HomeMy WebLinkAbout820202_OIC Designation Form_20240222State of North Carolina
Department of Environmental Quality
Division of Water Resources
Animal Waste Management Systems
Request for Certification of Coverage
Facility Currently covered by an Expiring Sate Non -Discharge General Permit
On September 30, 2024, the North Carolina State Non -Discharge General Permits for Animal Waste Management Systems will
expire. As required by these permits, facilities that have been issued Certificates of Coverage to operate under these State
Non -Discharge General Permits must apply for renewal at least 180 days prior to their expiration date. Therefore, all applications
must be received by the Division of Water Resources by no later than April 3, 2024.
Please do not leave any question unanswered Please verify all information and make any necessary corrections below.
Application must be signed and dated by the Permittee.
1. Certificate Of Coverage Number: AWS820202
2. Facility Name: Simmons Hog Farm
3. Permittee's Name (same as on the Waste Management Plan): . Judy Hobbs Simmons
4. Permittee's Mailing Address: 4641 Bass Lake Rd
City: Clinton State: NC Zip: 28328
Telephone Number: 910-564-4740 Ext. E-mail:
5. Facility's Physical Address: 4844 Bass Lake Rd
City: Clinton State: NC Zip: 28328
6. County where Facility is located: Sampson
7. Farm Manager's Name (if different from Landowner): ��h s 14 kle j ,Quoo<1
8. Farm Manager's telephone number (include area code): /D _ i Q q
9. Integrator's Name (if there is not an Integrator, write "None"): Murphy -Brown LLC
10. Operator Name (OIC): RTmrL. +fmTing` r l —�/ Phone No.: 4"-5 OIC #: 5^--
11. Lessee's Name (if there is not a Lessee, write "None"): �f �� — .-%D ---'1 i
12. Indicate animal operation type and number:
Current Permit: Operations Type Allowable Count
Swine - Feeder to Finish 2,940
Oneration Tvnes:
Swine
Cattle
Dry Poultry
Other Tvues
Wean to Finish
Dairy Calf
Non Laying Chickens
Horses - Horses
Wean to Feeder
Dairy Heifer
Laying Chickens
Horses - Other
Farrow to Finish
Milk Cow
Pullets
Sheep- Sheep
Feeder to Finish
Dry Cow
Turkeys
Sheep - Other
Farrow to Wean
Beef Stocker Calf
Turkey Pullet
Farrow to Feeder
Beef Feeder
Boar/Stud
Beef Broad Cow
Wet Poultry
Gilts
Other
Non Laying Pullet
Other
Layers