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Facility Number O Division of Soil and Water Conservation
O Other Agency
Type of Visit: (OC.ommpliance Inspection U Operation Review Q Structure Evaluation U Technical Assistance
Z Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: , - .16b - 2.3 Arrival Time: l0', DNpp Departure Time: ly: 3v County: d,J Region: )E1-0
Farm Name: Cc"N ���� Chaps RtSGiF��`1 Sift i ion) Owner Email:
Owner Name: �.l,C, sr/}r� 1,(,� r VZX I;, .` y Phone: 911, 31 L f
Mailing Address:
Physical Address: j 3 Z. 2-3 U.S -70 6 1 5- U!
Facility Contact: /{G 1 Y-h 57-A A N,- Title:
7 fly- sS3� � r yl
Phone: I rg- S%0 ' 413 7 9
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Hack -up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Swine
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
3 S' YI 11-ayer
Non -La er
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
3 0
Farrow to Finish
Gilts
Boars
Other
Layers
Non-L
Pullets
Other
Pouits
Design Current
Discharges and Stream Imuacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure El Application Field ❑ Other:
a. Was the conveyance man-made?
Design Current
Cattle Capacity Pop.
DairyCow
DairyCalf
DairyHeifer
Dr Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
El Yes No ❑ NA [3 NE
❑ Yes ❑ No NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
[] Yes
No ❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 511212020 Continued
Facility Number: 5 l - -7 a{ Date of Inspection: G 3 3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural Freeboard? ❑ Yes ❑ NoFT-NA ❑ NE
Identifier
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
Structure l Structure 2 Structure 3
A MA ScGc�; NAll
Structure 4 Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environment reat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes rNo
❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes ,E�/No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ENo ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
YfNo ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
g ;No
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
�No ❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
dNo ❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall [:]Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
[:]Yes
No ❑ NA
❑ NE
Page 2 of 3
511212020 Continued
Facili Number: 5 - Date of Inspection: G O • l 3
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �N ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes EfNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT") certification? ❑ Yes a No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes F5"No ❑ NA ❑ NE
❑ Yes 1I "'o ❑ NA
❑ Yes Zf No ❑ NA
❑ Yes � ❑ NA
❑ Yes ❑ N ❑ NA
❑ Yes No ❑ NA
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
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Reviewer/Inspector Name: 4S J /tc
Reviewer/Inspector Signature:
Page 3 of 3
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❑ NE
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curtis.#yree@ncdenr.gov
work cell: 919-810-2691
Phone: I/ I - 7 V r 12- S7
Date: - )O Z 3
511212020