310241_Application_20220401

Notification of Change of Ownership
Animal Waste Management Facility
(Please type or print all information that does not require a signature)
In accordance with the requirements of 15A NCAC 2T .1304(c) and I5A NCAC 2T .1305(d) this form is official notification
to the Division of Water Resources (DWR) of the transfer of ownership of an Animal Waste Management Facility. This
form must be submitted to DWR no later than 60 days following the transfer of ownership.
General information:
Previous Name of Farm: Marion Dean Brown Jr Farm Facility No: 31 - 241
Previous Owner(s) Name:
New Owner(s) Name: Fountain Farms, LLC
Marion Dean Brown
New Farm Name (if applicable): Fountain Farms
Mailing Address: 2529 Fountaintown Road
Phone No: [phone]
Phone No: [phone]
Chinquapin, NC 28521
Farm Location: Latitude and Longitude: 34` 49 31.87" / 77° 47' 1 er County: Duplin
Please attach a copy of a county road map with location identified, and provide the location address and driving directions
below (Be specific: road names, directions, milepost, etc.): 371 Pickett Bay Road Chinquapin, NC 28521
Operation Description:
Type of Swine No. of Animals
❑ Wean to Feeder
0 Wean to Finish
Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
4.320
Type of Swine
❑ Gilts
❑ Boars
No. of Animals
Ocher Type of Livestock: Number of Animals:
Acreage Available for Application: 56.17
Type of Cattle No. of Animals
❑ Dairy
❑ Beef
Type of Poultry No. of Animals
❑ Layer
❑ Pullets
Required Acreage: 39.77
Number of Lagoons / Storage Ponds: 2 Total Capacity: 978,648 Cubic Feet (ft3)
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Owner / Manager Agreement
1(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 fans 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 Tess 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 Resources to issue the required permit to the new land owner.
Name of Previous Land Owner: Marion Dean Brown
Signature: 4/1\- Date: /?' /
Name of New Land Owner: / /
hri F ntain on behalf of Fountain Farrr , LLC
Signature: Date:
Name of Manager (if di erent from owner
Signature: Date:
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
Raleigh, NC 27699-1636
June 12, 2015