110558_Application_20230220

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Animal Waste Management Systems
Request for Renewal of Existing Individual State Non -Discharge Permit
Please do not leave any question unanswered.
1 Facility Number.: 11 - 558 or Permit Number: AWI1 10558
2 Facility Name: Western North Carolina Agricultural Center Horse Complex
3 Landowner's name (must match the name on the Certified Animal Waste Management Plan): N.C. Department of Agriculture and
Consumer Services
4 Landowner's Mailing address: 1301 Fanning Bridge Road
City, State: Fletcher, NC Zip: 28732
Telephone Number (include area code): 828-687-1414
Email address (if applicable):
5 County where facility is located: Buncombe
6 Farm Manager's name (if different from Landowner): Matt Buchanan
7 Farm Manager's telephone number (include area code): 828-687-1414
8 Farm Manager's email address (if applicable): matt.buchanan@,ncagr.gov
9 Number and Type of Animals: (example: 2000 Feeder to Finish Swine) Swine:
Confined Cattle:
Poultry with liquid waste system:
Other: Horse - 874
Submit a copy of the most recent Certified Animal Waste Management Plan (CAWMP) with this application. The CAWMP
must be signed by the owner and a technical specialist. — NC General Statutes 143-215.IOC
I attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that if all
required parts of this application are not completed and that if all required supporting information and attachments are not included, this
application package will be returned to me as incomplete. Note: In accordance with NC General Statutes 143-215.6A and 143-215.6B,
any person who knowingly makes any false statement, representation, or certification in any application may be subject to civil penalties
up to $25,000 per violation.
Printed Name of Signing Official (Landowner, or if multiple Landowners all landowners should sign. If Landowner is a corporation
signature should be bya a principal executive officer of the corporation):
Name: I? 3t.ic A/ iq Title: /lf/v49 eaf
Signature: ar' Date: !0 %� 0
THE COMPLETED APPLICATION SHOULD BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DIVISION OF WATER RESOURCES
ANIMAL FEEDING OPERATIONS
1636 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1636
TELEPHONE: [phone] FAX: [phone]
Request for Renewal - Individual 02.17.2017