310844_Application_20230621

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 15A 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: Aaron Smith New Farm Facility No: 31 - 844
Previous Owner(s) Name: William Aaron Smith Phone No: (252) 568 - 3627
New Owner(s) Name: Olivia Sutton Smith Phone No: (252) 568 - 3627
New Farm Name (if applicable):
Mailing Address: 3657 N NC 111 AND 903 HWY - Albertson, NC 28508
Farm Location: Latitude and Longitude: 36° 6' 27.93" / 77° 49' 36.38- County: Duplln
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.): 3665 N NC 111 AND 903 HWY - Albertson, NC
Oaeration Description:
Type of Swine No. of Animals Type of Swine
❑ Wean to Feeder ❑ Gilts
❑ Wean to Finish ❑ Boars
® Feeder to Finish 3,520
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Other Type of Livestock:
No. of Animals Type of Cattle
❑ Dairy
❑ Beef
Number ofAnimals:
Type of Poultry
❑ Layer
❑ Pullets
Acreage Available for Application: 34.91 Required Acreage: 27
Number of Lagoons / Storage Ponds: 1 Total Capacity: 991,146 Cubic Feet (ft3)
No. of Animals
No. of Animals
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 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 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: Deceased: William Aaron Smith
Signature: Date: 6/20/2023
Name of New Land Owner: Olivia Sutton Smith
Signature. . Date: 6/20/2023
Name of Manager (if different from owner): a0 Tt7ct<� - A-�N
Signature: IL Date: (�o `Z 0
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

Animal Waste Management System Operator Designation Form
WPCSOCC
NCAC 15A 8F .0201
Facility/Farm Name: Aaron Smith New Farm
Permit #: AWS310844 Facility ID#: 31 - 844 County: Duplin
Operator In Charge (OIC)
Name: Aaron Todd
First Middle
Cert Type / Number: AW A 17397
Signature: �b 3 a. Lozo
Smith
L< st Jr, Sr, etc.
Work Phone:( 252 ) 560 - 8766
Date: 6/20/2023
"I certify that I agree to my designation as the 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 failing to do so can result in Disciplinary
Actions by the Water Pollution Control System Operators Certification Commission."
Back-up Operator In Charge (Back-up OIC) (Optional)
Garrett Faison Smith
First Middle Last Jr, Sr, etc.
Cert Type / Number: AWA 1002867 Work Phone: ( 252 ) 286 - 6610
Signature: "3sm*
Date: 6/20/2023
"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 failing to do so can result in
Disciplinary Actions by the Water Pollution Control System Operators Certification Commission."
Owner/Permittee Name: Olivia Sutton Smith
Phone #: ( 252 ) 568 - 3627 Fax#: L
Signature:Crz­'t�cy J •
(Owner or authorized agent)
Mail or fax to: WPCSOCC
1618 Mail Service Center
Raleigh, N.C. 27699-1618
Fax: [phone]
(Retain a copy of this form for your records)
Date: 6/20/2023
Revised 82007