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Home My WebLink About960109_Application_20230620RerIeW Notification of Change of Ownership ,V� 2 Q 2Q23 Animal Waste Management Facility (Please type or print all information that does not require a signature) Q�®wR In ac Rie requirements of 15A NCAC 2T .1304(c) and 15A NCAC 2T .1305(d) this form is official notification to thesion 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: j 1 1 a, / Facility No: - Previous Owner(s) Name- i �� , � nh � (d u P/L cl Phone No: .L, �1� l� New Owner(s) Name: SC O Phone No• 19) New Farm Name (if applicable): Mailing Address: .�J72.0int 4 Gr: v GL Li ut- Farm Location: Latitude and Longitude: / County:. 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.): `:� i , 1 P 4, aL--1 ,d 77 .�� . .17 10� "■ 1 r (� L Operation Descrintion: Type of Swine No. ofAnimals Type of'Swine ❑ Wean to Feeder - D ❑ Gilts ❑ Wean to Finish ❑ Boars Feeder to Finish Q ❑ Farrow to Wean , 1) - ❑ Farrow to Feeder - d " ❑ Farrow to Finish -y No. ofAnimals P_ _0 - Other Type ofLivestock.-. _� Number ofAnimals: Type of Cattle No. ofAnimals ❑ Dairy '/J0 - ❑ Beef -r1- Type of Poultry No. ofAnimals ❑ Layer ❑ Pullets - Acreage Available for Application: Required Acreage: Number of Lagoons / Storage Ponds: Total Capacity: 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 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: i e Date: "Z1J Name of New L nd er: eD '+- . Q (s✓i ' A. Signature: Date: rame of Manager (if different from owner-):,gnature• Date, Please sign and eturn this form to: Animal Feeding Operations RECEIVED N. C. Division of Water Resources 1636 Mail Service Center JUN 2 0 2023 Raleigh, NC 27699-1636 Ge . 2023 W, w 9W WIN t14-1,11 ? Un W% 4 STATE OF NORTH CAROLINA 7 WAYNE COUNTY OFFICE OF REGISTER OF DEEDS rJ NORTH CAROLINA DEPARTMENT OF HEALTHAND HUMAN SERVICES N.C. VITAL RECORDS CERTIFICATE OF DEATH 00H I I ONCIE 0 5 4 1 STATE FILEND.— id Fillb. MIDDLF is r FIX 1e.LASTNA1d P R TO Fie reRtiomilirw William IJoseph Britt ..... MARRIAGE 115LA(;K, BLUE. HLACAUR k. OLI.ItINK 2. S,k 3a-A 3b.UND R1 3., LIN (Canty�t 8 te w F one i a —n-� i-2 BIRTHDAY s) IDAY t. ATEQFS.';--- LACE 1 6. D--1H YEAnVy3 6 male 69 Mont , -y- Hours ,nines NOV 22, 1953 Wayne, NC May 25, 2023 2. LA DFD1AIH 7b. A " NA E (Iff'.t in. boon. give sinset, number, eiy or toxin) Helping Hands Assisted Living 2052 U S 70 Highway W, Goldsboro, NC 27530 au7 OF DEA .MARITAL To . SURVIVING SPOUSE( ';y '- OF a- Currently arried Lynn Lancaster C q, ri. y�n Im S ca 10a.UEC-�EDEN:T'S dUAL-C-----M- L g. ECE.F.T I TIDAL E] CUPATI llQb. KIND ^' ausiNESS;INDUSTRY 11,13E 5• '3AL E.URII Farmer Agriculture NUMBER 242-76-0945 113-- R7S-1D-0TdE--§ �& 5R FOREIGNC 3LINTRY 11b, E -C N ESIDENCE-rrry OR TOWN North Carolina Wayne Goldsboro N. �NUMBE 7- 1. -ECrr7Uk s I zip IN 7-1ws-lo' 107 Myrna Drive I ARMED FORCES? I No 27534 No 1-4l5MEDl!TTf9-ff UCATION --rr3rCNIQUIRIOIN! I- GE N .1r.E Associate degree No, S,E11""lalrishjHi.p.1nic/Latino White 1413 jjj=7rMHER/PARENTN MMiddle Last, Sue.b THERIPA ENTNAM first, die, Lasts ,a)(Laxt Name PNorro First Ma age) William Harvey Britt Julia Wiggins 9NIZILING -, mE5s tqv --, and Number,Number,ctti IS Is zip �--) Lynn Lancaster Britt I Spouse 1107 Myrna Drive. Goldsboro, NC 27534 R. -9-.wj,-1, 51'ION �WldA OU6 - I .�N(1,anh.-cemetery, C—ato, aMer "OI ry�a- t7ta Cremation �oSimCremation Service rldsboo,—, North Carolina "'RF-17i 71-1-11 �ARAC U"IE-ell 01.1t .?In II E 14Q �M ' .1'1.s".Renee Sall (Signature Authenticated) FD4310 R Fu neral Home, 108'N Caswell St, La Grange, NC 28551 .Go ba'ib"' th, arti.Enterthe �Ids, Inquiries o, plubst*hs) the respiratory ..8fn 01f events jdi,,'e...�%,nss UT—.. pit -Innate hit-ld: a-sLbrv@nbdb,Ia,flbnIItjn 4th_t,h_i,g ,siniolb, lines b, C nrdlbrd- EI.ronlynnilbauibe., . in..Do N`DT`A1-3`SR-E'VdiL-A�T-E— Onset to death for IMMEDIATE TCAUSE IMMEDIATE CAUSE MMEDIATE CAUSE = .d''d t1,111 1: ;ondlln cerebral vascular disease unknown in Due W (.1 as . n.e,.—. .1) Sequentially No conditions,Ing 11 Me'.!Zdy".nsdi E.,.=e i5u.hbn-aixnsequ UNDERLYING CAUSE s'o-0 tt�D as injury that 12 in flat the events esuki Due to (or a- - �.-Queh. of) �j s In death] LAST d. PART IL--i Int. �l P causa given in PART 1. but not resulting in the -dedyinp WASANAUTO SY 24b. WERE AUTOPSY FINDINGS AVAILABLE 91. PERFORMED? TO COMPLETE THE CAUSE OF DEATH? S! It - & :i� No !!77T!7� ! I 1H �26. —WA S CASE REFERRED 27.TIME OFDEATH To ME MINECON to TOBACCO USE PREGNANCY STATUS, IF APPLIES: MEDICAL E�ER TO MIEDICALEXAMINER9, A,.p..m a) CD TRIBUTE70DEATH? Natural N. N 08:42 AM Unknown Not Applicable IMEDICAL EXAMINER ONLY I certify that, to the best of my knowledge, death occurred at the Ilme, date, and place, and due to the cause(s) and manner stated. Wa--SrG-NATURFE-AN—DYIT-LPUFCE—RTFiER 33b. LI N., N . 33.. DATE SIGN-rD— Phillip Walker Move, MD (Signature Authenticated) 2007-01219 105/30/2023 F3-d-.N AMC A�NM R� , �92 at Philrip Walk Y. 9 18387720 WAD xL I F Michael Brand (Signature Authenticated) 105/3112023 05/31).2023 'Ev-S M.s tat? Volume 110 - -- -- Page 541 - - This is to certify that this is a true and correct reproduction or abstract of the official record filed in this office. Constance Be Coram STA TP L Register of Deeds -rw /x ne County X. T' Witness my hand and official seal Way thi s the 9 day of June 2023 By: Deputy/Aaamilikkerift Register of Deeds V Any alterations or erasure volda this certificate. Do not accept unless on security paper with Register at Deeds seat clearly embossed in left c, Ar other. 5 `-' _ " 'b - S R' � n :ti � .Ti 7 •.^• � :� r O Ci •� U� . � :: U ,'�. --K 'C7 • v `•� �_ •J• O .X ^O � � ee ..'3 � � •`�'.' ,,,� O '.�^.. ^ � S 5 „ i ' C 7 ^^' Z O -iJ �^ 1 � ;J � ., ^.C E C£�, C7 , •'r-+.....: o h i, n "C7 � � � s �' � � J � � i r C, p � .^_. .� • i ci CZ f uc rTJ+ 3 r U y p -=� 5 .Z r" T •;, ✓ ., U — r. bp t U U O K ',nr :C td IU Eo �U^. A- -O.^ '" O > ., O `' .^'�. = O •'"` C nM �. 'C •r `•b ,� y O bee Q.. 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