understand that there are significant penalties for submitting
false informationpcluding the possibility ofjfines.
Signature:
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Date: 17/ 42 c.)/ ,R
Please send this completed form to the following address:
North Carolina Division of Water Resources
Animal Feeding Operations Program
1636 Mail Service Center
Raleigh, North Carolina 27699-1636
RECEIVED
FEB 0 4 2022
NC DEQ/DWR
Central Office
FORM: REG-MHO 12/06