HomeMy WebLinkAbout310656_Application_20220906Notification 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 ISA 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 Naive of Farm: Lynn & Annette Smith Farm Facility No: 31 - 656
Previous Owner(s) Name: Timothy L. Smith Phone No: 252-568-4795
New Owner(s) Name: Jeffery L. & Cynthia S. Davis Phone No: 252-526-7682
New Farm Name (if applicable): 13ig D Farm
Mailing Address: 281 Burncoat Rd, Pink Hill. NC 28572
Farm Location: Latitude and Longitude: 35.024642 / 77.821503
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.): Take NC 111 north of Beulaville 7.9 miles to farm on the left.
Operation Description:
Type of Swine No. ofAnimals Type ofPoulhy No. of Animals Type of Cattle No. ofAnimals
❑ Wean to Feeder 0 Layer 0 Dairy
► gSI Feeder to Finish 3672 0 Pullets 0 Beef
0 Farrow to Wean
0 Fallow to Feeder
0 Farrow to Finish Other Type of Livestock: Number of Animals:
❑ Gilts
0 Boars
Acreage Available for Application:
t{tr , 7 Required Acreage: 40.47
Number of iJagoo s / Storage Ponds: I Total Capacity: 767,479
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Cubic Feet (ft3)
Owner / Manager Agreement
I (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 PIan (CAWMP) for the farm 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 less 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: Timothy L Smith
Signature: X 2-4 4111,4 /� A
Name of ew wne : N Land 0 te J ffL&Cynthia S avis
Date: 8/16/22
Signature: i ft,�1C Date: 8/16/22
v l
Name of (if: Manager diffm owner)
:
)
Signature:
Please sign and return this form to:
Date:
•
N. C. iliVision of Water Resources
Water Quality Regional Operations Section
Animal Feeding Operations Branch
1636 Mail Service Center
Raleigh, NC 27699-1636
June 23, 2014
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