310082_Owner (Name Change)_20240312

DocuSign Envelope ID: 3AB8D6F8-6895-4198-AC4F-551CB13C977F
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: Blanche Jones Nursery
Facility No: 31-172
Previous Owner(s) Name: Blanche Jones Phone No: 910-296-3088
New Owner(s) Name: James B Jones Jr Phone No: 910-296-3088
New Farm Name (if applicable):
Mailing Address: 156 S Country Club Dr.
Farm Location: Latitude and Longitude: / County: D u p I I n
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.):
476 Eva James Rd. Warsaw NC 28398
Operation Description:
Type of Swine No. ofAnimals
12 Wean to Feeder 3600
❑ Wean to Finish
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
Other Type ofLivestock:
Acreage Available for Application:
12
Type of Swine
❑ Gilts
❑ Boars
No. of Animals
Number ofAnimals:
Required Acreage: 4.
Type of Cattle No. ofAnimals
❑ Dairy
❑ Beef
Type of Poultry
❑ Layer
❑ Pullets
Number of Lagoons / Storage Ponds: 1 Total Capacity: 172237 Cubic Feet (ft3)
************************************************************************************
No. ofAnimals
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: Blanche G Jones
Signature: Date:
Name of New Land Owner: James B Jones Jr
Signature: Date: 3/12/24
Name of ManageroWferent from owner):
Signature: Date:
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

DocuSign Envelope ID: 3AB8D6F8-6895-4198-AC4F-551CB13C977F
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