310407_Integrator Registration_20220614

Change of Swine Integrator Registration Form
Farm Name: JBJ Kilpatrick Farms Inc.
Facility Number: 31
- 407
Physical Location of the Swine Farm: 211 JBJ Farms Ln
Magnolia
NC 28453
Owner(s) Name: JBJ Kilpatrick Farms Inc
Mailing Address: 1650 Hwy 50 South
City, State, Zip Code: Magnolia
NC 28453
Grower(s) Name if different than Owner: Same
Mailing Address: Same
City, State, Zip Code: Same
Phone: [phone] Email: [e-mail]
Current/New Integrator: Clearview Farms LLC
Integrator Contact Name: Baird Kilpatrick
Mailing Address: 1656 Hwy 50 South
City, State, Zip Code: Magnolia NC 28453
Phone: [phone]
Email: [e-mail]
ep.077,y,
6-13-22
Owner's Signature Date
We appreciate your cooperation. This information is required in accordance with G.S. 143-215.10H. If
you have any questions contact the AFO Unit at [phone], otherwise please return this form to:
NC Division of Water Resources
Water Quality Permitting Section
Animal Feeding Operations
1636 Mail Service Center
Raleigh, NC 27699-1636
ELECTRONIC SUBMISSION IS ENCOURAGED. PLEASE EMAIL TO: [e-mail]
CISIR 03-25-2021