620002_INSPECTIONS_20171231

NUH I H UAHULINA
Department of Environmental Qual

NORTH CAROLINA
�J
Department of Environmental Qua

Division of Water Quality
Facility Number 0 Division of Soil and Water Conservation
Other Agency
a
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
I A -e
Date of Visit: 11 Arrival Time: 1qj Departure Time: County: M010RITISU Region: r 1 0
Farm Name: ?' 20 aE 4l�S Owner Email:
Owner Name: Leomcwd A�rn Phone:
Mailing Address:
Physical Address:
Facility Contact: _�+��� ram' Title: Phone No:
l{
Onsite Representative: Integrator:
Certified Operator -
Back -up Operator:
Location of Farm:
Swine
❑ Wean to Finish
59 Wean to Feeder
RO Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gifts
❑ Boars
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = , = Longitude: = ° = , 0 „
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
O _ ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: [all
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters ol'the State
other than from a discharge?
❑ Yes ❑ No ® NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
❑ Yes
❑ No
['ONA
El NE
EVA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
RNA
❑ N E
❑ Yes
[:]No
ERNA
❑ NE
Page 1 of 3
12128104 Continued

Facility Number: Date of Inspection 2 z
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ No DNA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No M NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier: 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): t\)A- N A
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No IM NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑ No P NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement'?
[--]Yes
❑ No P NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the pen -nit?
❑ Yes
❑ No ' NA [INE
Ir
(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/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
❑ No NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
6:L12. Crop types) R�C, � �alki e
13. Soil type(s) JX4eWN , ;j"�v-t
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[:]No
1P NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
❑ No §9 NA
❑ NE
17. Does the facility lack adequate acreage for land application`?
❑ Yes
❑ No
1� NA
❑ NE
18. is there a lack of properly operating waste application equipment'?
❑ Yes
❑ No
EP NA
❑ NE
�S
doS.ed
ehd o(— zo i O
AA 1 c�
G �GLvl2
Uc-" e,
bre d
Jcpt�
r ' �I'WVJ�.r ..l'" (a!{ �}Ci'Ji'1 CZl✓11%�.v`�t�
7 � �BIY.1 � .
Reviewer/inspector Name
,�' `1'
}
E a t , t I �' ,, : '1: Phone:
Reviewer/Inspector Signature:
Date: !/
Page 2 of 3
12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No 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 ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No O NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers [:]Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
0 NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
i NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
P NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
T NA
❑ NE
26,
Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
T NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
0 NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
1P NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
❑ No
E� NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
❑ No
NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
❑ No
® NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
I
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative`?
❑ Yes
❑ No
NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
M NA
❑ NE
�kr 1j0 ?1i)��Ss N 7� Y/Y1 a f ��1vrt`/'
�'fL C d (e T� �� . 1�%r I r ' f'r' 1�0u1 �i�-✓) J� tr��-�,1��� s.�
Page 3 of 3 12128104

«-
" Division of Water Quality
W
Facility Number O Division of Soil and Water Conservation
O Other Agency
Type of Visit 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 0 Arrival Time: Departure Time: Q7�c� County: mt�t ro Region:
Farm Name: t4 V1 e f Z10 SS "tiS Owner Email:
r
Owner Name: _ 1"'�e oviawd I4ew-n Phone:
Mailing Address:
Physical Address:
Facility Contact: y_r_0t1ou'U r-Wn Title: Phone No:
OnsiteRepresentative: I Integrator: ' 1'Lr. NnLAzo
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Back-up Certification Number:
Latitude: = o = ' = Longitude: = o =
Resign Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
yCYX-) I ❑ Non -Layer I I Ell
Other
❑ Other --
Dry Poultry
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
T-11—
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes P No ❑ NA ❑ NE
❑ Yes
❑ No
[P NA
❑ NE
❑ Yes
❑ No
®NA
❑ NE
[P NA
❑ NE
❑ Yes
❑ No
❑ Yes
QgNo
❑ NA
❑ NE
❑ Yes
4 No
❑ NA
❑ NE
12128104 Continued

I
Facility Number: Date of Inspection 8 O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes 1�No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
F NA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): .26 0 h
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes PNo
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes P No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes M No [DNA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit'? ❑ Yes No ❑ 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 [79 No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �-eSCtkp _
n
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[P No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement'?
❑ Yes
M No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
(59 No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
[S No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
M No
❑ NA
❑ NE
Tit '.vI "I 'I 1. �,. '�.w 1. i4 'p pp.iE'S 4d �i4�ld.".�ral
k ti i rk ..u:3. .., l l u. ki .Iwl rr !- i a& re'+ i ,i F i, ui r'r:.0 8 �g.r tl '' .
Comments (rcierttorquestton #) NTxplamtany YFS'answers and/or anyrecommendutions ar any otlicr,comtnents }
c i, � � W � •. a a s r��� f �
'Use draw�ngs of facili>tyto tietter expl yin s3ltuattans�""(use Addthonal pages as necessary}: ", a� �, f r ���
�� U, , ,
No AoS opi -%,v M s,'ne -e- emd or ��,,{s4- zoo.
cv Y41 t `7 ' �►^ P rDC��S LCc opv, c-r✓t? S I t.t,P S
Ir
_.
Reviewerllnspector Name Phone: /3Af0
Reviewer/Inspector Signature: Date: allallo
12128104 Continued

1'
Facility Number: 6H= Date of InspectionI�10.1
Reoulred Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Desig
n [I Maps [I Other
[]Yes
oNo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes F
No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
2$. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. 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
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
FNo
❑ NA
❑ NE
❑Yes
®No
❑NA
El NE
❑ Yes
No
F
❑ NA
❑ NE
❑ Yes
rp No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
[�j No
❑ NA
❑ NE
[:]Yes q No ❑ NA ❑ NE
[:]Yes [9 No ❑ NA ❑ NE
❑ Yes t8 No ❑ NA ❑ NE
[:]Yes [PNo ❑ NA ❑ NE
[:]Yes M No ❑ NA ❑ NE
[]Yes PNo ❑ NA ❑ NE
12128104

Type of Visit 0 Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit *Routine O Complaint O Fallow up O Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm (Same: 81acL Ankk s fu) Owner Email:
Owner Name: LeoP,r Phone:
Mailing Address:
Physical Address:
Facility Contact: LfnlRe 4Lx Title:
u
Onsite Representative:
k
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
❑ Wean to Finish
Wean to Feeder
Lf CM
Feeder to Finish
$5b�
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
1 Phone No:
N Integrator: G r Dvx-VtS �jDD
Operator Certification Number: �17D(ro
Back-up Certification Number:
Latitude: 0 0 = 1 = Longitude: = ° = 4
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
[ILayer
❑ Non -Layer
Dry Poultry
ElLayers
ElNon-Layers
ElPullets
ElTurkeys
El Turkey Poults
ElOther
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ElStructure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
El Dairy Cow
El Dairy Calf
El Dairy Heifer
❑ Dry Cow
ElNon-Dairy
ElBeef Stocker
El Beef Feeder
❑ Beef Brood Cow
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: ' ' "
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
J
❑ Yes )iNo ❑ NA ❑ NE
❑ Yes
❑ No
[)VNA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
❑ Yes
❑ No
DNA
El NE
❑ Yes
'p No
❑ NA
❑ NE
❑ Yes
`P No
❑ NA
❑ NE
Page I of 3 12128104 Continuer!

1.
Ii acility Number: Date of Inspection
Waste Collection & Treatment T�
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes JWNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No MNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5• Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 0 No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed []Yes S No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement'? ❑ Yes %No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes (CpNo ❑ 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 EANo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
{R No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window❑ Evidence of Wind Drift [:]Application Outside of Area
rr
12. Crop type(s) Fesqu
13, Soil type(s) ln , d &rl0[oo
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
0 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
figNo
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
'"-No
[I NA ❑ NE
17. Does the faciiity lack adequate acreage for land application? ❑ Yes
P No
❑ NA ❑ NE
18. is there a lack of properly operating waste application equipment? ❑ Yes
J7 No
❑ NA ❑ NE
n5l q�?o- uSe
�Lf$ sp �� a� p, phi :`k •„ i o
Reviewer/Inspector Name „ u r + � � •. d �;i h Phone: 410
Reviewer/Inspector Signature: Date: 41 !
Page 2 of 3 12128104 Continued

L
Facility Number: Date of Inspection l(J
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 9INo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
%No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
10 NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�d No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
N No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
®No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
tp NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
0 No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
tRNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
KbNo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
U No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
(!PNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
�Q No
❑ NA
❑ NE
Page 3 of 3 12128104

e
1.
Facility7umber 6a
0 Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit *Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 11 0 Arrival Time. Departure Time: Q County: Region:
r
Farm Name: 81ctc�_ A"K1'e /' wy ) iV#t&ner Email:
Owner Name: Leon" r"I 1�ef"Y1 Phone: 6_3081-3-78T1
Mailing Address: �3k) 3cxz -190&Q)_
Phvsical Address:
Facility Contact: LDYWI M ,0 %UC Lrl Title: Phone No:
Onsite Representative: Integrator: AJ. /
Certified Operator: tt Operator Certification Number:�p
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: 0 0 =' = Longitude: 0 0 =' =
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
Wean to Feeder Lj 000
Feeder to Finish Op
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La y er
❑ Non -La ct
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Capacity Population
❑
DaiKy Cow
❑
Dai Calf
❑
Dairy fleifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cow
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes PNo ❑ NA ❑ NE
❑ Yes
❑ No
RNA
❑ NE
❑ Yes
❑ No
P NA
❑ NE
PIA
❑ NE
❑ Yes
❑ No
❑ Yes
['No
l�
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
12128104 Continued

I
Facility Number:
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
identifier: 1 3
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ 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 JRNA ❑ NE
Structure 5 Structure 6
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 1�gNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation pnses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 0 No [DNA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 29 No ❑ 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 WNo El NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes KI No ❑ NA ❑ NE
l 1. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes [p,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 Area
12. Crop type(s) �QSC la.Q. �Gis-�-u r� I
13. Soil type(s) �QL�;1'1 gey-o'don „--
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes RNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement`? ❑ Yes
V No
❑ NA
❑ NE
16, Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
El No
❑ NA
❑ NE
17, Does the facility lack adequate acreage for land application`? ❑ Yes
n No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? [:]Yes
;S No
[]NA
❑ NE
Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pagees as necessary):
vrn 15 i F) ` CS1rz�e15 D� Uv/ api 7� /050ck s
-PlaKn�r,)
CLhd q-2�'r~ 5 p t- �t T J 0� bKS InfSSr
.TWO �Jwl`r*l G LCk_ 011
Reviewer/Inspector Name a Phone: q�oJ 433-3 3 too
ReviewerAnspector Signature: Date: l f 7
t 12128104 Continued

5
t � �
Facility Number: �? —a, Date of Inspection
Reouired Records & Documents ' [
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 19 No ❑ NA ❑ NE
the appropirate box. ❑ W­Up ❑ Checklists ❑ Design ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. []Yes R No []NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
[IS No
[I NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
'F] No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
i�3 No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
59 No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
H No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification'?
❑ Yes
UlNo
❑ NA
❑ NE
Other lssues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
CoNo
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
fpNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
[P No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
3 t .
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
n No
❑ NA
❑ NE
General Permit`? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
�ZNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
;9 No
❑ NA
❑ NE
Additional Comments and/or Drawings:
12128104

1
f
sion of Water Quality
Ir
===Number fp �-- ® ('� Division of Soil and Water Conservation
0 Other Agency
Type of Visit Q Compliance Inspection Q Operation Review p Structure Evaluation O Technical Assistance
Reason for Visit O Routine Q Complaint O Follow up Q Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: 15/CDT`j�, l 1Arrival Time: 10 • 00 Departure Time: � County: Region:
Farm Dame: —glac • Al f U, � dwy aab 6P �r` *n Owner Email:
OwnerName: if0rM4-d i"'1� aw-n T{ `Sr • Phone: 33(6 "06 3~ 7577
Mailing Address: 33L- 30�k.- lgi3lb au)
Physical Address:
Facility Contact: LecK�fr-\ Title:
Onsite Representative:
ll
Certified Operator:
Back-up Operator:
Location of Farm:
Igwine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
L�
Phone No:
Integrator: _ , Pu.i�yls
Operator Certification Number: /02)76
Back-up Certification Number:
=i�=I=14 g =0=1
Latitude: Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
i
❑ Non -La ei I
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turke s
ElTurke Poults
❑ Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current'
Cattle Capacity Population
❑ Dai Cow
❑ Dairy Calf
❑ Daia Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
b, Did the discharge reach waters ofthe State'? (Ifyes, notify DWQ)
c. What is the estimated voiume that reached waters of the State (gallons)?
d, Does discharge bypass the waste management system`? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation'?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes ❑ No ❑ NA K NE
❑ Yes
❑ No
❑ NA
$ONE
❑ Yes
❑ No
❑ NA
M NE
❑ NA
[] NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
[� NE
❑ Yes
❑ No
❑ NA
[�NE
12128104 Continued

I F
Facility Number: a=.
Date of Inspection 5 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ 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 ONE
❑ Yes ❑ No ❑ NA K] NE
Structure 5 Structure 6
❑ Yes ❑ No ❑ NA 19 NE
❑ Yes ❑ No ❑ NA ® NE
If anv of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DV
7 Do any of the structures need maintenance or improvement? % Yes ❑ No ❑ NA
8. Do any of the stuctures lack adequate markers as required by the permit'? ❑ Yes ❑ No ❑ 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 M NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes ❑ No ❑ NA V9 NE
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ;U NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[:]PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
P] NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
W NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determinations
❑ Yes
❑ No
❑ NA
�0 NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
® NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
W NE
kor5e, lqt� ► mo+ o� Lrx�ooh �� p,�ea
1f�a O,x " o°p kaS art &azoW ( Grass !15 � �� 16 if 0 K 0,e S.
C ` k , J o r\ k ar'SQ 5 y CO E-c —+1 v wa �,fl ►� l� bR 1VLq r�� �fl�yl ot,,�► cP r
)5iCGe[f tA+ +�melrOWAL�A-or`n Aft' j JFS
ReviewerlInspector Name F 7 go''- Pho
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: (Q — 7 Date of Inspection 5 to O
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA NE
the appropirate box.
❑ WUP ❑Checklists El Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA PS NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and l" Rain Inspections ❑ Weather Code
22, Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No ❑ NA F NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
50 NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
❑ No
❑ NA
NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
❑ NA]
NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
31 NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No ❑ NA P NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ❑ No ❑ NA [NNE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ❑ No ❑ NA ® NE
and report the mortality rates that were higher than normal'?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑ No ❑ NA t4 NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ❑ No ❑ NA �9 NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No ❑ NA W NE
12128104

0
Type of Visit
ompliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
0 Routine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit:Arrival Time: Departure Time: D7 County:.C11 Region:
Farm , me: (J� 7��n Si rfi �� • Owner Email: II
Ow r Vame: Phone:����9��-�j�
Mailing Address:
Physical Address:
Facility Contact: Ke v"yl- Title:
ORSite Representative:. _ -Lee/.. TL,
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone No:
Integrator: eged L
Operator Certification Number: Z
Back-up Certification Number:
Latitude: 00 ❑ i = Longitude: ❑ ° = ,
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
q ❑ Non -La et
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
3- O
3 a--
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Cilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkc s
❑ TurkeyPoults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ DairyCow
❑ Dai Calf
I
❑ Dairyhleifei
❑ D Cow
❑ Non -Dairy
❑ Beef Stocke►
❑ Beef Feeder
❑ Beef Brood Colt
--
Number
of Structures:
b. Did the discharge reach waters of the State`? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation`?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes f KNo ❑ NA ❑ NE
❑ Yes
RINo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
® No
❑ Yes
[nNo
❑ NA
❑ NE
❑ Yes
®..No
❑ NA
❑ NE
12128104 Continued

Facility Number: - Date of Inspection-p
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: 1 L
m
Spillway?: r
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ 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
Structure 5 Structure 6
❑ Yes �Z No ❑ NA ❑ NE
❑ Yes Q No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ® No ❑ 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 R 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/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes P.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 Hare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) Fk,-_ u" " r)- /S,,. ,- /751f /r✓7,Y-
13.
Soil type(s) _&L=e17d1V rL- Bad, ,ti .S7-0-e ^C �
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[HNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
K No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determinations❑
Yes
® No
❑ NA
❑ NE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
ZNo
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment`?
❑ Yes
0 No
❑ NA
❑ NE
f�r1 e,-- #0rsr
Reviewer/inspector Name ;� Y a n - -wo, - Phone:
Reviewer/Inspector Signature: Date: !o _ O (o
12128104 Continued

i^ Facility Number: — Date of inspection
Required Records & Documents
i
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes (Z No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ® No ❑ NA ❑ NE
the appropirate box. ❑ WDp ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement'? if yes, check the appropriate box below, &Yes ❑ No ❑ NA ❑ NE
O--Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit'?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. 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
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
1Z No
❑ NA
❑ NE
❑ Yes
allo
❑ NA
❑ NE
❑ Yes
CKNo
❑ NA
❑ NE
❑ Yes
®No
❑ NA
❑ NE
❑ Yes
fgNo
❑ NA
❑ NE
❑ Yes BNo ❑ NA ❑ NE
❑ Yes
ERNo
❑ NA
❑ NE
❑ Yes
S No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
tA No
❑ NA
❑ NE
R Yes ❑ No ❑ NA ❑ NE
A3dditianal,Camments and/or Drawings
W( ) t C en r c �a �1�~ `ta lYl >' S u �� ¢�®�� r �� ��G r� O �
7w re
12128104

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
o��F v�+r��,QG
1 t
Q
April 5, 2005
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Mr. Leonard H. Kern
454 Black Ankle Road
Star, North Carolina 27356
Subject: NOTICE OF VIOLATION
Administrative Code 15A NCAC 2H .0217
Black Ankle Rd & Hwy 220 By -Pass Farms
Facility No. 62-2
Montgomery County
Permit No. NCA262002
Dear Mr. Kern:
Alan W. Klimek, P.E. Director
Division of Water Quality
You are hereby notified that, having been permitted to have a non -discharge permit for the subject animal waste disposal
system pursuant to 15A NCAC 2H .0217, you have been found to be in violation of your 2H .0217 Permit.
Violation 1: Failure to apply animal waste at rates in accordance with your permit and Certified Animal Waste
Management Plan. (Permit No. NCA262002 Section 11.4)
On March 30, 2005, representatives from the DWQ, responding to a referral from the DSWC, inspected your facility's on -
site records and confirmed that PAN over -application occurred on pulls #7 and #9 of field #13. According to the WUP, the
fescue crop for both pulls could receive a maximum of 124 lb PAN/ac. The pulls received 148.7 lb PAN/ac (+19.9%) and
143.62 lb PAN/ac (+15.8%), respectively.
Required Corrective Action for Violation 1:
In the future, please confirm that the values for maximum PAN application on your IRR-2 forms match the corresponding
values stated in your most recent CAWMP.
The Division of Water Quality requests that, in addition to the specified corrective action above, please submit the
following items on or before May 2. 2005:
1. An explanation from the OIC as to how this violation occurred
2. A list from the OIC of the steps that will be taken to prevent this violation from occurring in the future
Please be advised that this notice does not prevent the Division of Water Quality from taking enforcement actions for this
violation or any past or future violation. Furthermore, the Division of Water Quality has the authority to levy a civil penalty
of not more than $25,000.00 per day per violation.
F�
M
Division of Water Quality/Aquifer Protection Section
N CbMR
225 Green Street, Suite 714, Fayetteville, NC 28301-5043
Phone: (910) 4W1541 FAX: [phone]
Internet: http:/1gw.ehnr.state.nc.us
Customer Service: [phone]

e -.
Mr. Kern
April 5, 2005
Page 2
If you have any questions concerning this matter, please do not hesitate to contact either Mr. Todd A. Bennett,
Environmental Engineer, or myself at [phone].
Sincerely,
Stephen A. Barnhardt
Regional Aquifer Protection Supervisor
SBltab
cc: Keith Larick - Compliance Group
Montgomery County NRCS
Trent Allen - SWC, FRO
Central Files - Raleigh

REl. ERITED .

A
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 620002 Facility Status: Active Permit: NCA262002 ❑ Denied Access
Inspection Type: Compliance Insoection Inactive or Closed Date:
Reason for Visit: Referral County: Montgomery Region: Fayetteville
Date of Visit: 03L30L2005 Entry Time: 12:00 PM Exit Time: Incident #:
Farm Name: Black Ankle Rd & Hwy 220 By -Pass Farms Owner Email:
Owner: I-eonaW tj 1jer l_
Mailing Address: 46.4_BlackAnkle Rd Star NC 27356
Physical Address:
Phone: [phone]
Facility Status: ❑ Compliant ❑ Not Compliant Integrator: N G Purvis Farms Inc
Location of Farm: Latitude: 35°29'36" Longitude: 79'47'36"
On the east and west side of Hwy 220 at its intersection with SR 1354, north of steed, NC.
Question Areas:
© Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Operator Certification Number:
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
Primary Inspector: Todd Bennett Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Larry Baxley Phone:
Phone:
Inspection Summary:
11. Site visit in response to referral from DSWC about two incidents of overapplication of PAN.
Field #13 Pull #7 2.17 ac fescue plan = 124 lb PAN/ac
applied = 148.7 lb PAN/ac
over -application = 24.7 lb PAN/ac (+19.9%)
Field #13 Pull #9 2.99 ac fescue plan = 124 lb PAN/ac
applied = 143.62 lb PAN/ac
over -application = 19.6 lb PAN/ac (+15.8%)
There was a change in the WUP from 158 lb PAN/ac to 124 lb PAN/ac, and the change was not transferred to the IRR-2 forms. Mr.
Kern was operating according to the original plan,
Page: 1

.y
Permit: NCA262002 Owner - Facility: Leonard H Kern
Facility Number: 620002
Inspection Date: 03/30/2005 Inspection Type: Compliance Inspection Reason for Visit: Referral
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
Lagoon
LAGOON 1
Lagoon
LAGOON 3
Lagoon
LAGOON 4
Page: 2

.,
Permit: NCA262002 Owner - Facility: Leonard H Kern Facility Number: 620002
Inspection Date: 03130/2005 Inspection Type: Compliance Inspection Reason for Visit: Referral
Discharges & Stream Impacts Yes No NA NE
1. Is any discharge observed from any part of the operation? ❑ ❑ ❑ 0
Discharge originated at:
Structure ❑
Application Field ❑
Other ❑
a. Was conveyance man-made? ❑ ❑ ❑ 0
b. Did discharge reach Waters of the State? (if yes, notify DWO) ❑ 1313
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWO)
❑
❑
❑
■
2. Is there evidence of a past discharge from any part of the operation?
❑
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a discharge?
0013
Yes
No
NA
NI
;te CoileClion. Stg[agP P.Treaatmeant
4. Is storage capacity less than adequate?
❑
❑
❑
0
If yes, is waste level into structural freeboard? ❑
5. Are there any immediate threats to the integrity of any of the structures observed (Le./ large trees, severe erosion, ❑ ❑ ❑
seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management or
❑
❑
❑
.
closure plan?
T. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks
❑
❑
❑
M
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
0000
improvement?
,la ppliration Yes No NA NI
10. Are there any required buffers, setbacks, or compliance aitematives that need maintenance or improvement? ❑ ❑ ❑ M
11. Is there evidence of incorrect application?
❑ ❑ ❑
If yes, check the appropriate box below.
Excessive Pending?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
Total P2O5?
❑
Failure to incorporate manurelsludge into hare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Crop Type 2
Crop Type 3
Crop Type 4
Crop Type 5
Page: 3

M
Permit: NCA262002 Owner - Facility: Leonard H Kern
Facility Number: 620002
Inspection Date: 0313012005 Inspection Type: Compliance Inspection Reason for Visit: Referral
Crop Type 6
Sall Type 1
Sail Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)?
❑
❑ ❑
15. Does the receiving crop andlor land application site need improvement?
❑
❑ ❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑
❑ ❑
17. Does the facility lack adequate acreage for land application?
❑
❑ ❑
1 B. Is there a lack of properly operating waste application equipment?
❑
Ves
❑ ❑
No NA
E
NE
Records and Documents
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
0 ❑
❑
20_ Does the facility fail to have all components of the CAWMP readily available?
❑
0 ❑
❑
If yes., check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after > 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22, Did the facility fail to install and maintain a rain gauge?
❑
❑
❑
23. If selected, did the facility fail to install and maintain a rainbreaker an irrigation equipment (NPDES only)?
❑
❑
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
❑
❑
26. Did the facility fail to have an acfivety certified operator in charge?
❑
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
❑
Page: 4

Permit: NCA262002 Owner - Facility: Leonard H Kern
Inspection Date: 03/30/2005 Inspection Type: Compliance Inspection
Facility Number : 620002
Reason for Visit: Referral
Other Issues
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those mortality
rates that exceed normal rates?
30, At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air Quality
representative immediately.
31, Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewertinspector fail to discuss reviewrnspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Yes No NA NE
❑ ❑ ❑ ■
110 ❑
013130
❑ ❑ ❑ ■
O ■ O ❑
❑ M ❑ ❑
Page: 5

State of North Carolina
Department of Environment
and Natural Resources
Fayetteville Regional Office
Michael F. Easley, Governor
William G. Ross, Secretary
Division of Soil & Water Conservation
March 14, 2005
Mr. Leonard Kern
454 Black Ankle Rd.
Star, North Carolina 27356
SUBJECT: Operation Review Notice of Referral for
Black Ankle Rd. & Hwy 220 By -Pass Farms,
Facility Number 62-2
Montgomery County
Dear Mr. Kern,
A�1�
NCDENR
NORTH CCAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
On February 25, 2005, an operation review was conducted of Black Ankle Rd. & Hwy. 220 By -
Pass Farms, facility number 62-2, in Montgomery County. This review, undertaken in
accordance with G.S. 143-215,10D, is one of two routine site visits scheduled for all subject
animal operations in 2005. Staff from the Division of Water Quality will conduct a separate
compliance inspection.
During the operation review, the following items were noted:
• Pull #7 -- Field #13 (2.17 acres — fescue graze) was over applied on by 24 pounds of
nitrogen. The allowed amount of nitrogen was 124 pounds per acre according to the
waste plan.
• Pull #9 —Field #13 (2,99 acres —fescue graze) was over applied on by 19 pounds of
nitrogen. The allowed amount of nitrogen was 124 pounds per acre according to the
waste plan. These over applications may have been caused by the rate reduction
changes in the revised waste plan.
225 Green Street, Suite 7141 Systal Bld. Fayetteville, forth Carolina 28301-5043 Telephone [phone]
FAX [phone] An Equal Opportunity Affirmative Action Employer

• Mr. Leonard Kern
March 14, 2005
Page 2
It was for these reasons that your operation was referred to the Division of Water Quality for
further investigation. G.S. 143-215.10E requires staff from the Division of Soil and Water
Conservation to notify the Division of Water Quality and the owner/operator of these observed
violations
A copy of the operation review report is enclosed for your information. Site findings and
recommended corrective actions as discussed are noted in the comment sections.
Please remember that in order for your facility to remain in compliance with environmental
regulations, animal waste cannot be discharged into the waters of the State, and the animal
waste collection, treatment, storage and disposal systems must be properly maintained and
operated under the responsible charge of a certified operator.
On behalf of the Division of Soil and Water Conservation, I appreciate your cooperation with
this operation review. Please do not hesitate to contact me at 910-486-1541 if you have any
questions, concerns or need additional information.
Sincerely,
Trent Allen
Environmental Engineer
cc: Art Barnhardt, Division of Water Quality
Montgomery Soil & Water Conservation District
Vernon Cox, Division of Soil & Water Conservation
Tony Moore, Purvis Farms
RE MO -
MAR 15 2005
OENR _ FAY1:MLLE REGIONAL OFRCE
225 Green Street, Suite 714 I Systel Bld. Fayetteville, North Carolina 28301-5043 Telephone [phone]
FAX [phone] An Equal Opportunity Affirmative Action Employer

❑ Division of Water Quality
® Division of Soit and Water Conservation
❑ Other Agency
Facility Number: 620002 _ Facility Status: Active _ Permit: NCA262QQ2 _ ❑ Denied Access
Inspection Type: Operations Review_ Inactive or Closed Date:
Reason for Visit: Routine County: Montgomery Region: Fayetteville
Date of Visit: 0212512005 Entry Time:.10030 AM Exit Time: 01:00 PM - Incident #:
Farm Name: Bfack Ankle Rd & Hwy 220 By-Pg55_Farms _ Owner Email:
Owner: Leonard H Kern Phone: [phone]
Mailing Address: 454_Black Ankle Rd._. 5fgr NC 27356
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator: N G Purvis Farcos I,nQ
Location of Farm: Latitude: 35 493300 Longitude: 79 793300
On the east and west side of Hwy 220 at its intersection with SR 1354, north of steed, NC.
Question Areas:
® Discharges & Stream Impacts Q Waste Collection & Treatment ® Waste Application
® Records and Documents ® Other Issues Technical Assistance
Certified Operator: Leonard H Kern Operator Certification Number- 18876
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
On -site representative Leonard Kern Phone:
24 hour contact name Leonard Kern Phone:
Primary Inspector: Trent Allen Phone:
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary:
11- Pull #7 field #13 (2.17 zeres - fescue graze) is allowed 124 pounds of nitrogen. Applied 148 pounds. Over applied 24 pounds
Pull #9 field #13 (2,99 acres - fescue graze) is allowed 124 pounds of nitrogen. Applied 143 pounds. Over applied 19 pounds.
DWQ wil! be notified.
64,21- Start checking lagoons and initial after 1 inch rainfall or monthly check.
Page: 1

Permit: NCA262002 Owner- Facility: Leonard H Kern Facility Number: 620002
Inspection Dalo: 0212512005 Inspection Type: Operations Review Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Swine
IN Swine -Feeder to Finish
5,500
3,101
10 Swine - Wean to Feeder
4,000
0
Total Design Capacity: 9,500
Total SSLW: 862,500
Type Identifier Closed Date start Date Designed Freeboard Observed Freeboard
Lagoon
LAGOON 1
54.00
Lagoon
LAGOON 3
37.00
Lagoon
LAGOON 4
30.00
Page: 2

Permit: NCA262002 Owner- Facility: Leonard H Kem Facility Number : 620002
Inspection Date: 02/25/2005 Inspection Type: Operations Review Reason for Visit: Routine
Qischarge & Stream Impacts Yes No NA NF_
1. 1s any discharge observed from any pan of the operation? ❑ • ❑ ❑
Discharge originated at.
Structure ❑
Application Field ❑
Other ❑
a. Was conveyance man-made? ❑ ❑ ❑
b. Did discharge reach Waters of the Slate? (if yes, notify DWQ) ❑ e ❑ ❑
c. Estimated volume reaching surface waters?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
❑
O Cl
❑
2, Is there evidence of a past discharge from any part of the operation?
❑
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a discharge?
❑
yps
■
No
❑
NA
❑
NE
)&ante Collection�Storacie & Treatment
4. Is storage capacity less than adequate?
❑
■
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (Led large trees, severe erosion,
❑
0
❑
❑
seepage, etc.)?
G. Are there structures on -site that are not properly addressed andlor managed through a waste management or
❑
®
❑
❑
closure plan?
7. Do any of the structures need maintenance or improvement?
❑
❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (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 maintenance or
❑
®
❑
❑
improvement?
Yes
NA
NE
WaZte.Appficaflnn
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
Ho
■
❑
❑
11. Is there evidence of incorrect application?
❑
❑
❑
If yes, check the appropriate box below.
Excessive Pending?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%110 lbs.?
M
Total P2O57
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Fescue (Hay)
Crop Type 2
Fescue (Pasture)
Crop Type 3
Crop Type 4
Crop Type 5
Page: 3

Permit: NCA262002 Owner - Facility: Leonard H Kern
Facility Number: 620002
Inspection Date: 02/25/2005 Inspection Type: Operations Review Reason for Visit: Routine
rite Application cation yPs Nn NA NF
Crop Type 6
Soil Type 1
Salt Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)?
❑
®
❑
❑
15, Does the receiving crop and/or land application site need improvement?
❑
0
❑
❑
16, Did the facility fail 10 secure and/or operate per the irrigation design or wettable acre determination?
❑
®
❑
❑
17, Does the facility lack adequate acreage for land application?
❑
■
❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
Yes
0
No
❑
NA
❑
NE
Records and Doruments
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
H
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
■
❑
❑
It yes, check the appropriate box below.
WUP?
Cl
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
❑ ❑ ❑
If yes, check the appropriate box below.
Waste Application?
Cl
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
Cl
Rainfall?
❑
Inspections after > 1 inch rainfall & monthly?
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑
Stacking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
0 ❑ ❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■ ❑ ❑
24. Did the facility fait to calibrate waste application equipment as required by the permit?
❑
N ❑ ❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
0 ❑ ❑
26. Did the facility fail to have an actively certified operator in charge?
❑
0 ❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑H
❑ ❑
Page: 4

Permit: NCA262002 Owner • Facility: Leonard H Kern
Facility Number: 620002
Inspection Date: 0212512005 Inspection Type: Operations Review Reason for Visit: Routine
Other 155ues Yes Nn NA NIF
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? ❑ a ❑ ❑
29, Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those mortality ❑ ■ ❑ ❑
rates that exceed normal rates?
30, At the time of the inspection did the facility pose an air quality concern? if yes, contact a regional Air Duality ❑ ❑ ❑
representative immediately,
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? ❑ e ❑ ❑
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ ❑ ❑
33. Dees facility require a follow-up visit by same agency? ❑ ® ❑ ❑
Technical A5505taoCe Yes No NA NE
Needed Provided
34. Waste plan revision or amendment
❑
35. Waste plan conditional amendment
❑
n. Review or evaluate waste plan wlproducer
❑
37. Forms need (list in comment section)
❑
38. Missing components (list in comments)
❑
39. 2H.0200 re -certification
❑
40. Five & Thirty day Plans of Action (POA)
❑
41. Irrigation record keeping assistance
❑
42. Organizelcomputerization of records
❑
43. Sludge evaluation
❑
44. Sludge or Closure plan
❑
45. Sludge removal/closure procedures
❑
46. Waste structure evaluation
❑
47. Structure needs improvement
❑
48. Operation & maintenance improvements
❑
49. Marker check/calibration
❑
Page: 5

Permit: NCA262CO2 Owner - Facility: Leonard H Kern
Facility Number: 620002
Inspection Qate; 02/2512005 Inspection Type: Operations Review
Reason for Visit: Routine
Technical Assistance
50. Site evaluation
.Y_e5_Un Na NF
❑
51. Irrigation calibration
❑
52. Irrigation system designlinstaliation
❑
53. Secure irrigation information (maps, etc.)
❑
El
54. Operating improvements (pull signs, etc.)
❑
El
55. Wettable acre determination
❑
56. Evaluate WAD certificationlrechecks
❑
57, Crop evatuationlrecommendations
Cl
58, Drainage worklevaluation
❑
59. Land shaping, subsoiting, aeration, etc.
❑
Cl
ri
60. Runoff control, stormwater diversion. etc.
Cl
61. Buffer improvements
❑
62. Field measurements (GPS, surveying, etc.)
❑
63. Mortality BMPs
❑
64, Waste operator education
❑
65. Operation & maintenance education
❑
66, Record keeping education
❑
El
67. Croptforage management education
❑
El
68, Sail and/or waste sampling education
❑
Cl
69. PLAT Assessment
❑
11
70. Other
❑
Page: 6

Permit: NCA262002 Owner- Facility: Leonard H Kern
Inspection Date: 02125/2005 Inspection Type: Operations Review
List Improvements made by Operation
Improvement Z
Improvement 2
Improvement 3
Improvement 4
Improvement 5
Improvement 6
Facility Number: 620002
Reason for Visit: Routine
■
Page: 7

Type of Visit 9 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 2.066 Arrival Time, QS? Departure Time: Q: DD County: 140 0nler Region:
Farm Name: fQYIk AnWc Pj 7-0 g,� A,% f /yr s Owner Email:
Owner Name: Le on )4•K Phone:
Mailing Address: 45y 61Q&- �2 S r 1� a7 OU) -h 3-78711
Physical Address:
Facility Contact: d 14wn Title:
Onsite Representative: �eoy%w�'C-�Kern
Certified Operator: Ltor\RJ � V&n
Back-up Operator:
Location of farm:
Phone No:
Integrator., N G PIy t)1S
Operator Certification Number: �" r
Back. -up Certification Number:
Latitude: =] o ❑ ' F-1 Longitude: =1 0 0 , = "
Design C*urrent
Design Current Design Current
Swine Capacity Population Wet Poultry
Capacity Population Cattle Capacity Population
❑ Wean to Finish
❑ La er
❑Dair Caw
Wean to Feeder
t90 0
on -Layer
❑Dair Calf
Feeder to Finish
❑ Dairy Heifer
Farrow to Wean Dry Poultry
❑ Farrow to Feeder
❑ Farrow to Finish ❑ La ers
❑ Gilts on -Layers
❑ Boars ❑ Pullets
❑ Turkeys
❑ D Cow
° ❑ Non -Dairy
El Beef Stocker
El Beef Feeder
❑ Beet' Brood Cow
Other E-1 urkey Poults
Numbe of Structures: 3
❑ Other JEJ Other
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (]Eyes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (if yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes tlo ❑ NA ❑ NE
❑ Yes
❑ No
NA
❑ NE
El Yes
❑No
NA
❑NE
❑ Yes ❑ No �O NA ❑ NE
❑ Yes QONo ❑ NA ❑ NE
❑ Yes 'No ❑ NA ❑ NE
Page 1 of 3 12128104 Continued

' Facility Number: (, 1 Date of Inspection /
Waste Collection &'Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes '�jNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No
[ ANA
❑ NE
Structure I Structure 2 Structure 3 Structure 4
3
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): v1� 31 3
5. Are there any immediate threats to the integrity of any of the structures observed?
Yes � No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No
[DNA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes P No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 09 No ❑ 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/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes P No ❑ NA LINE
❑ 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 ❑ fEvvidence of Wind Drift ❑ ApplicationOutsideof Area
12. Crop type(s) `` `` SG..¢_ rPqs4w.P_) } i:esc �,2
13. Soil type(s) Ti �1"I�Q,011 , gQttn
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
® No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[�No
❑ NA
❑ NE
hComments refer to nestion # Ez lain `an YFS answers and/or an recommendation an other comments
9 ) P Y Y: Y ,
Use drawings of facility to'better: explain! situations. (use additional pages'as necessary):
Reviewer/Inspector Name ` .: Phone�fL -Do
Reviewer/Inspector Signature: 40teiDate: / / e006
Pape 2 of 12/28/04 Continued

Facility Number: `dL Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 191 No ❑ NA El 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 ❑Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [!�No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections ❑ Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
D9 No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
`f' No
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
FUlNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
P No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
O No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
(§ No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
'No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
[�lNo
❑ NA
❑ NE
General Permit'? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
$.No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
&No
❑ NA
❑ NE
Page 3 of 3 12128104

V��
✓ 10,
gj,i/a
Type of Visit ® Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine O Complaint O Follow up * Referral O Emergency O Other ❑ Denied Access
Date of visit: rj�3p D� Arrival Time: Departure Time: County: Region:
Farm Name: Btale #,,.1tle. Q�_. f4w, __2 ZZ -?,Ac- Owner Email:
Owner Name: Leona.e-dPhone:_
Mailing Address: 645,q 61" A"Wel � , N �' Z
Physical Address:
Facility Contact: Title:
Onsite Representative: L�
Certified Operator:
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certitcation Number:
Latitude: Longitude:
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
10 Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -La ei
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
Turke Poults
HEl
Other
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifei
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
i
Number of Structures: =,
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes ❑ No ❑ NA XNE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
12128104 Continued

Facility Number: �Z— 7.
Date of Inspection I Meg 0
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
❑ No
❑ NA
❑ NE
Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed'?
❑ Yes
❑ No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
❑ No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ 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 Apglication
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
❑ NE
maintenance/improvement?
11, Is there evidence of incorrect application? If yes, check the appropriate box below.
2SYes
[]No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,
Zn, etc.)
❑ PAN g 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 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
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑
Yes
❑ No
❑ NA
❑ NE
17, Does the facility lack adequate acreage for land application`?
❑ Yes
❑ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Reviewer/Ins ector Name "
Reviewer/inspector r Phone: Sf0 — yob • I ,S_
Reviewer/inspector Signature: Date: 3 f 3a A0$�
12/2UO4 Continued

b.
Facility Number: &7, — Z Date of Inspection $ 30 0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes SNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes t.No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
❑ Waste Applicatiow ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the pen -nit`?
26. Did the facility fail to have an actively certified operator in charge?
27, Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other lssues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. 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
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
rr. old 293 PO A tk T Z . I -+ ac. 4 sc u-e
F,- .Q '* l3 ?o %I * 1 2-11 Lr- 4,s�
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes ISNo ❑ NA ❑ NE
0a, = L 2`{ kIa f'A -1/ate q
a Ipa
!�$.f�l� tl�•{fib
rW3.(P ;L lb f'"Itc,
AA N/a
` ngw.e- wr.s o_ c.10
.,..grQ, W U f -01 o 1518 16 -{-a i Z J f L PA KI/
alc. , a.w+a t l ql a. ukas t4b+ Ja Ate I ?-R - L IAi-,
kee►- -ja.S op.Qm-k .,a ate4-,r0,-cK -0 1'-a oC'►Q11V .k % 111, .
1 V2VO4

Facility Number [late of' Visit: Time: ��
Not Onerational__Q Below Threshold
0 Permitted 0 Certified 0/Conditionally Certified f0 Registered Date Last Operated or Above Threshold:
Farm Name: Zzny" !.i A"e g-A�` TA e1131 �Art+c��7�lQayCounty: /1� b� hM CA—i.�
Owner Name: 4e 1, ���4.1 • C ' �'+•Q t/��1.(J. Phone No:
Mailing Address: p f �' +� � c ►�."`• �' t^ NC_
Facility Contact: v► c.. Title: Phone No:
OnsiteRepresentative: Jryi Integrator: SI+'C 10"t" '-.S
Certified Operator: _ L e,., .. , .k i - Operator Certification Number:
Location of Farm:
swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude 0 0�
y. :DeSig'rt? ' ' urrent� ��� E `� i Design �1 Cilrrent' 1 t,t DCSIgII CprCCnt�s E k
;Swine , Ca a¢ity, Pn` �ilationiPoulf - , , . 3�;,ari.-Ca acitv��^Pd `elation. ;Cattle„ 'Gap itv,?i;Po ulation
��. ❑ Wean to Feeder ;' ❑ Layer ` ❑ Dai
Feeder to Finish 19, % `� � ;� : ❑Non -Laver ' 10
[] Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish Ttitel'°DesignGz}pacity:`
❑ Gilts s 4
❑ Boars Tot,EWSSLW i
j Number of Lagoons ���,, t,{�l ,E �j _-i, Subsurface Drains Present ❑ La oon Area Sum Field Area
j �II, _ f Ir IR �_ itf It�i Sid H Hol-.�.
k i.Pands hT;�❑„ i; ❑ No Liquid Waste Management tem �:; E�lI
. i—.1. , raps ! Sys
Dischar es & Stream impacts ,.,��
1. Is any discharge observed from any part of the operation? Yes i__ o
Discharge originated at: IN Lagoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify,DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DbVQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillwav
Structure t Structure 2 Structure 3 Structure 4
Identifier: st s i � 3
__jiL
Freeboard (inches): 41,
05103101
Structure 5
❑ Yes/ [In No
f fc i ilhri
0 Yes ❑ No
❑ Yes No
❑ Yes [ No
❑ Yes t[�. io
Structure 6
Continued

Facieiq Number: Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, Yes ❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ❑ No
closure plan?
(If any of questions 4.6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes CI No
S. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
❑ No
elevation markings?
_Waste APPUcation
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Odor issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
❑ No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
❑ No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
❑ Yes
❑ No
Air Quality representative immediately.
Co�menta (xder ev aesbaa #) E ilt a + !answfta marl/or say or'
',gw�...w.:..:-.......w.�a.:�..c..;.-:_'
Us�€C?§dr of i3aeaiity tee btlteribaiiilioc?sdd#tioeP n ) ❑ Field Copy ❑ Final Notes
}?3 ti ::. 1�Ui�' Css' .ails `� ` .�, t ; 5^;.. ° ?,a L�M2
r R �q �J
�..�.%� !V
�.te.,4 L�Pe
lkdllr,... t gz t :P, +%) res i .i v I'
(3 _ i ✓ P I e ci.Pe, ] �C
.tl ( ,p�aPa►,.� ��` ��.
� Fu
L E , S "F7
ReviewerAhipector Name w < t ry t IN
a , e� € � �.
�'$, � §5f � ' F3 IL: ,-.9 Y �Nt
Reviewer/Inspector Signature: r Date: 1 JLL
12112103 / Cowed

RECEIVED
SEP 142004
1

RECEIVED
SEP 2 9 2004
1-17 --- -- --
r�t i C P-FAYEII RMOMOMM
- -- ------ - - 33 6.8 ? 3 7 8-
_- 33 3O2 1.938. cG��
- ._ -_-- r - _I- .- __ - - - . ._ - - - _ .---- - __ - -- - -

L. R 1. - - ♦ Y• 1 'rr 1 x+
�F '1! � r � }�,� ;rr 'e@ini7i.5,.��R 'S' i „a':'�u' •C iY ,xn Iw ,
:3.�i:i'hc :v,Fti�...�Le'-. •�' n�Yg7+.dn:a:�:�e�7i"�i.:t.5i:?lc!M..'�3t�:Cr�'i� � �i': :.'.i ui.� tw,� .k1 1'.c".... ..:irk ..�n� 'i.-.�.i���,,:i J ., r.�L� :.F,.- .t. aal�ii
i. KC. 'L I' L N `-i„a,,;
,d 1. S' '� •- µ � ;f:33�-t-�•,1�•�
': 1nR..i: s G;. , . .. .. a 1��'i ,.r'f;f.:_..
:, ' :...m'i r1':L't;t: , M1 in,1.^z s �•.;f-{ � 1�Iri,.l 1, it}1'M•r.iln , .T;1; 1 , , ........
-.
IType of Visit ® Compliance Inspection O Operation Review 0 Lagoon Evaluation I
Reason for Visit ®Routine Q Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facilitv lumber Date of Visit: d Time:
Not O erational 0 Below Threshold
Permitted ®Certified Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: t`� ` I.- e �� �i-��� , Count►•:. ��h S.tn :,� el l _ r b
Owner !Name: .�gQk*ld CC 8er e4 Phone Na: Uer' 1/3�dl3 - T-$ 7:7-
Mailina Address: 4*6 4- A i C'CJA., .:hklG Ad _ _. C
Facility- Contact: Le- o k\e r-A 14je-r,\ Title: Phone 'so:
OnsiteRepresentative: Per+ [+.r 11e� Integrator:. P &tui"
Certified Operator: _ -claa rA (Ge.r•►' Operator Certification Number:
Location of Farm:
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 6 0- Longitude • Ai
Design Current
Swine ('anariiv Pnnnistinn
® Wean to Feeder
OD
® Feeder to Finish
_ O
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Po ulation
❑ Laver I 1 ❑ Dairy
❑ Non -Laver I ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons © ❑ Subsurface Drains Present J10 Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 0 ❑ No Liquid Waste Management System
Di arms & Stream Impacts
1. Is any discharge observed from any pan of the operation?
Discharge oriOnated at: ❑ Lagoon ❑ 5prav Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes. notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. is there evidence of past discharge from any pan of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4, is storage capacity (freeboard plus storm storage) less than adequate? ❑ Suillwav
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: 1 .3LLA
Freeboard (inches): 3 I 40
05103101
❑ Yes D5%No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes [allo
❑ Yes 0 No
Structure 6
Continued

Facility Number: — g Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes (P No
seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed through a waste management or
closure plan? ❑ Yes P No
(If any of questions A-b was answered yes, and the situation poses an
Immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes 50 No
8. Does any part of the waste management system other than waste structures require maintenance/improvement! ❑ Yes [ No
9, Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste AgplicatlOn
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
1. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes [�j No
12. Crop type Ctr..e
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes IP No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
b) Does the facility need a wettable acre determination? ❑ Yes ❑ No
c) This facility is pended for a wettable acre determination? ❑ Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes No
16. Is there a lack of adequate waste application equipment? ❑ Yes E1No
BQuimd
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
E4 No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
El Yes
�No
19.
Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
%No
20.
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
❑ Yes
ElNo
23.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
V] No
24,
Does facility require a follow-up visit by same agency?
❑ Yes
EgvO
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes 52 No
[] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
2-6-1— A. J (L-_ L<s�t�j G tnA i.<s C) GY OC.0 1
Reviewerllnspector Name C.
Reviewer/Inspector Signature:
❑ Field Copy ❑ Final Notes
Date:

Facility lumber: G — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 9 No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes 0 No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments and/or Drawings:.
05103101

DIVISION OF ENVIRONMENTAL MANAGEMENT
September 23, 1995
Mr. Len Kern, Jr., President
Kern Livestock
2101 Black Ankle Road
Star, North Carolina 27341
SUBJECT: Compliance Inspection
Kern Livestock
Montgomery County
Dear Mr. Kern:
On September 14, 1995, I had the opportunity to inspect your swine
operation in northern Montgomery County near Seagrove. A copy of our
Compliance Inspection Report is enclosed for your information and review.
Please note specifically the comments concerning minimum freeboard
requirements and the need for fill on the lagoon on the east side of Highway
220.
Thank you for your assistance in conducting these inspections. Should you
have questions concerning any items on the enclosed inspection form, please
contact me at [phone].
Sincerely,
Ken Averitte
KA/ka
cc: Facilities Assessment Unit

Site Requires Immediate Attention:
Facility No. .�
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: , 1995
Time:
Farm NE
Mailing
County:
Integrator: .� ,u Phone:
On Site Representative: L,g-Phone: /4-- 9'73 — % 77
Physical Address/Location: o E sT 4Je s r — �v
'j0-f- 4� 135
Type of Operation: Swine Poultry Cattle
Design Capacity: --k- lo IQ O Number of Animals on Site: 3 3 e::D
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: Longitude: "
Circle Yes or No
Does the Animal Waste Lagoon have suff ent freeboard of i Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes oza Actual Freeboard: Ft.i Zo Inches
Was any seepage observed from the lagoon(s)? Yes or(9 Was any erosion observed? Yes or(o
Is adequate land available for spray? 9e or No Is the cover crop adequate? �Gor No
Crop(s) being utilized: kj!�cuC- 5>,t-6TvAfiFs _
Does the facility meet SCS minimum setback criteria? 200 Feet from DwellinEes>r
e or No
100 Feet from Wells? o
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or o
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue ine: Yes o No
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes o No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes o No
/0 Ads17 TC-
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

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