090014_Application_20220220

Notification of Change of(hvnership
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 15A NCAC 2T.1305(d)this form is official notification
to the Division of Water Quality(DWQ)of the transfer of ownership of an Animal Waste Management Facility. This form
must be submitted to DXVQ no later than 60 Jays following the transfer of ownership.
Genernl Information:
Name of Farm: Eason Swine —Facility No:9-14
N
Previous Owner(s)N Ravmond C.Marlowe _ Phone No:910-876-2899
New Owner(s)Name: Eason Swine Phone No 910-874-4172
New Farm\ame:Eason Swine —
Mailing Address: 69 Doc Crossine.Elizabethtown,NC 28337
Farm Location: Iatitude and Longitude:34 766367/78 590849 County: Bladen
Please attach a copy of a county road map with location identified and describe below(Be specific:road names,directions,
milepost, From Ammon,Take NC 242 south 1.7 miles to Cain Loon Rd.Turn 101,travel 1.1 miles to farm on left
Operation Descrintion:
4pe ofSwnne No.ojAmmals Type ofPonitry No.ojAmmals Type of
Cattle No.ojAmmals
❑Wean to Feeder ❑
Layer ❑Dairy
❑x Feeder to Finish 6840 ❑
I
Pullets ❑Beef
❑Farrow to Wean
❑ Farrow to Feeder
❑Farrow to Finish Other7ype ofLrvestoek: _ Number
of Animals: _
❑Gilts
❑Boars
Acreage Available for Application: 47_44 Required
Acreage: 47�44
`Jumberof lagoons/Storage Ponds:1 Total Capacity: .1 2, 98.594 Cubic
Feet(H3)
(Tyner/Manager Agreement
I(we)verify that all the above information is correct and will be updated upon changing. 1(we)understand the operation and
maintenance procedures established in the Certified Animal Waste Management Plan(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 stale 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. 1(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 Quality to issue the required pen nit to the new land owner.
5 wile of Previous Land(honer: Raymond C
Marirnoe
SlPrrat Dale: a Zkeal?,3
Is o Nc.o I.anJ(honer:Fason tirrine

Signature:
Date. �_ Z
Name of Manager(W differ6nt fro m
owner):
Signature:
Date:
Please sign and return this form to: N.C.Division of water Quality
Aquifer Protection Section
Animal Feeding Operations tint
1636 Nkii Service Center
Raleigh,NC 27699-1636
May 2,2007

Animal Waste Management System Operator Designation Form
WPCSOCC
NCAC 15A 8F.0201
Facility/Farm Name:
Permit# _/�►W_�� (J(�f Facility ID#: - County: a
Operator In Charge(OIC)
Name: ,rpmtI--z 16-4-.6 - row
First Middle Last Jr.Sr,etc, c
Cert Type/ ber: ft 73� Work Phone:( /I�)�17111'' y/72
Signature: / Date: J"•2��3 y
"I certify that I a to my designation as the Operator in Charge for the facility noted.I understand and will abide by the rules and regulations
pertaining to that ponaibilWas sot forth in ISA NCAC 08F.0203 and failing to do so can result in Disciplinary Actiooa by ilia Water
Pollution Control.System Operators Certification Commission."
Back-up Operator In Charge(Back-up OIC) (Optional)
Name:
First Middle Lott Jr,Sr,as
Cert Type/Number: Work Phone:( 1
Signature: Date:
"I certify that I agree to my designation as Back-up Operator in Charge for the facility noted.I understand and will abide by the rules and
regulations pertaining to the responsibilities set forth in 15A NCAC 08F.0203 and falling to do so can result in Disciplinary Actions by tho
Water Pollution Control System Operators Certification Commission."
Owner/Permittee Name:
Phone#: Fa)W: /
Signature: Z Date: /`2S ,�_3
vmer o ut t)
Mail,fax or entail the WPCSOCC, 1618 Mail Service Center, Raleigh,NC 27699-1618 Fax:[phone]
original to: JEmail:certadmin a(lncdenr.gov
Mail or fax a copy to the Asheville Fayetteville Mooresville Ralelgh
appropriate Regional Office: 2090 US Hwy 70 225 Green St 610 E Center Ave 3800 Barrett Dr
Swannanoa 28778 Suite 714 Suite 301 Raleigh 27609
Fax:[phone] Fayetteville 28301-5043 Mooresville 28115 Fax:[phone]
Phone:[phone] Fax:[phone] Fax:[phone] Phone:[phone]
Phocn:910.4333300 Phone:[phone]
Washington Wilmington Winston-Salem
943 Washington Sq Mall 127 Cardinal Dr 450 W.Hanes Mall Rd
Washington 27889 Wilmington 28405-2845 Winston-Salem 27105
Fax:[phone] Fax:[phone] Fax:[phone]
Phone:25294&6481 Phone:[phone] Phone:[phone]
(Relate a copy of this fonn for your recor ds)
Rc v=J U-20 15