820388_INSPECTIONS_20171231

NORTH CARULINA
Department of Environmental Quai

( �Nv
t1 ! fC ►Y L-)
Type of Visit: O'Com lance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up O Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: 11 Departure Time: (1;a2 County: Ss •7 Region:F_j�
Farm Name: _� 1 _ I � � -t r S��l �` F d'� Owner Email:
Owner Name: ( 1 S� Phone:
Mailing Address:
Physical Address:
Facility Contact: vL�v(��1C' Title: Phone:
Onsite Representative: / Integrator: y- 5-
Certified Operator: g r/ 52r Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design Current Design Curren#
Caacity Pap. Wet�Paultry Capacity Pap.
Desigtt Current
Cattle Capacity Pap.
Da Cow
Da' Calf
o Finish
La er
o Feeder
Non -La er
to Finish Z4Y
Design Curren#
I) . Poult > Ca aci Po
Dai Heifer
to Wean
to Feeder
LpBoars
D Cow
Non -Dairy
to Finish
La ers
Non -La ers
Beef Stocker
Beef Feeder
Pullets
Beef Brood Cow
ke s
Turke Points
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
t9 ""
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
❑.NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
[J'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
❑ No
[] NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
❑'No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[f No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412015 Continued

Facili Number: - Date of Ins ection: �u �G
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [f'No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No �A ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): M
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
VXo- Ej NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No ❑ NA
❑ NE
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 DWR
7. Do any of the structures need maintenance or improvement?
[] Yes
❑ No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�Io ❑ 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
❑-I o
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ErNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below.
❑ Yes
to
❑ 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): C 6 " p SIT 0
13. Soil Type(s): J3i a,t, V-1 SCz vl' w 4e A-1k.
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
KKO
❑ NA
❑ NE
I5. Does the receiving crop and/or land application site need improvement?
❑ Yes
[r"No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑11 Io
[] NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
[D Yes
21 o
❑ NA
[] NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[g-1Go
❑ NA
❑ NE
Ruired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Ea`&o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Dfo ❑ 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 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes B No NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes o ❑ NA ❑ NE
L
Page 2 of 3 21412015 Continued

Facility Number: 9 A, - I P f6 I Date of inspection: cTrrw
24. Did tie facility fail to calibrate waste application equipment as required by the permit? ❑ Yes 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 provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
29. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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 Reviewerlinspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes �` ❑ NA ❑ NE
❑ Yes E�Jo ❑ NA ❑ NE
[—]Yes [r] N9 ❑ NA ❑ NE
❑ Yes Q"Ko ❑ NA 0 NE
❑ Yes Q, o ❑ NA ❑ NE
❑ Yes [;J, ❑ NA ❑ NE
❑ Yes
E2 o
❑ Yes
[[> No
[:]Yes
©<o
❑NA ❑NE
❑NA ❑NE
❑ NA ❑ NE
Commedts (refertoaqnetio.n #)- Eaplain any YESanswersand/or an additional recommends
;#eons or�any oticommenr
Uedwty,'to.,better explain situations (use additibnal pages asnecessary}e
w =
© `f
o- �- ifs(
Reviewer/Inspector Name:
Reviewer/Inspector Signs
Page 3 of 3
( Ll Phone: , o 13 u 3J 'J-
r a
tore: , Date:l. W� D
21412015

s- 1-714t4y r
,s
Type of Visit: (3-Co lance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: Arrival Time: ;ci Departure Time: ; County:
Farm Name: `Al k,e'—` S ! -r�[ Owner Email:
Owner Name: l c, (4f Phone:
Mailing Address:
Physical Address: //�� �f
Facility Contact: l�t,u�,s `a,t�lv�Sr` _ Title: Phone:
Onsite Representative: Integrator:S
Certified Operator: D C40�`a LL si s'� Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification ,Number:
Longitude:
Region:��
Design
Current -- _ = t4
B.D:esign
Current-esign
Current
Swine
Capacity
Pop. "- ��r Wet Poultry Capacity Pop.
apacity Pop.
CattImc,
Wean to Finish
Wean to Feeder
Feeder to Finish
q 0
Layer
P Nan La er
OO
—
airy Cow
airy Calf
Dai Heifer
Farrow to Wean
-` -
Design
Current
D Cow
Farrow to Feeder13iv
Poultry*
Ca aci
P,o
Non -Dairy
Farrow to Finish
Layers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Other
a
Turkey Poults
Other
10ther
Discharges and 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?
❑ Yes �❑ NA ❑ NE
❑ Yes [] No C3­11-A ❑ 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 ❑ No MA [:]NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes I rJ "o ❑ 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 I of 3 21412015 Continued

Facility Number: le Ell Date of Inspection: �sf
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[3-?++ice❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No E "A
❑ 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
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
[�I'Go ❑ NA
❑ NE
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 DWR
(>o any of the structures need maintenance or improvement?
es
❑ No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E rNo ❑ 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
e-I-o ❑ 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'?
l I. Is there evidence of incorrect land application? If yes, check the appropriate box below, ❑ Yes M40___E1 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): CIW, 1 e,- i". 0, s(_ 0
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
[:J�o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the imgation design or wettable
❑ Yes
FE No
❑ NA
❑ NE
acres determination.)
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
�Io
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available'?
❑ Yes
ONo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available`? If yes, check
❑ Yes
[jlo
❑ 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 No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge'? ❑ Yes E]/No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [-]Yes Yo ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: - Date of Inspection:
24. lid the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q-3do❑ NA ❑ NE
25, Is the facility out of compliance with permit conditions related to sludge? If yes, check Yes [3-lZo_o 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 provide documentation of an actively certified operator in charge? ❑ Yes o NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes o ❑ NA ONE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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:
❑ Yes❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ONo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
I_ Kc_ ❑ NA ❑ NE
glNS ❑NA ❑NE
No ❑ NA ❑ NE
Comments (refer to question #): 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).
C�, S-11 5 f � _r), t, - 9 r I ;-o 0­zq� ? P-q. 3
v� a_4_�e-4
Reviewer/Inspector Name:
Reviewer/Inspector Signatu
Page 3 of 3
M e-ew 4 te
D fS
0
46L
L) Phone: R��
re: ��J2.Date:
21412015

Type of Visit: e'Compliance Inspection 0 Operation Review p Structure Evaluation p Technical Assistance
Reason for Visit: QKRoutine O Complaint 0 Follow-up O Referral Q Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: �rU County: 6 J ""
Farm Name: Owner Email:
Owner Name: r he Phone:
Mailing Address:
Physical Address:
Regiou m
Facility Contact: t-4ci.�j�S �Q-uW��' ` Title: Phone:
Onsite Representative: Integrator: 6— -.
Certified Operator: eAe G! Certification Number: -7-0--07O
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Deq ren
f
n& Current
Design Current
Swine
Capacity Pop
Wet Pointry
Capacity Pop
Cattle Capacity Pop.
Wean to Finish
La er
Dai Cow
Wean to Feeder
Non -La er
Dai Calf
Feeder to Finish
`[�
Dai Heifer
Farrow to Wean
Design Current
Cow
Farrow to Feeder
D , tl?oult .
Ca ace aI'o
Non -Dairy
Farrow to Finish
Layers
F
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
..
:..
Turke s
W�
Other
�
Turkey Points
Other
Other
Discharges and Stream Imoacts /�
1. Is any discharge observed from any part of the operation? []Yes DX0❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? [—]Yes ❑ No [3IQA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) [—]Yes ❑ No E],<A ❑ 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 DWQ) ❑ Yes [:]No E�< ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes 0 No ❑ 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 I of 3 21412011 Continued

i"acili Number: - Date of Inspection:
01
Waste Collection & Treatment
,4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes Z],Ko ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [—]No [R-KA ❑ NE
Structure I 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 [ Ncr ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑R'd'✓f ❑ NA
❑ NE
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 DWR.
7. Do any of the structures need maintenance or improvement?
❑ Yes
O-Wo
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[G]•Isi'o
❑ 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
[Z AXo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10_ Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
GD�do
❑ NA
❑ NE
maintenance or improvement?
I I . Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes Ea•>Qo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 101bs. ❑ 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): ""-R&
13. Soil Type(s): O -CCA W
14. Do the receiving crops differ from those designated in the CAW -MP? ❑ Yes MAo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes g2rNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [201fo ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes [R<o ❑ NA ❑ NE
❑ Yes [2No [:]_NA ❑ NE
Reguuired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes eNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [ `5lo ❑ 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 E No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes Zo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑NA []NE
Page 2 of 3 21412014 Continued

Facility Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ ❑ 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 ®'Flo [] NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes gfo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. 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 file 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? ❑ Yes [?(No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ]Yes L a N ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes l_ J o ❑ NA ❑ NE
Comments (refer to questeon;tf)Explamn anyY.ES.answers .and/or any additional recommendations or any other:. comments:
Use dirawings of facility to better:eitplatnsiti ations (use additional pages as necessary). _
c G-6
, d&
344
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
❑ Yes dNo ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ Yes ER<o ❑ NA ❑ NE
❑ Yes dNo [DNA ❑ NE
Phone: `V t3
Date: It
21412011

Type of Visit: Q<ommpliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance I
Reason for Visit: "utine O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: En
Arrival Timer Departure Time:( f 1 County: Region: f-�l
Farm Name: I �'1.as�` t��l Owner Email:
Owner Name: M. f Cc SQr/' Phone:
Mailing Address:
Physical Address:
Facility Contact: Clw�,; ;(Ctk' Title:
Onsite Representative:
Certified Operator: slo e4
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator: -'0 /113
Certification Number: 9),079 - -_
Certification Number:
Longitude:
Design Can"ent ,
Design
Current- Design Current
Swine
Ca act Po :Wet Poul
P ty P by
Ca aer ;1'0
` h P Cattle Capacity Pop.
9.
-P.
#,
Wean to Finish
Layer
DairyCow
Wean to Feeder
Non -La er
DairyCalf
Feeder to Finish
L[ b0 i"""' '
:.r DairyHeifer
Farrow to Wean
��
Design
Current D Cow
Farrow to Feeder
D Roul
@a aci
Po Non -Dairy
Farrow to Finish
ILayers
Beef Stocker
Gilts
Non -Layers
Beef Feeder
Boars
Pullets
Beef Brood Cow
Turkeys
Turkey Poults
�r
Other
Other
Discharges and 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes [ i o ❑ NA ❑ NE
[-]Yes
❑ No
�IA
❑ NE
[—]Yes
❑ No
[a'gIA
❑ 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 DWQ) [—]Yes [—]No []' NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes �o ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Q'TVo ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: Date of Ins ection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes M-No— ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No IA ❑ 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 [qI06- ❑ NA 0 NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
D-Wo
❑ NA
0 NE
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
to
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[;kNl —
❑ 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
�i
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[rr5o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land 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 I0 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): Oat/ _
13. Soil Type(s): C �� l�.4±!A L—eDvi
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ZLNo'
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0-N&
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
F "o
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E5-Ro
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
0 Yes
❑-Nho
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the 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
[3'196
❑ 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 ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall 0 Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes FDINo
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: Date of Inspection:
1
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes E3'1q-oT ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes EKo ❑ 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 �o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 8-<o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
[:]Yes
�o
❑ 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?
❑ Yes
No
❑ NA
❑ NE
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
❑ Yes
�To
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
3 1. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
[:]Yes
[No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑';K6
❑ NA
[] NE
33. Did the Reviewedlnspector fail to discuss review/inspection with an on -site representative?
❑ Yes
C], o
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Cj,Po
❑ NA
❑ NE
ents (refer to question f Explarnn�y YES answers and/or any additionaltreconimendations or any other comments m �
Mie
rawof.facihty to better eiiplain,siluations [use additional pages as necessary):-
ui
oatl 4 _�� 7 -1 Y
'3 61w, t C)� �- N -
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
o - q, 7
? q( -3 nZe
Phone: 33-3us
Date: {�
21412014

(Type of Visit: L;OComph a Inspection O Operation Review O Structure Evaluation Q Technical Assistance
'Reason for Visit: outine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time:Departure Time:�T County: Region:
Farm Name: f 4 G Q' " �� 7!l Me
S 'f ,J- OA Owner Email:
v
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: P
Certified Operator: OM /let��
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator: ' '1 r C
Certification Number: Vzq Z
Certification Number:
Longitude:
Design.-Curent
Design Current: ; . Design Current
Swine
CapacttyPop:
Wet HitF­.apacity
Pop m. Cattle Capacity Pop.
Wean to Finish
jDairy Cow
Wean to Feeder
Non -La er
airy Calf
Feeder to Fituslt
47.
Dairy Heifer
Farrow to Wean
Desi' Current Ji.
Dry Cow
Farrow to Feederon-
airy
Farrow to Finish
Layers
Beef Stocker
Non-La ers
Beef Feeder
±.Goars
Pullets
Beef Brood Cow
' Turkeys
....
Other
-
Turkey Poults
Other
Other
Discharges and Stream Impact
1. 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? (if yes, notify DWQ)
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 DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[:]Yes Gab� NA ❑ NE
❑ Yes [:]No D<A ❑ NE
❑ Yes [] No ❑ NE
[:]Yes ❑ No 21 A ❑ NE
[:]Yes [ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: JlDate of Inspection:
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 �A ❑ 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 Lam- ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes Q.Nt-_ ❑ NA ❑ NE
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
�l - ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[D-Nia-0 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
[Ej oo ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ NA
❑ NE
maintenance or improvement?
'
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
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): 4rM aA - 16 G -0
r
13. Soil Type(s): D
14. Do the receiving crops differ from ose. designated in the CAWMP?
❑ Yes
[f'M ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
ETNo ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
lam Ko ❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
[3 No ❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
[j Yes
E] No ❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
®'9io ❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yesne?o
❑ 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 6No ❑ 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? 0 Yes &1140 ❑ 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 21412011 Continued

Faci Uty Number: - Date of Inspection:
14. Did the facility fail to calibrate waste application equipment as required by the permit? ❑Yes NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [D-Ntt- ❑ 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 - Ll 5o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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:
❑ Yes [3"No ❑ NA ❑ NE
❑ Yes [g Ko- ❑ NA ❑ NE
❑ Yes CD — ❑ NA ❑ NE
❑ Yes 2< ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes [J] No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes �o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 21<0 ❑ NA ❑ NE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
214/201

Li ype of visit: t_*compnance inspection u Vperatton KCvtew Ntructure r vatuatton u i eennicat Assistance
Reason for Visit: CKfoutine 0 Complaint Q Follow-up 0 Referral Q Emergency 0 Other O Denied Access
Date of Visit: Arrival Time: d $ Departure Time: 01.' County: SAeAsgrl
Farm Name: MrXL ;iA2Ell kLic Fgly�t Owner Email:
Owner Name: f14 AR-f t9 iGL it Phone:
Mailing Address:
Region: Ffid
Physical Address:
Facility Contact: Cu ,-VT5 P Qwr,,,K Title: Phone:
Onsite Representative: S.A"mc n integrator: „And {�Qf1,�11
Certified Operator: ;L��R(� _ sor-11 Certification Number:
• r —
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Design�Current Design Current Design Current
Swine Capacity" Pap. Wet Poultry Capacity Pop. Cattle Capacity Pop.
Wean to Finish
IDairy Cow
Wean to Feeder
Non -La er
IDairy Calf
Feeder to Finish
aye
Dairy Heifer
Design Current Dry Cow
Farrow to Wean
Farrow to Feeder
D . P,oultry
I,a ers
Ca aci P,o Non -Dairy
Beef Stocker
Farrow to Finish
Gilts
Non -La ers
Beef Feeder
Boars
Pullets
Turkeys
Beef Brood Cow
Other
Turkey Poults
Other
Other
Discharses and Stream Imoacts
1. 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? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
❑ Yes [3Io ❑ NA ❑ NE
❑ Yes
❑ No
K3"NA
❑ NE
❑ Yes
❑ No
❑AA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No [jrNA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes ❑ No [�TA [] NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes Fg/No ❑ NA ❑ NE
of the State other than from a discharge'?
Page I of 3
21412011 Continued

Facili Number: - $ g Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
I!'<o
❑ NA
❑ NE
a. if yes, is waste level into the structural freeboard?
❑ Yes
❑ No
[D.XA
ONE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): 19 „-
Observed Freeboard (in): 3 5' —
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[9*�Io
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
[-]Yes
[ /No
❑ NA
❑ NE
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
E340
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[:]Yes
dNo
❑ 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
[EI No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
[9`f4o
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. [] Yes [J/14o ❑ 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): [Ormc.,upta C o4s"O
13. Soil Type(s): 0ko LEE A
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[ "Ne
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[g No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[2"No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
g/ No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
dNo
❑ NA
❑ NE
Required Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
dNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
E;/ 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 No ❑ 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 dNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No [h]'�A ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: - 3X Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes [V'6o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes EUN6 ❑ 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:
2b_ Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes EgXo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes ❑ No ❑ NA [aXNE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes [�Wo ❑ 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?
❑ Yes Eg o ❑ NA ❑ NE
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
❑ Yes Cg"'N'o ❑ NA ❑ NE
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? ❑ Yes UKo ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 610
"'o ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? [:]Yes ❑ NA ❑ NE
Comments (refer to question:#): Explain any YES answers and/or any additional recommendations or any other comments4 t '-
Use drawings of facility to'better explain situations (use additional pages"as pecessary).:
❑ Yes Q No ❑ NA ❑ NE
AoorWS!> \JZ_4 00 knr,
Reviewer/Inspector Name: _110E.." _ �Qat�S Phone: 910-3c$-(- 6-
Reviewer/inspector Signature: Date: Q31 �y
Page 3 of 3 21412011

YPV u1 v 131G 40 t,umpHance inSpecuuu V uperaiwn Review V airuciure r ra1uauun V i ecUiucai n3313tautm
Reason for Visit: tine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 2 / Arrival Time: C 00 Departure Time- county: Region:
w
Farm Name: Wi 1 Owner Email:
Owner Name: 1`r\IL�G-�l� Phone:
Mailing Address:
Physical Address:
Facility Contact: �j t, 6 TjoLf-W ll r1G, Title: l �C� . Phone:
Onsite Representative: p'45OL y..e-_� Integrator: M__3
Certified Operator: Certification Number: Z �
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
Desig4 Current
Design Current
Design Current
Swinle Capacity heap
Wet Poultry Capacity Pop
Cattle Capacity Pop.
Wean to Finish
Wean to Feeder
JIM
I Dairy Cow
JDairy Calf
Feeder to Finish
t a'
Dairy Heifer
Farrow to Wean
Desrgn4Co;rrent
Dry Cow
Non -Dairy
Beef Stocker
Farrow to Feeder
Dr, Poultr. Ca \achy rPo
Layers
Pullets rl
Farrow to Finish
Gilts
Beef Feeder
Boars
—Non-Layers
Beef Brood Cow
:.. ..
Turkeys
Other -
Turke Foults
01 Other
0ther
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
[—]Yes
[B o
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
[] Yes
❑ No
E3' A
❑ NE
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
❑ Yes
❑ No
[ A
❑ 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 DWQ)
❑ Yes
❑ No
[g NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
[ -No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
[E�No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

1~ acili Number: - Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes 2<o ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [91�A ❑ 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 CR14o ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
D lvv
❑ NA
❑ NE
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
[ o
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
�o
❑ 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
[3-No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
[j3-'90
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land 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 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
G;144o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
['No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
dNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[]3"No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
Q No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
[D14o
❑ 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 [D'fqo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [t"No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [—]No [grNA ❑ NE
Page 2 of 3 2/4/2011 Continued

Facili Number: - Date of Inspection:17—Iff
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes Q No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes 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 provide documentation of an actively certified operator in charge? [—]Yes �io ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes [:]No ❑ NA GJ 1�E
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
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?
ck- 4, K,
6—
Reviewer/Inspector Name:
Name:
Reviewer/Inspector
Page 3 of 3
❑ Yes [;?Ilo DNA ❑ NE
[:]Yes [TN— o ❑ NA ❑ NE
[:]Yes [9-No ❑ NA ❑ NE
[—)Yes [ o ❑ NA ❑ NE
❑ Yes
[;],No
[:]Yes
211&0
[—]Yes
[B o
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Phone: J lO —143 3' 33
--t
Date: 7— /1
24, /2011

Type of Visit QYCompliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit Routine O Complaint O Follow up Q Referral O Emergency Q Other ❑ Denied Access
Date of Visit: Arrival Time: �[� Departure Time: f County: ` Region: —
1
Farm Name: C Owner Email:
Owner Name: Chot 1 LS1`%� (I Phone:
Mailing Address:
Physical Address:
Facility Contact: C-A ewiy, 4 Title: ��" .� _ Phone No:
Onsite Representative: f� J� S B MLVI C�_ r Integrator:
Certified Operator: _Deborall _ Sr i f Operator Certification Number: Oaf
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: =° =` =" Longitude: =o =' [_]"
. �D� ry Ca act Rouia... ... : ...n
g Current g _ ent Design Current
SwineCa acityPo ulation �W�etf�ou� p 'ty"p lion Cgttle , ' Capacity Pgpuiadon
❑ Wean to Finish , ❑ Layer ❑Dai Cow
❑ Wean to Feeder ❑ Non -Layer I i❑Dai Calf
® Feeder to Finish Dairy Heifer
❑ Farrow to Wean ❑ Dry Cow
©ry Paiiltry
❑ Farrow to Feeder ❑ Non -Dairy
❑ Layers
El Farrow to Finish ❑ Beef Stocker
❑ Gilts ❑ Non -Layers
❑ Pullets ❑ Beef Feeder
❑ Boars ❑ Beef Brood Co
- -El Turke s k. .
Other �_ _ ❑Turke Poults
❑ Other Other Number�of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
tRNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
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)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
f TNo
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
allo
❑ NA
❑ NE
other than From a discharge?
Page 1 of 3
12128104
Continued

FacilityNumber: —,J'STI
Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes To ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in): j
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
15kNo
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
Ncdo
❑ 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
15cNo
❑ 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
Wo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
CgNo
❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes PTo ❑ 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 ElEvidence of Wind Drift ElApplication Outside of Area
12, Crop type(s) W(h -f6 i Re
13. Soil type(s) Ro Q ii�d_ ` Lea)_S i2A ` wQ g is
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes CE�No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
[SNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[:] Yes
5i7No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
�R No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
1�'No
❑ NA
❑ NE
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date: 3.2-010
Paine 2 of 3 U 12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available'? ❑ Yes N No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes [;JNo ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ p Other
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 I" Rain Inspections ❑ Weather Code
22,
Did the facility fail to install and maintain a rain gauge?
❑ Yes
5?No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
15jrNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
(5jNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
ERNo
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
NNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
® NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
[S�No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
[N�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
Mo
❑ 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
DrNo
❑ 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
ERNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
RNo
❑ NA
❑ NE
Addittonal Commepts and/or Drawings:
'Pteau- cleantrt)h ovto-c- a q-)rAou or yol)o� yveod weeds l(,Irid-e
S.
Hvc,1 M. PL record_ hwe Mon, 1 ea-f p 0!
Pleaje ' ,me dow., )a- if Fossf ble,
�ViMPrl^_rof Fl dbit- hay �a-F-E -09(-dd ve* c aid- wpa-t�
Page 3 of 3 12128104

Facilky No. Sa3W Farm Name l IllJ Date 1 a l 3 /l Q
Permit CDC
OIC NPDES (Rainbreaker PLAT Annual Cert)
FB
Drops
Lagoon
1
2
3
4
5
6
7
Spillway
Design freeboard
Observed freeboard in
I
j
Slud a Survey Date
Sludge Depth(ft)
A�A�
Liquid Trt. Zone ft
4,
Ratio Sludge to Treatment Volume
�-f-
Far. irrrc-nmmmr rri fii
Calibration Date
1
2 tt
3
4
5
6
7
8
Design Flow
S�
Actual Flow
}
y
Design Width
3 C
Actual Width
Soil Test Date 0 !• f �'�C Wettable Acres RAIN GAUGE
pH Fields r WUP Dead box or incinerator
Lime Needed' �� Weekly Freeboard Mortality Records
Lime Applied 1 in Inspections Cu-1 ✓Zn-I ✓ �`� 120 min Insp.
Needs P 1 Weather Codes r�
Croo Yield / Transfer Sheets Y
Waste Analysis Date
3a 1
r
r '
j!
- 60 Da
+ 60 Da
N Amt Ib11000 Gal
H
7i 7
r 7y
`7i
-JJ
~T
a MA",43J
PulliField
Soil
Crop
Acres
PAN
Window
Max Rate
Max Amt
i
:R ' '
q
LEA
50All
�!a
•�
s�
1
ni
Verify PHONE NUMBERS and affiliations
Date last WUP FR( -�-Q) Date last WUP at farm
FRO or Farm Records
Lagoon #
Top Dike
Stop Pump
Start Pump
Conversion- Cu-I 3000= 108 Ib/ac; Zn-I 3000= 213 Iblac
App. Hardware

11
Type of Visit �mpliance Inspection U Operation Review Q Structure Evaluation U Technical Assistance
Reason for Visit routine Q Complaint Q Follow up Q Referral Q Emergency Q Other [I Denied Access
Date of Visit: Arrival Time: Departure Time: I zztoDflCounty: Region:
Farm Name: ,,f%�;C./la�� . Sl�11/rn- Owner Email:
Owner Name: _ %77�'G�l�x l S�� !� Phone:
Mailing Address:
Physical Address: j
Facility Contact: Title: Phone No:
Onsite Representative: ^ •5�� Integrator:
Certified Operator: Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: [_—] o ❑ ' Q « Longitude: El ° = ' = u
Design Current. Design
Swine Capacity Population Wet Poultry Eapacity
Crr uent Design Current
Population Cattle Capacity Population
❑ Wean to Finish
❑
La er
Non -Layer I
❑ Dairy Cow
❑ Dairy Calf
Wean to Feeder
1
1110
FFeeder to Finish
Dry Poultry
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy —
❑ Beef Stocker
El Feeder
ElBeef Brood Co
Number of Structures:
❑ Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑
La ers
❑
Non -La ers
❑
Pullets
❑
Turkeys
❑
Turkey Poults
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
El Yes
M-No
❑ NA
El NE
Discharge originated at: ❑ Structure [I Application Field El Other
a. Was the conveyance man-made?
El Yes
El No
[I NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
El Yes
El No
❑ NA
El NE
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)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
allo
El NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
El Yes
ONo
❑ NA
El NE
other than from a discharge?
12128104
Continued

Facility Number: '3 Date of Inspection�9
• Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes B No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I 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
P3No
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
MNo
❑ 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
Jallo
❑ NA ❑ NE
S. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
L3 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 altematives that need
❑ Yes
KNo •
❑ 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
12. Crop type(s)
13. Soil type(s) _� ZZ Z3
-
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
TLCI No
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
allo
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
R-No
❑ NA ❑ NE
Comments (refer to quests n o,Explain any YES. answers and/or anv recommendations or. any other comments.
Use drawings otfacilJ to Better explain situations. (use additional pages as,necessarv);. .Ale aj
ReviewerAnspector Name I } Phone:
Reviewer/Inspector Signature: Date: /;L-

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes allo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Q 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 0,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
allo
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
Eallo
❑ 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
[RNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
Callo
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
QNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® 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
Ej 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)
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
R No
❑ NA
❑ NE
12128104

Type of Visit compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint �Ilow up 0 Referral Q Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: r� Departure Time: 05�'i7 County: Region:
Farm Name: _ �r jL'1 w So,— 1 . + Y' YP.L- Owner Email:
Owner Name- - Sd� �� Phone:
Mailing Address: r3 I_- ems.t�r C__Gi rn`rrr-
Physical Address:
Facility Contact: Title:
Onsite Representative: 1JD
Certified Operator: 42�11 __—
Back-up Operator:
Location of Farm:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = f ❑ Longitude: EJ o ❑ , EJ «
Design Current
Swine Gapty Population
Design Current
Wet Poultry Capacity Population
Design Current
Cattle Capacity Population
❑ Wean to Finish
❑ Layer
❑ Dairy Cow
❑ Wean to Feeder
I J[j Non -Layer
El Dairy Calf
El Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
❑ Feeder to Finish
Dry Poultry
❑ La ers
❑ N Nets ers
El Pullets
❑ Turke s
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
El Boars
Other
❑ Turkey Poults
❑ Other
❑ 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?
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 Q No El NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes [ ,No ❑ NA ❑ NE
❑ Yes [3No ❑ NA ❑ NE
12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [SNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ 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 ® No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not property addressed and/or managed ❑ Yes RNo ❑ 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? g] 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 Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes VJW ❑ NA ERNE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes []No ❑ NA ONE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or I O lbs []Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ 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
NNE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
[&NE
l Comments (refer to question ft Explain any YES answers and/or any recommendations or any other comments.
IUse drawings of facility to better explain situations. (use additional pages as necessary):
U/imVC L) t"& - 74"'j.
av w- 7 e
rf't C�a'29�/u� d• T C�+2� r �' uJaj�t
Reviewer/InspectorName ,� 7. Phone: V�
Reviewer/Inspector Signature: Date:
71"21A4 !`nnfint�vd

Facility Number: 3y Date of Inspection 6 -a
' Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes ❑ No ❑ NA 53 NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ No ❑ NA to NE
the appropiate box. ❑ VIUp ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA RNE
❑ 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
❑ NA
ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
❑ NA
[9NE
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
ERNE
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
❑ NA
&NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ No
❑ NA
f9NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
❑ No
❑ NA
[K 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
NNE
General Permit? (ie/ 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
DINo
❑ NA
❑ NE
Xdditional Comments and/or Drawu�i gs:
�._S _ - � -
Fug a� b��,•-r ���z) I'ra�
i u Drt__ h a s bra"It 4c,"V '_'_ �00 t= &_Olool
Page 3 of 3 12128104

Type of Visit Cel;omp ante Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit outine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: %�'` Arrival Time: Departure Time: Coun Regionf f 2
Farm Name: S T4p,;Jn Owner Email:
Owner Name: T1� Phone:
Mailing Address:
Physical Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator: <1.9_ _
Back-up Operator:
Phone No:
Integrator 4
Operator Certit c ion Number:
Back-up Certification Number:
Location of Farm: Latitude: = e = " = Longitude: = 0 0 " 0 u
me
— Desid�n Current �Des�gn Cnrrent "Capuoity
Current
Swine - C aci "Po elation Wet'Poult Cap l 1'o elation Cattle ty „p.�P
❑ Wean to Finish
❑ La er
El Dairy Co0w
❑ Wean to Feeder ❑Non -La er
❑ Dairy Calf
Feeder to Finish
0 Dairy Heifer
Ej Farrow to Wean D . Ponit
El D Cow
❑ Farrow to Feeder
. "
El Non -Dairy
❑ Farrow to Finish El Layers
❑ Beef Stocker
❑ Non -Layers
❑Beef Feeder
PGilts
Boars ❑ Pullets
❑ Beef Brood Co
•,� �� ❑Turke s
Other ❑ Turkey Poults
_..w
❑ Other 10Other
Number of Structures:
Discharges & Stream impacts
1. Is any discharge observed from any part of the operation? -
❑ Yes
KINo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
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)
❑ Yes
❑ No
❑ NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
[]Yes
P No
❑ NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
CgNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number- Date of Inspection
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 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): _C29�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes tZ 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 53No ❑ 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? IKYes [:]No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
19 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 91 Yes
❑ No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
NNo
❑ NA ❑ NE
maintenance/improvement?
IL Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
25 No
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ FaiIure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) frn Y_ L4 tV42�Tr14
—
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
RNo
❑ 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
ES No
❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes
® No
❑ NA ❑ NE
'-
Cornments (refer4to question,#} -Explain any lYES answers and/or any recommendations or any other comments.
Use di�awings_of facility:ta betterlexplaia_sit cations. (use*additional pages as„newessary):
M'ouJ �'a Remote Trash. rfVh-
Reviewer/Inspector Name r--- prI�r', Phone: 0—.�D
Reviewer/Inspector Signature: Date:`
Pase 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 EYNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes R No ❑ NA ❑ NE
the appropiate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 0 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 ® No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 54 No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
10 No
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
10 No
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
R No
❑ NA
❑ NE
2T
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
® No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
® 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
t@ 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
® No
❑ NA
❑ NE
33_
Does facility require a follow-up visit by same agency?
❑ Yes
►RNo
❑ NA
❑ NE
Page 3 of 3 12128104

n
Division of Water Quality
Facility Number j$' Q Division of Soil and Water Conservation /a -3 j—
O Other Agency
Type of Visit 0 ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: ,3A-07 Arrival Time: D Departure Time: /S County: Region:
Farm Name: I :2_ 071, Owner Email:
Owner Name: %y% .' �� 5�/, Phone: �J
Mailing Address: r-ry
Physical Address:
Facility Contact: .1w; Ae S Title: V U2 n Z�-V" Phone No: f r D "3kS--jqq67
Onsite Representative: f MID Integrator:
Certified Operator: efl ►l T Operator Certification Number: C2'q i) 7a
Back-up Operator:
Sack -up Certification Number:
Location of Farm: Latitude: =1 O = I = 1
4 Longitude: = o 0 , =
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other _
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Nan -La ers
❑ 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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Da' Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Strictures: EL
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 ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes ZNo ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
12128104 Continued

Facility Number: J Date of Inspection 17
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 I 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 N No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Arc there structures on -site which are not properly addressed and/or managed ❑ Yes CKNo ❑ 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
CUNo
❑ 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
2SNo
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
CR No
❑ 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 l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) �t ►'Yl L(�IGt _ / © V -er
--
13. Soil type(s) _ � L k e A / 5 as _
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
29 No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes
P9 No
❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
[3 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
IComments (refer to question #): Explain any YES answers and/or any recommendations or any other comments. I
Use drawings of facility to better explain situations. (use additional pages as necessary):
iC h4%it e - jdoe-3 c�- lni7&.) i rt sid lac Y\
Wari'C
aDo �7C W 'V'VfP
Reviewer/Inspector NamePhone:
Reviewerlinspector Signature: Schrr&rl Date: %
�a
I L/L6/U4 UURrLnuCu

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? (9 Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CA;Rksign
adily available? If yes, check 'et_ [,No [INA [I NE
the approprrate box.
ElWUP El Checklists El Maps [I Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No ❑ NA ❑ NE
19 Waste Application ® Weekly Freeboard 14 Waste Analysis ® Soil Analysis ❑ Waste Transfers ❑ Annual Certification
10 Rainfall ❑ Stocking 1KCropYield ® 120 Minute Inspections ® Monthly and 1" Rain Inspections ® Weather Code
22. Did the facility fail to install and maintain a rain gauge? (AYes ❑ No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ® No ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? 'M Yes ❑ No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? 19 Yes ❑ No ❑ NA ❑ NE
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? (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?
Comments and/or Drawings:
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No 19 NA ❑ NE
❑ Yes [9 No ❑ NA ❑ NE
❑ Yes [9 No ❑ NA ❑ NE
❑ Yes ® No ❑ NA ❑ NE
❑ Yes CR No ❑ NA ❑ NE
t[ Yes ❑ No ❑ NA ❑ NE
2.Yes ❑ No ❑ NA ❑ NE
OD7
p o 3o; L ,Sail -ems
0o(-C1 AA6f'
T1 tiSL.u�ae ,�'u.rll�r � e
33 �-- s d' w �r'n'1 i6 S 1 a �, T Dv � MKS -�
.sh��� I
daleWe W; -UP W"K te-F
a° i?7%`/h I`reon .5 rl� i I C��CC. 9 1t28/D4�U
LSO 2 _ 1�d��f9Lv N 1/f S i Ii 1/ ��s-� fl eri`7 ' ''. Zn � /

J 4r- /� , /2 FZ,L,, I Co
l�.Division of Water Quality
Pheiltt}" dumber $Z. _3 $ $ O Division of Soil and Water Conservation x µ
--- O Other Agency
Type of Visit *Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit O Routine 0 Complaint 0 Follow up O Referral 0 Emergency 0 Other ❑ Denied Access
Date or Visit: %ZZI %-O Arrival Time: Departure Time: O S ' 001 County: Sd Ato6_o nJ Region:
Farm Name: !M i [ 1, q e_ �� t11-10 Ckciy_yy� Owner Email:
Owner Name: %�iGlt�e—i Spy 11 Phone:
Mailing Address:
Physical Address:
Facility Contact: __.AAZt-Sw _el Title
Onsite Representative: Certified Operator: b e 66 /-',/� w//
Back-up Operator:
Location of Fartn:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
.Boars
Other
❑ Other
Phone No:
Integrator: —We'/y
Operator Certification Number: Z Za /9
Back-up Certification Number:
�O �+ �u g =OF` =a
Latitude:Lon itude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
, HNon-Layei
Layer
Dry Poultry
❑ Lavers
❑ Non -Lavers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges $ Stream Impacts
I . Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field El 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: 173
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 ❑ NE
❑ Yes
[P No
❑ NA
❑ NE
❑ Yes
V No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
VNo
❑ Yes
[)�Nc,
❑ NA
❑ NE
❑ Yes
VfNo
❑ NA
❑ NE
12128104 Continued

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 I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): g i�
❑ Yes N1 No ❑ NA ❑ NE
❑ Yes LdNo ❑ NA ❑ NE
Structure 5 Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
V1 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 4fi 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
V1 No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes
[XNo
❑ 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
0No
❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
94 No
❑ NA ❑ NE
maintenance/improvement?
]I. 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 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) %jz rm I& c1 c, C Gra; e� S',. T4 !l C9.-� %�/ �4, S .
13. Soil type(s) ac (3 80.9. L t& ,
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
rM No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
�9 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
P No
❑ NA
❑ NE
Reviewer/Inspector Name t GV f'� Phone: P10) j933
ReviewerA nspector Signature: , v Date: / Z — Z —Z0
rage z of s IZI-16104 uonunuea

Facility Number: f Z —:eWl Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [XNo ❑ 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 El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes V1 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 ® No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes V 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
M No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
(Z No
❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA ❑ NE
29. Did the facility fail to property 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
[INo
❑ 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
K 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
WNo
❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
10 No
❑ NA ❑ NE
Page 3 of 3 12128104

Facility Number Date of visit:
1-a
Not Operational 0 Below Threshold
ImPermitted 00 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: Si.r+eN S nT,1i _.Far..._ County:
SaV,wo0
Owner Name: _ 5$24-It } i Y a P Phone No:
Mailing Address: 1317 i' 11e<ne.., 4 13 i I`i C
Facility Contact: _ 1�ti k� S D�'1� _ Title: YY? a� - Phone No: j o -• s7o —3q
Onsite Representative: y�(f m'-'. + Integrator: Pr r s k Q•s `
Certified Operator: Operator Certification Number: �2;24o7Y
Location of Farm:
"u3., '701 5V A-%% �t'vOw. G��•a�c.n �a %3,%T r,L St- QaQ.lt. TA, Ic-(4 a.`Q
4C r .ter. 1 S 01, t %. "AL O ►, +A, C I C .
U Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ©0 S�f ©" Longitude ®' 0
Design:.. _ CUrrent
- Design Current = _Destgri_^ - Curieot
_Swine =- _ - °Ca nc3itv:'.Population
Poultr _ _ Ca achy Population Cattle :=:Ca atrtv-'= Pa ulatma
[] Wean to Feeder
❑ Layer ❑ Dairy =_
..... +
Feeder to Finish 9�
❑Non -Laver ❑Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacit3 ? G
Gilts
_
❑ Boars
- -: Total SS
Nnmber. of Lagoons L�
❑Subsurface Drains Present ❑ La oon Area ❑ sp. y Field Area
IiolditkgPonds / SoItd'Traps
❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Yes
❑ No
Discharge originated at: ❑ La2oon 0 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)
Yes
❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
p?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
[9 No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Yes
❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier:
Frccboard (inches): Z "
05103101
Continued

- ' _ - -•..- _ .� T _ .. .•--.rr. - •._ �-r-srT•."T'.c"1r�s►-'4Vry'•c"+. rT^r..�+"Psae°"i" �`�'14.^-. •v-�-+"..��.. ,r7
Type of Visit $ Compliance inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Faciliri• Number
Date of visit: -34-43 Time:
rO Not Operational 0 Below Threshold
Permitted R1 Certified Q Conditionally Certified ❑ Registered Date Last Operated or Above Threshold:
c r w► County-:0 Y_ S l0 H
Farm Name: �4 a ►++�... � PIP 11 � __ Count
Owner Name: s r i 5 i rn a,,, Phone No:
Mailing Address: A-0 U ^J 53aP
Facility Contact: �� � Y�, e [>� L Title: _ Y VI r ^ C_ r Phone No: I J U " 510 — 3 47q
OnsiteRepresentative: Sk2<\k-(�N-4112­L S+o�/integrator: P*y a e -
Certified Operator: s +n� 1 1 l e.� nv-
p t�_ Operator Certification Number: 7.70M
Location of Farm:
IcJ�
o r\ e 1 e i rr
R Swine [] Poultry ❑ Cattle ❑ Horse Latitude Longitude
- -
Desi yCorrent :. Design _'Current Design - zCUrmnt
_ -_ _ -
Svrtne..-z - - Ca- acit� =Po ulation -._. _ Pvultrc.- - :._C activ -Po Watian Cattle . Ca adtv� 7 Pv dation=
❑ Wean to Feeder ❑ Layer
❑ Dai
® Feeder to Finish D
- Non -Layer. , ❑Non -Dairy
❑ Farrow to Wean -
Farrow ❑ O
; Other ht_..-. _
_ =
❑ to Feeder - _ - -
❑ Farrow to Finish Total Desi Ca sh
❑ Gilts: Psc
7 U
❑Boars - Total sSk / `j40
Number of Lagooas '` _� -= ❑ Subsurface Drains Present ❑ L oon Area ❑ Spray Fietd Area
_ .Holding Poas"/ SohdTraps . ;> _
_=. - -_- ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? Yes ❑ No
Discharge originated at: ❑ Lagoon ® Spray 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) i Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min? p?
d. Does discharge bypass a lagoon system? (If yes, notify DV4'Q) ❑ Yes ® No
2. is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection R Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway [ Yes ❑ No
Stricture I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): z
05103101 Continued
I

Facility- Number: Qa — 3jV8
Date of Inspection S- .29- o. 71
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ 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? ,
(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?
8_ Does any part of the waste management system other than waste structures require mainrenancehmprovement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste A lication
10_ Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hvdraulic Overload
12. Crop type
❑ Yes V No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
I3. 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
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ 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.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ 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?
❑ Yes
❑ No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24, Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AR'MP?
❑ Yes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Coii menu!(refer ta';.gitestson #I) _E:iplatn ariy YES anstrers andlor,sny recommendations or say'other,eDmmei ts. --
[3se'drawtsegs of faca�tty to Getter explata situattons °(use >�ddtt, n I pages as neeessarv) _- 0 _
❑Field Copv Final Notes_
Pwl 19,0.p6jh JA►*4 tec) Icy V;.J1+CA Agnri rGr M+ QN ..5'� f�Q�. TAlrt
wca eu.cfdwcc o1Y C wma1j"4 cQLtGi.lnrc�c. tAk+'+i p�aCc {-�oF+ y�t,k t'"m."p-7C. ct;tGt',
50—f,ICS L.rCr� }0.clr• 1-1 AA% -Cc 16L.A-ki �1� 7�G OQ:w� W�G�� i+JG�'IGiJn`Gl^ GA�CrGCX }L�
l
d[1'fG F�� �-S6e.�r Ct� AI.O ter fRM. I?1C Wdi �G �Cws n+
i.,to a. 1�.� IQ t� irdZ Ian �aKcw. 1rsc•.... {�.c o�.-rt.�'l6w c��
C�a�s C-�w�. TL.ts
r%4Ns into Creek las# :n 4orn,a�t�� is PKrtl.r►cr� �a r:.r
C,,�11 ablCc� �WQ �7Crson+�c1 �4 1ta�c. 4+�y prcp�.tli ct,�,�R-�-�,tY Co.w�Ia1+t•Q..
11
LZ
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: S-� mil-
0510310I i i Continued

Facitih Number: Qa — 3f78 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
closure plan? ❑ Yes © No
(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 ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ❑ No
9. Do anv stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑Yes El No.
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
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
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ 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.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ 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?
❑ Yes
❑ No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
�] No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit..
Couimeptsa (refer to questiGn #) Esptain any YES answers and/or sny reeistntneudations ©r any other comments:
Use drawtngs of facility to better explatn situations. (pise addrttnusl pages ss necessary)xw [] Field Cnt)v El Final Notes
_ _ _,.-•W
p 7tirrc
Pkl3dmob& RC&jIJrH?A-1l.;c ftilh,IG cat�� 1a,�7 tg�iticf
,�.+�si+��
tt1G S ev. e . cc o•+ PC W e oQ*-fCh`a.SG +4 V.^S
pc�d<.0 Yr cp w -Ci t-IJ, f1uu-0 (Y7 '�o GL �rt'G�l,
110
11on't
1+
Sor fle$ we r, '!A/1ci1� •"1 1�YCC 1UL8�1Oh+i�Sc �p�� whGY� O]7CW�\i �eI�CT C�Xy ��p�
tIU
nY
of,.-G `,C.�OkrGt� .f G'Y•. plG WG] "(/�i-%kc t7D�n{
,�/'�%�+Uj1��cv
i n 1 G7 a F"f t h ♦ Y tQ, W G J '� c iC G M 4 r 0 N.. -t G p,ri -i-1 (� W Ia F ��
p e c�... �- p n r �� ,..., 1, : ab, ¢ �+ a i. � c.« I lkT
.►r+'') \\ 1 ) . T /-1
rN/JS ih�0 �}MG1�t1l�Yr, CTttl< CCta�sC�aW i�ti 1Gi� tnYGr Git�/� IJ YJlYl4A�� �J M-N i
5�c1� GSI;rrR +nWQ pGr�or`nc1 �v 1Cc�.� I�.S �7rLs�e«CL ay.t� #�CY tO.M11�1tc.�.
t f
�
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
05103101 Continued

CDMPLAINT AU"
Division of Water Quality, Fayetteville Regional Office
Initial WQ Contact Person: Ro !\ , �s� Date Received: 3 -- 3 )—a 3 ; vc)
Investigator (if different from above): . !oG„� �, ��., Date Received:
Complainant's Name: j�,��,R,�ou _ Check if Anonymous
Address:
City / State / Zip Code
County: Phone
Complaint: Spe 1 j 3 t m 6r,, Cmnc t ci sn ro : s\ e : r\ c.1� ; n
ki
Location of / Directions to Complaint:
d eLl J . s erg M rr. SP e ll .4„ 4.,-. l ( Mike 4-v Io o o L" 4„ 1
` . . .. r . _ L - T —1 - .L A -I1. !_i —L
Date of Investigation or Referral:
Samples Taken: Yes_ No Photos Taken: Yes— NoY
Narrative of Investigation, Actions Taken, Recommendations:
Follow-up Necessary: Y N
Other Sections/Agencies Involved (Name, Section/Agencies, Telephone No.):
Please submit the completed form to Paul Rawls.
Date form entered into tracking system (to be entered by Barbara)_
Rev. 1 /9/2003
F:IDATAIWPDATA\WQ12003 COMPLAINT REPORT FORM.doc

aT ',
_ r i•.a ,, a 't. ,, . O- Other. °�F +r e.2?.+t $-5. r � s_ ti � f i�: s YS •.r .;
..•�"s�k�b,i #si��.s te:ti�.'`'�.a,F� �kurj `�a '^� 57t ...F. fl�Gf.w ��ek...{.`r..x��'"�' .. 4c'A,73�e ..� . �s'alaw'r�-,�'.. „a+}.Q S.rrs.�4� ia. • �_
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O routine O Complaint O Follow up O Emergency Notification *Other ❑ Denied Access
Facility Number $2 38$ Date of Visit; 02-2�2003 Time:
NNot Operational Q Below Threshold
13 Permitted ® Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: SimRRSpeRFarm............................................................... ... County: SamsoD-_.-------..__---.-----.--.--.--. FRQ---------
Owner Name: Simon_
- ----- - - - _ _ Spell --- - - --- - --- ----- - - Phone No: 910 S99 3474 ----- - - --- --- - --- - --
Mailing Address: J3.j7..Q4jacgx.Rd................................. . CG.Axoju..NC.._...................... ... 283.2.8 ..............
Facility Contact: Mike Spell . ... .. ....... _ __. _.. _'Title: Owner ........_... _ Phone No:
Onsite Representative: Integrator: '
p Mik��Re1L----------------------------------------. if�Q�asstfCarQlina---------------------•
Certified Operator: De,QKab.1.................. , Operator Certification Number:
Location of Farm:
4wy. 701 south from Clinton to Butlers X-roads. Turn left, farm is 1 mile on left- A
V
® Swine ❑ Poultry [I Cattle ❑ Horse Latitude 34 • ® Longitude 78 a 18 4 12 u
;Design Current
Design Current
Design Current
Capacity Population
Poultry,.
Po Cattle
C`aty PoSwine uEahon : `
❑ Wean to Feeder
❑ Layer
❑ Dairy
® Feeder to Finish 2940
JE1 Non -Layer
I❑ Non -Dairy
❑ Farrow to Wean
-
❑ Farrow to Feeder
❑ Other.
❑ Farrow to Finish
Total Design Capacity;
2,940
❑ Gilts
❑ Boars
Total SSLW
f 396,900
Dischargues & Stream Im acts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray 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 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? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
Structure 6
Identifier:
Freeboard (inches): ._.......... 1h............
_.__.._.._.._..- .......................... _....._.. _.._. ..__.-.._.._.._.._.._.. - ....................
OS/03/A 1 Continued

Facility Number: 82-388 Date of Inspection 02-26-2003
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
closure plan? ❑ Yes ❑ No
(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 ❑ 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 Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ❑ No
I4. 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
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, chccklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ 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?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative'?
❑ Yes
❑ No
24. Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comtnen#s (refer #o`queshon'#} Explain any YES`answers an aoy, recommendations or any othergcomments
k }fie"ti 3r. .. '" > "F` "{ 9:. - •. .-v ;. r_ i y _-:.•'a
Use drawings of facility to Better explain sitnatrons..(use'addthonalpnges as necessary):, t
[] Field Copy ❑ Final Notes
x ,
-site during routine freeboard evaluations during wet weather. Lagoon level was discovered to be 16 inches. Mr. Spell had not
+
contacted DWQ. Mr. Spell was informed that he was required to inform DWQ whenever the lagoon level surpassed the 19 inch
compliance mark.
At the time of our arrival Mr. Spell was irrigating. No runoff was observed during our visit. It was recommended that if Mr. Spell was
Ding to continue to irrigate, that he closely monitor the fields for any runoff or ponding. Mr. Spell was informed that DWQ was not
requiring him to irrigate and it was under his own responsiblilty that the irrigation continue. We informed Mr. Spell that we would retu
tomorrow to inspect the lagoon level and sprayfields.
er/Inspector Name Paul Sherman ;,'John Hasty;.erAnspector
E
Signature: Date:

05/0.i/U! Continued
Facility Number: 82-388 Date of Inspection 02-26-2003
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 ❑ 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 ❑ 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' omments and/or Drawings

Type of Visit O Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint Q Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 02/27/2003 Time:
Facility Number 82 388
Q Not Operational O Below Threshold
Permitted ® Certified D ConditionaUy Certified © Registered Date Last Operated or Above Threshold
Farm Name:$jva9mSgeJAF4Km ........................ County: Saw$.4nt-------------------------------- FBQ__._..__.
Owner Name: 5im40. - -- ----------- SFeA- - - - - --- ----- - --- - - Phone No: 91Q 599 47�------ --- ------------------
Mailing Address: ��12.Cha�tl:try..�d ............................... ......... CAUj4lu..N'C............................ 283.Z.8 ..............
........................................ ................................
Facility Contact: Mike SpteR............ -Title: O..Wi er.--.....---. Phone No: ......................................
Onsite Representative: M1k�S42e1L------------------------------•---------- Integrator: RS4�YU�.R[��[StJiaa.�lUs.----------------•
Certified Operator:) et?Q�Ob.,�............................ sile'll ................. Operator Certification Number: z2,Q78...................
Location of Farm:
Hwy. 701 south from Clinton to Butlers X-roads. Turn left, farm is 1 mile on left. +
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 34 • 54 ° 36 u Longitude 78 • 18 4F 12 u
Design _"Current"
Desig© Current'
Design Current
Swine , Ca " ci Po"' ulAd
Poultry
Ca aci Po` idatioo Cattle
Ca ace Po `elation, ,
❑ Wean to Feeder
❑ Layer
❑ Dairy
® Feeder to Finish
2940
❑ Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
2,940
❑ Gilts
Total SSLW
396,900
❑ Boars
Number of Lagoons l ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
Sohd "Traps ';� ❑ No Liquid Waste Management
Haldhig Ponds 1 System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ® Spray 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 systcm? (If yes, noti fy DWQ)
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? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
® Yes ❑ No
❑ Yes ® No
® Yes ❑ No
5
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
Identifier:
Freeboard(inches) ...._.._-•l9.-_.._..--•-- ---- •--._.._.- .---- - - -- - .......................... ........................... - .._.._.._.._....._.._.
05/03/01 Continued

Facility Number: 82-388 Date of Inspection 02/27/2003
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
closure plan? El Yes ❑ No
(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 ❑ 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 Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
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
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ 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.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in erect at the time ofdesign?
❑ 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?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer, to question #) Explain any YES answers and or any recomiiiendahons or any other comments t R, x ,
,,
Use drawings"of facility to defter explain situations.-(nse addrdonal pages as necessary): , µ '
❑Field Copy ❑Final Notes
Y _ ,
E:, r ..,. ',a -: ,. ._ ;.',: .=, '., a'. ., •,"w, , r7., _ •.,*--`K ^a�-:-•r,".n^rC.. :<"r.1+" "�'w z
-site to follow up on high freeboard inspection yesterday. Upon review of sprayfields, discovered runoff discharge of wastewater out
f sprayfield. Discharge occurred at the center east edge of the eastern most sprayfield. The discharge was due to excess rainfall runoff
washing the recently irrigated wastewater out of the sprayfield. The wastewater left the sprayfield in a channelized flow caused by the
natural draw in the field. The channelized wastewater flowed overland approximately 600 feet to a natural groundwater spring. The
astewater converged with the natural spring that eventually flows to Buckhorn Creek (Class C-Sw). Samples were taken at the source o
the discharge, the midstream flow between the discharge point and the natural spring, and downstream of the convergance with the
natural spring.
Reviewer/Inspector Name Paul Sherman John Hasty
Reviewer/Inspector Signature: Date:

US/Jl3/UI
continued
' Facility Number: 82-388
Date of inspection 02/27/26 3
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
❑ 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
❑ 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: 5 " _ rf ,. •. - -
x.
t was recommended that Mr. Spell construct a divergance to prevent any further discharge. Mr. Spell followed the
recommendations and constructed a dam at the edge of the sprayfield to divert the wasterwater runoff back to the sprayfield. Mr.
Spell was informed of his requirement to notify DWQ, in writing, of these events within 5 days. . r
J

��� �, Date of Z�isit:Time: Facilih� Number
Not Operational 0 Below Threshold
0 Permitted 4Certifed ©Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: - J e; wiy., � U �e � � Fci r- ,-, County: _ �� 5-c,"
Owner Name: A ike_ -SAP e [1 Phone No:
Mailing Address: 13 1 `7 C ka k c eu C ! r -g, _
Facilitv Contact: b IaJ M f r _ Title: Phone No:
Onsite Representative: 4G / d1 -el.,,-- „ „ Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:
T
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �' �• 0
Discharg-es 8 Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Sprav 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 floe.- in gal/min?
d_ Does discharge bypass a lagoon system? (If yes. notify DWQ)
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 _ect_ion ce Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard (inches): 2
05103101
❑ Yes J�No
❑ Yes Ap No
❑ Yes -q No
❑ Yes Z No
❑ Yes KNo
❑ Yes XNo
❑ Yes lid —No
Structure 6
Continued

Facility Number: t�L — ?r I Date of Inspection Z F-o
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ 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?
(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?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
`Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? , ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type �.�/N•t r�� �.5i.. e _ dde i Set
❑ Yes jKNo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes pizo
❑ Yes qNo
❑ Yes JkNo
13. Do the receiving crops differ with t6se designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
RNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
RNo
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) this facility is pended for a wettable acre determination?
El yes
No
15. Does the receiving crop need improvement?
❑ Yes
r ^No
16. is there a lack of adequate waste application equipment?
❑ Yes
MNo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
gNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19. Does record keeping need improvement? (ie/ 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?
❑ Yes
L,rN" No
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
NIq
24. Does facility require a follow-up visit by same agency?
ElYes
No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
0 No
19 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
_ _ _
Comments (refer:to question #) Explain arty YES answers an[i/or.any reeomn3endatwns ozany other comments.
_
drawings of facility ta.better explam`sEtetahons.'(ose addtttot►al pages as neee saryj -_
E ❑ Field Copv ❑ Final Notes,
YL
9 �"� -
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:
0510.3101 AP 7
Continued

Type of Visit Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit Routine Q Complaint. O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: 10 15 1 Time: o�
ro—NotOperational Q Below Threshold
© PermittedCertified 13 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name P.a.... .451 fir'-) County:....... '�` r! ......... _�........ ?.
Owner Name:
...............
4� k?....... ..... ?!'.11.................................................... Phone No: ....�90....��! t..............................._..._...�_.
Facility Contact: .......... M.'..Y e
.++........., �.1l....... '..................Title:.....�l...._.. ..............�.40a—
Phone N
Malng Address: ........ ....... ............................. .......C4 ! K6.1.4.... ....................................
5... ...
Onsite Representative:
Integrator:
Certified Operator:........ D�;6,r � r�2M
...... .. ............••-...,.�5...................._..........-..-..-... Operator Certification Number:
Location of Farm:
(% Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' & 04& Longitude • '
y Design, Current ' Design Current Des�g�. Catri�eat
;Swtae Ca Po elation . Poa![Ty ,. ..iCa ci Po elation _ :Cattle, Ca ii =Pa tion
❑ Wean to Feeder ❑ Layer ❑ Dairy
Feeder to Finish -9q0 10 Non -Layer ❑ Nan-Dairy
Farrow to Wean
Farrow to Feeder Outer
Farrow to Finish TOW Design; CgRipity
❑ Gilts
❑ Boars Total kst'w w -
Nntatber:iifLagooas _ Subsurface Drains Present Lagoon Area ❑ Spray Field Area .
Holding Pond§ /Sold Traps:, No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray 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 gaumin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
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? ❑ SpiIlway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: .................................... ........................................................................................................................................
Freeboard (inches): t�
5/00
❑ Yes] No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
r 0
❑ Yes t [� No
Structure 6
Continued on back

Facility Number: — $ Date of Inspection S
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
closure plan? ❑ Yes No
(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 No
8. Does any part of the waste management system other than waste structures require maintenancerrnprovement? ❑ Yes No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes No
Waste Application
10, Are there any buffers that need maintenance/improvement? ❑ Yes X] No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes j No
12. Crop type M (,ra '0.2
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 10 No
16. Is there a lack of adequate waste application equipment? ❑ Yes 0 No
Reeuired
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available? N"+ �`r^'%uQ
❑Yes
El 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.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis it sample re
0 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
j No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
1% No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
P No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
U(No
yiQlp tnjs:er ftficjei;c{es ire )io ��4s:vis�t; Y'o wjt t�eeeiye o t r.
comes' dei>&abaU this visit:
14- i� ce�}},,%c F,,,�;� rII , ���*`•,y a Cep►� e 4`s ye� Sc; j srnple
5on-Q � Q ;,L � copy �-P LOLLP 4, '��e4 4-- ca,,,plda po[cSS .
s2 3 --gt`'k"f z � t ?e J~3`
Reviewer/Inspector Name dve1-M._ .z= ., _:in
Reviewer/Inspector Signature: Date: O S100

Facility Number: �' — Date of Inspection JO 16 O/
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 0 No
28. 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)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes l 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 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
lAdditional:Commentg an nr= rAwrngs:.
J
5100

Type of Visit ® Compliance Inspection O Operation Review O Lagoon Evaluation
(Reason for Visit O Routine e Complaint O Follow up O Emergency Notification O 0ther ❑ Denied Access I
Facility Number Date of Visit: % .� / Time:
0 �Notoperatiional Q Below Threshold
0 Permitted MPCert fled [3 Conditionally Certified [j Registered Date Last Operated or Above Threshold: ... __ _......
Farm Name: ...........2: % s.- ... !f�l�. j .. County:.........._
OwnerName:....... ... i,�,�--._....I........................... .... .»... Phone No: ..................... »........ . »..... _._....:....
Facility Contact: ..��..� .......Title:........................................_........ ..... Phone No: »........»..._ ........» .... . Mailing Address: v....i� Div
Orisite Representative• au.� �f Integrator:.......... ...... ......................................................... .....
Certified Operator:__ Operator Certification Number:
----.................... _.......-----.........._..�...___...._.._....
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 46 Longitude • 4 44
S+CDesiiga , Current Design —Cnrreist
dpaiity:,Popida1iozi-'.Poultry - Ca -p ,;:Po Wation . Cattle. n•E
Wean to Feeder
Feeder to Finish
a 9 fO
�j
Farrow to Wean
Farrow to Feeder
❑ Farrow to Finish
El Gilts
Boars
❑ Layer ❑ Dairy
❑ Non -Layer I I 1 10 Non -Dairy
Other
Total Design Capacity
"Total.' SLw
- < Number of Lagoons.: _: -- Subsurface Drains Present 11OLagoonArea ❑ Spray Field Area
Holdurg Ponds / Solid Traps No Liquid Waste Management System -
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes Pff No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 9Na
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes PrNo
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes C') No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes Aio
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:........................................................................................................ -........
Freeboard (inches):
5/00 Con#nued on back

_'�. � �4 vu�+ ...,..y.,.Y..-.rev.,.,n•...t..-rr..--.a�-�...ray...�f.i:.f.tir:�y.,.s:-,.:�,�r �r%..5,..�;;�5•twv. �+' _... �-..... �u �... ..
IType of Visit O Compliance Inspection Q Operation Review O Lagoon Evaluation
for Visit O Routine © Complaint O Follow up O Emergency Notification O Other , ❑ Denied Access
Facility Number
Date of Visit:
7 .�FAI Time:
Q Not rational Q Below Threshold
0 Permitted JaCerti led 0 Conditionally Certified 13 Registered
Date Last Operated or Above Threshold: -..» »» ....... ».....
FarmName: ...........s/-?.........»........}��- .........................
Countv:...........5�........... »...».......»».
OwnerName:...... .. :/C�.........E�/................................ I....---...............
Phone No:...................................................................' ...».. :.
Facility Contact: ............. �.......�....�......... Title: .....................................................
1 ».
.. Phone No: »................. ........... ...
Mailing Address:......... �..✓ i$........../�i✓-�----�I
». :. ».:.
ve• Onsite Re resentati.. .........................
Integrator: . f .................... ».. » .»... »
Certified Operator;,,,,,,,,,,,,,,
O rator Certification Number-
,�'
„'..............................�.................................................
pe........••--•.......................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' ° 46 Longitude • 4 Du
Design-, Current
Ca as ` Population
Wean to Feeder
El Feeder to Finish f� Q
Farrow to Wean
El Farrow to Feeder
Farrow to Finish
❑ Gilts
Design Current
Poultry .Ciipaiity Population
❑ Layer
❑ Non -Layer
❑ Other
Total Design Capacity
Total SSLW
Nember of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area 'ry
Hotdrng Ponds / saud Traps.;:r� ❑ No Liquid Waste Management System'
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ;ffNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 9No
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes 9No
r
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes 1®-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ❑ No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .................................
Freeboard (inches):
5100 Continued on back

4
Facility Nzunber:X2_—.a1 Date of Inspection E..J
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, 0 Yes ❑ No
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
(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 maintenancermprovement? ❑ Yes ❑ 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 Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ,4No
t 1. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes )§LNo
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 XNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes ;9 No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes ❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.)
❑ Yes ❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) ❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design? 4gVs�
o21.
Did the facility fail to have a actively certified operator in charge?
❑ Yeso
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes ❑ No
23.
Did Reviewer/Inspector fail to discuss reviewfiinspection with on -site representative?
❑ Yes M No
24.
Does facility require a follow-up visit by same agency?
AYes ❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP? G,��Yesio
4 Yiolii41 ;er 4001460005 ire 00dig �his'v�sit; Yoh wii1]teegiye 0o WOO
comes deli& allouti this visit: ... ... .... ... .
ale rs-. —
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date: .� dl S/p0

i`.
! -- s • ,4 - .r r� wf — vy:r. .. .win-a"�.:.., «-�c�-•�--'— r— �, ..�f'
A `
Facility Number: X2 — Date of Inspection
—5. Are there any immediate threats to the integrity of any of the structures observed? (iel 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
closure plan? ❑ Yes ❑ No
(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 ❑ 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 Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes .ONo
11. is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes kNo
12. Crop type Xde.�L_-
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 XNo
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ Yes ❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Oe/ WUP, checklists, design, maps, etc.) ❑ Yes ❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports) v El Yes ❑ No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? XOC' e 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?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes ❑ No
❑ Yes No
24. Does facility require a follow-up visit by same agency? [KYes ❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? Awkyes 990
: NO y1000q>�s:e- 000CWndbg 00 j1Wd• dttrft g ��tjs; 4 • yoo wi��•tebfty # #it . . .
• coriespo deli& abaniti this visit .......::............................ .
.ev
s -
Reviewer/inspector Name�-
Reviewer/Inspector Signature: _ Date: 5/00

Type of Visit 0 Compliance Inspection 0 Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Z Date of Visit: .z� �` Tune:
rO Not Operational 0 Below Threshold
® Permitted ® Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name; .............. ..
yyryy..���.�.r.�....,��..... ....... ............................ County:.........
OwnerName:.. l!!�/............ �. .._....»................... Phone No:........... _..........»................................. .........
...
Facility Contact: ..../..�!��...- .....................Ti le:....................................... Phone No: .... .......... ...........
W ....W
Mailing Address: ... WcM?.....�. .. .............� ����.�� /Y �..r �f.1�....._.. . ... .......y................ ..........
Onsite Representative:._...,` . ..0 Integrator:
........... ... ............... _. _ ._�.�_... ......
Certified Operator: ................................. h�/ Operator Certification Number: ...................
Location of Farm:
❑ Swine' ❑ poultry ❑ Cattle ❑ Horse Latitude • 4 « Longitude s 4 �u
Design Current Design Current °Design Current
Sw1ne , . __ . Ca ci Pa elation Pouf „ ; Cattle Ca... p Po Hon';-' . Ca c1 Po ulai>aon
Wean to Feeder ❑Layer F.5airy
Feeder to Finish p ❑ Non -Layer Non -Dairy -
❑ Farrow to Wean
Farrow to Feeder Other
❑ Farrow to Finish Total Deskn Ca aci,
Gilts P - '
.� ❑ Boars Tot$1:SSI W
Number,olL 'Dons / ❑Subsurface Drains Present Lagoon Area ❑ Spray Field Area
�.-... :.
H61ding.P6n6 / Solid Traps:_ = No Liquid Waste Management System .-
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
040
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
El No
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
[] Yes
&No
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
CR-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
KNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: .............�� .
Freeboard (inches):
5100
Continued on back

of Visit OP Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Vlsit 0 Routine d Complaint_ O Follow up O Emergency Notification O Other 1 ❑ Denied Access
Facility Number Z Date of visit: .�Q d/ Time:
Q Not Operational 0 Below Threshold
® Permitted 0 Certified 0 Conditionally Certified 13 Registered Date Last Operated or Above Threshold:
Farm Name: .� �.!!^l�rJ.. ,/ll'�.. _ : County: . ....... . .
Owner Name: F!Phone No: . ................ �................... .. __
Facility Contact: ... .............. .................. Title:.. ......._......... ................
........ ...... Phone No: ........... ....... ........ .....
_� ».
Mailing Address:.........I..... --- ����.�►... / Y ,fir....... �----...-
Onsite Representative:....... _ �` f------------.............. Integrator: ........ 13,e-a4a l; (Jd---•t �.✓�!
.............. - - --%..
Certified Operator: ........ .....f Operator Certification Number:.
....... ................... ... ...................... �.... .
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ' °' Longitude �• �4 is
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes J�f_No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made? ❑ Yes jl No
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes E!jjVo
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ANo
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ,9 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes [&No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Str ctyre�,Structure 2
Identifier: ............................
Structure 3 - Structure 4
❑ Yes dNo
Structure 5 Structure G
Freeboard (inches):
5100
Continued on back

Facility Number: Z-3 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ 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?
(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 maintenancelimprovement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type %j 9A61
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ,
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application).
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0; �-YiQla�i�gs;o� d�f c�ep�ie* ire �pte� di»ing tfiis;v�sit; - Yb� w��•lree$iye ttio i'u�ther .
coriespondeike' about this visit.::::.::::..:::::..:..:::.......... .
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes >No
❑ Yes Xb10
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �rNo
o❑ Yes
❑ Yes ❑ No
❑ Yes No
AYes ❑ No
❑ Yes PkNo
Reviewer/Inspector Name
5/pp
Reviewer/Inspector Signature: �„ _ _ Date:

- �`•"°.:`..ssr'75�+iii+.#�i'�{`+'W-'P�vi�•+!t!''��/`.'^"wr`..-z.,. �a-..r--mom--�.._-.. ,o.—.- r--,.sv».w�-.r-,....-s-+r�..., ..�K.. ..- �.. -..,( .•._rx+�'r1.r:'a.-:...,i ... �.r �.- ,.....�. ..-, w,
" Facility Number: g732 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
closure plan? ❑ Yes ❑ No
(If any of questions"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 ❑ No
8. 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
elevation markings? ❑ Yes ❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
IL Is there evidence of 11over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ❑ No
12. Croptype JJ 40,,, �
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
�12
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ 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.)
❑ Yes
❑ No
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
D No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
tKNo
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?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
23, Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
•
❑ Yes
[KNo
r
24. Does facility require a follow-up visit by same agency?
[es
❑ No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
MNo
i'VQ�yib���lQnjs:e� d�fr�encie� wire nQfec�• �lH`}t�g �his:vis�t; • Y.o4>E wi��•t�ee�iye �o: fui'g1�r -: :
corresporideirC'e abuat this visit ::..::..:::.:....::::::..:..::.... .
(iG///•r/r/1�� G�SiGt*C�'
Reviewer/Inspector Name t: ram• '
Reviewer/Inspector Signature: `�' Date: ^ c'L� a2%!� 5100

Type of Visit O Compliance Inspection O Operation Review 5 Lagoon Evaluation
Reason for Visit 0 Routine O Complaint. O Follow up O Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit: I Z o i Time:
a i00
Not Operational O Below Threshold
13 Permitted Of Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
Farm Name: 5,:�,on SPa�� Fzr .... County:... s�Sg!►...................
_. ........ �......^ 1 ..................... --- .......... _.._ ....... .
Owner Name:.......... S.'.'ti'IGz+�..........--•- r-3R'k:. ............................................... Phone No: .... �f t �J9Cj..... .. . ............ .
Facility Contact: ..... A... e- i-."�^__5—ij..... ...... ..... Title: t� Phone No: CM 0
.....................�...._... II....... ..
MailingAddress:...�.._��.....�.� 11a�,t* S .. . ................................................... ........ NC............... .................. .a�
Onsite Representative: ..............�i............. ..................... ......................................... Integrator: BIZ?+-�Y:)..�...... ............. .........
Certified Operator: q,-!.r?c l� S-.......... Operator Certification Number O
Location of Farm:
M Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ' '° Longitude �` �' �"
Design..: Cu�rent'. Design Cdrrent Desa<gtn Ctvr=t
rSvviwe'Ca Population Catte ,.F_ foCa Pelation
Wean to Feeder ❑Layer ❑ Dairy
Feeder to Finish ALI p ❑ Non -Layer 1 ❑ Non -Dairy
Farrow to Wean -
❑ Farrow to Feeder Other
El Farrow to Finish Total 0t3`
❑ Gilts Diiign Ca aP ..
❑ Boars Total SSL-W
Number:of bons Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area -
-.;13old�ng Ponds L Solid Traps No Liquid Waste Management System
a
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray 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) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes (' No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes J-No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ......................................................................
Freeboard (inches): �g
5100 Continued on back

Facility Number: goZ — agg 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
closure plan? ❑ Yes ❑ No
(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 maintenancelimprovement? ❑ Yes ❑ 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 Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
H. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
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
Reauired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
❑ 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.)
❑ Yes
❑ No
19.
Does record keeping need improvement? (ie/ 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?
(ie/ discharge, freeboard problems, over application)
❑Yes
❑ No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
❑ No
24.
Does facility require a follow-up visit by same agency?
® Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
4 tiorwoos or. dcficjencie weretptt alx i4g}s;visiti Yo{t vv�i �eeei}'etie�
6ries deuce' ahauti this visit
OA - n+ -1i - fo�lat- lagoon e�llai�.a .c+n. kc%arx, Iivel o�Pav' 4, to
be- 1ns;k A 95yr &Iq kr S4,np-. Ale tte"r s5n.
CtV�;�u�'� ;� �,•h'rM. �l"��''� � �'mn�ac.'� �(� Q �514F� � �is[u5.s i��r+
lowel C-4 !'erd 13U)a 100�n �oc,�crr'r� lugcor► [we�
-.��
Reviewer/Inspector Name Slit = l - `_
�:�I:-xQ.: f —.. r z.`is Wes.-_ �. a'T-ems,
Reviewer/Inspector Signature: _ _ Date: Q 50to 5/00

e,Dlvmon of Water Qoshty m
py.
' ' Q ion of So�t7 aad Water Conservation Dives
O;'Other Agency.—
X2^=`
r
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Sz. 3S' Date or visit: lz %�'Time: �� Printed on: 10/26/2000
Not Operational Q Below Threshold
© Permitted ® Certified p Conditionally Certified © Registered Date Last Operated or Above Threshold: ..................
r
Farm Name: ........ sf �.a .................................................. County:........: ''7�cY�� ........................ .
Owner Name' 1� Phone No: .`;3y�
1..� m''........ ,,......�. ..............................
Facility Contact: ° ",. _ n ............ Title: Phone No: ...............................
..........h.. .................... J `......................................................
Mailing Address: ..... .!-Ju�....1.!e!G �. ds. �i,.�. I1! ................................................. ..........................
y�....... ........
,�j /
Onsrte Representative: //!� �il —'./� Integrator: s�,�' �f ,g' o�,✓
.................t............. ...'._......................e-..........<t...............
Certified Operator............��F�,�Q;f+./� Operator Certification Number: ..........................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ° 14 Longitude • 4 64
Design Current
Swine C'anacity Panulatinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharp,es & Stream Impacts
1. Is any discharge observed from any part of the operation`? []Yes t No
Discharge originated at; ❑ Lagoon ❑ Spray 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) ❑Yes No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) ❑ Yes No
2. is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes JJ No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ElSpillway RYes ❑ No
Structury, I Structure 2 Structure i Structure 4 Structure S Structure 6
r
Identifie: ....................................
Freeboard (inches):
5/00 Continued on back

Facility Number: 2 -7W Date of Inspection Printed on: 10/26/2000
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes TA No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? [I Yes �No
(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 No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yest1N o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes XNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes XNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes XNo
12. Crop type A-.e. "4' ,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes MNo
14. a) Does the facility lack adequate acreage for land application?
❑ Yes A 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 )0 No
Renuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑ YesXNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) �/ ✓ ❑Yes XNo
19. Does record keeping need improvement? (iel irrigation , freeboard, waste analysis & soil sample reports) ❑ Yes ,W No
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes allo
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?
(ie/discharge, freeboard problems, over application) ❑ Yes No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ®No
24. Does facility require a follow-up visit by same agency? ❑ Yes [R No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes P No
�'�10 yioiatioris o� dgfcie'r��ies mere ngte ...... th:..... .. . . . . . r... . they
correspondence. a"baut this visit_
(re€er toq
Comments ! t .. -
uestion #) Explain any -YES answers and/or any recommendations or any other comments:
Use driiwings of:facility to:better explain sifuations.-(use,additiiona_l pages as neeessaiy)
ReviewerMspector Name
Reviewer/Inspector Signature:Date: /-z 2% �"� 5100

Facility Number: S�Z — 3V Date of inspection Printed on: 10/26/2000
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
No
roads, building structure, and/or public property)
29. Is the land application spray system intake not Iocated near the liquid surface of the lagoon?
❑ Yes
NNo
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
NNo
31. Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
P(No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
xYes
❑ No
Additional- Comments -an or rawin
•
5100

. 4
1
r a+6V°x
z5i� �
f
s0 Division of Soil
1 Division of Soil
-MDivision of Wat:
Other Agency,-:
Routine 0 Complaint 0 Follow-up of
Facility Number
'ater Canservabon .Operation Renew �. �- - j t � � S �,
'ater Conservation Compliance inspectron�,
�l►ty ';CompEiance Iaspgctioit
inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection bl
Time of Inspection 11,4 24 hr. (hh-.mm)
[Permitted Certifiedd (3 jCoonditionallly Certified (] RegisteredJE3 Not operational Date Last Operated:
Farm Name: .....a `Y1 48t� �� !/ &rr'' a_...... ... County:........- 3 .......... .. ..................
14
Owner Name:... ......................................... ... ....'.. . Phone No:.......-..........-.
FacilityContact: .......... ....�!�........,sp�` .. ...Title: ................................................................ Phone No: 5.....................-.........................
Mailing Address:••••....a1.a1-.......c.......... -..........................................1 N..c................. 235
Onsite Representative lkr Integrator: f
p (.... ......... �..........._............ .......................... (................ .......
Certified Operator:.....-lJ.e t kL 1---...— `............�p....�.. r . ......................... Operator Certification Number:..........................................
1 ....
Location of Farm:
.................... ................................................................................................................................................................... ..................... I ................ .
.............................................................
.............................
Latitude 9 6 •4 Longitude
Design Current ; ; _ :. „,. Deli ' g gn Current' Design Guirrent _
Swine
Capacity Population ',.Poultry Capacity -Po ulation Cattle Ca acity _Population
Wean to Feeder Layer
Feeder ❑ Dairy
Feeder to Finish ❑ Non -Layer I ❑ Non -Dairy
Farrow to Wean
❑ Farrow to Feeder ❑ Other _ -
❑ Farrow to Finish Total Design Capacity a q y o
❑ Gilts -
❑ Boars Total SSLW .
$Number of.Lagoons ❑ Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area
I :oldmg Ponds [Solid -Traps ID No Liquid Waste Management System _
Discharg & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ YesNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance inan-made? ❑ Yes E)rNo
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes No
c. If discharge is observed, what is the estimated flow in gal/tnin? IWIA
d. Docs discharge bypass a lagoon system'? If yes, notify DW ❑ Yes No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure ? Structure 3 Structure 4 StrucWre 5 Structure 6
Identifier:
Freeboard (inches): .........4W_ .
5- Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑
seepage, etc-)
3/23/99 Contina
i

Facility Number: SoZ — Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
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?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
1. Is [here evidence of over application? ❑ Excessive Ponding ❑ PA
12. Crop type nm ,Z//J
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
h) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
1.5. Does the receiving crop need improvement?
16- Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail] hall co onents of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, ru s, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge'?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
P. � ,604'tigris or def eieucites -were ,n - dirtt:itng this:visit: YO. will -receive d6 further -. •
rorres oiidei><ce. moot: this vislt.
a� `recommendatii
aces as necessary
❑ Yes to
❑ Yes No
❑ Yes No
[]Yes Q'No
❑ Yes IgNo
❑ Yes ❑ No
❑ Yes �fNo
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [)(No
❑ Yes No
❑ Yes ❑ No
❑ Yes No
❑ Yes ❑ No
❑ Yes No
❑ Yes WNO
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ Yes No
` � /t¢ CB`t� -Uv 3 l�at ov+R c'�LOt�IY� atQ Q l
Ir
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
3/23/99

Facility Number: gi —� 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?
ii
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ��io
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
roads, building structure, and/or public property) II
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 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
_ iti6na Comments -an or awtn 4
rt
AL
.r
3/23/99

0 �Division of Soil and Water Conservation [3Other Agency
a`
Division of Water Quality k ,�
® Routine O Com laint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection /!
Facility ;'umber Z
Time of Inspection d 24 hr. (hh:mm)
13Registered 0 Certified 5 Applied for Permit ©Permitted JE3NotOperational Date Last Operated:
Farm Name: �. c .s 1 � -- t`.. . ......... County ,. ,��............
. .......
Owner Name: , �H^u^ ..... �........... Phone No: �.... 2 l . 7....................................... ... 9... ......... 2l�.. ..-•-.------...
. .. . ... .... ..... .
Facility'
Contact: ..... Title: ,�•!."�r.�..r..��/J.�................. .............. ......_....------..... Q------- Phone No:
Mailing Address:........ / / 'c ate.- , C�.✓.i✓ /t/.. .2 F�?P ........................................................... ..........................
Onsite Representative:...............�/.....��7............................................... .--....... Integrator:--...-- �.. �...�.... � ��................................
Certified Operator:...............PX0% ....--/.......... `�............................ Operator Certification Number...........................-..............
Location of Farm:
Latitude • f 0 ff Longitude • ' [f
r
wDesign Current £ "iiesign Curredf Des
A
Capacity `.Population Poult%y , , " Capacity Population Cattle Cap:
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
- � - --- --
Pltl IDer 0111, Lagoon5l I H
�.L
❑ Layer
❑ Dairy
❑ Non -Layer I
I-❑Non-Dairy
,nJ❑ Other
Design Capac►ty tt `
T snt^,
i-'. ,,1w,
✓r ode ,v4S<,., R�
A H '. '3 site ..
•'£3.ie
Total SSLw
11
,` ❑ Subsurface Drains Present 110 Lagoon Area ][]_Spray Field Area
❑ No Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes VNo
2. is any discharge observed from any part of the operation? ❑ Yes QrNo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes krNo
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes WjNo
c. If discharge is observed, what is the estimated flow in gai/min? IL/
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes qXNo
1 Is there evidence of past discharge from any part of the operation? ❑ Yes RNo
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes P`No
5. ,Does any part of the waste management system (other than lagoonVholding ponds) require ❑ Yes No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
7/25/97

Facility Number• —
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LagsoonsHoldine Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
❑ Yes kNo
❑ Yes XNo
Structure 5 Structure 6
Identifier
Freeboard(ft): ......... .............................. ................................ .................. ............................................................... .
10. is seepage observed from any of the structures? ❑ Yes XNo
11, Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes XNo
12. Do any of the structures need maintenance/improvement? ❑ Yes XNo
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13.
Do any of the structures lack adequate minimum or maximum liquid level markers?
❑ Yes eKNo
`3'aste A lication
14.
Is there physical evidence of over application?
❑ Yes A No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type1Qi .t�........................................ ......... ..........................................................
................... ....... ........
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes XNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes )(No
18.
Does the receiving crop need improvement?
❑ Yes �,�LVo
19.
Is there a lack of available waste application equipment?
❑ Yes 19No
20.
Does facility require a follow-up visit by same agency?
❑ Yes Vo
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes XNo
22.
Does record keeping need improvement?
❑ Yes WNo
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes XNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
Ves ❑ No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes ❑ No
0-No.violations:or deficiencies:were,noted^during this'. Y.ou,will receive.no' ftirtlier.:,
:•corresporideQceatioutthis'vis�t:�:.:.. ...... .....�..�..�:. :•;•:-.:::•:�:-.� :�.. ::•.. .�
9 /W
w
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature:—��,�f�e Date:

10 Routine 0 Complaint 0 Follow-up of Dw2 inspection 0 Follow-up of DSWC review 0 Other
Facility Number
Date of Inspection
3
Time of Inspection 1-'ZD 24 hr. (hh:mm)
Total Time (in fraction of hours �
Farm Status: ❑ Registered El Applied for Permit (ex:1.25 for I hr 15 min)) Spent on Review LZ_J
El Certified ❑ Permitted or Inspection includes travel and processing)
❑ Not Operational Date Last Operated:....
Farm Name: _ ...5/.'x- p.-�l .._ ``... _ ...�_...._ ..___.. _... County: _ ..... ....., _ .. _.�. �.
Land Owner Name:.
_.. Phone No:
__/�... �_...__........._ ....l.. _ ......... _ ..... .... _
Facilely Conctact: ►1 L ? �` !!... !! Ti le: _ .... W_... .... _ .......... Phone No: .... . . .... ..... _..... _...
�f ._..
Flailing Address:..-. �.��....5 2!9�' .... _ .. _ .... Cr/�-�' (`!. :.... . _ ...... ——...... ,.......
Onsite Representative. ...?.1y—...... /��_ .... _ ... ...__ Integrator:-,,,c�J���� ........_.... _.... _.... _ .
Certified Operator: �"'4!J, r �'
p .............__..... PG.I� .. ...._ �..:.`.`.��.............._...._..., Operator Certification Number:
Location of Farm:
Latitude E=" LongIX1
itude L�J• �` �"
Type of Operation and Design Capacity
Design: ..Ciirrent Design X aCIIReIIt � � Design Cll[Tenty .,
.
ry
nK ❑C
Swine
tPix Ca act xPo ulatiCacttvPoluatonCa aco tationv
e❑ Wean to Feeder Dairy
Feeder to Finish ❑ Non -Laver ❑ Non -Dairy
Farrow to Wean Ark Farrow to Feeder "Z Total Design Capaeity�
.�
Farrow to Finish
TotaI SSLW
n
❑ Other
� a,w ,�. �� 3? ` r,�r �v C � ,x„"� �.*f'." � �w X,: x�' ;uw �s�a�✓€ s'b¢�s'z,�s.
. , .`�esz?r 7� ,�.E,'�,wou,._ .:.-.,,... ,,,, �-w..;�eavo-..... naL'�, ei r ,_ „ --;, ,,.�.. �r ''.. swt '�.dE.M.e. ,?.. ,<..w.q. ui<ra:. ,�s•v� ,
Number of L g ons Hold g ponds / ❑ Subsurface Drains Present
x La ooa Area10 SprayField Area
Hera[
1. Are there any buffers that need maintenance/improvement? ❑ Yes RNo
2. Is any discharge observed from any part of the operation? ❑ Yes )N[No
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes 1$No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes RNo
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes R "o
3. Is there evidence of past discharge from any part of the operation? ❑ Yes J9 No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes KNo
5. Does any part of the waste management system (other than lagoons/holding ponds) require � Yes ❑ No
4/30/97 maintenance/improvement? Continued an back „

�[3 DSWCAmal Feedlot Operailoa Review
DWQ Animal Feedlot Operat>on SICe Inspeetl<on '
10 Routine ® Complaint O Follow-ue of DWQ ins ection ollow-up of DSWC review O Other
unit vs ■�3aNrtiE��i� I//7��
Facility Number
Time of Inspection y_'10 24 br. (bb:mm)
Total Time (in fraction of hours
Farm Status: ❑ Registered ❑ Applied for Permit (ex:1.25 for 1 br 15 min)) Spent on Review L
❑ Certified ❑ Permitted or Inspection includes travel and processing)
❑ Not Operational Date Last Operated: _. .............
Farm name. Corn _.... 5...... ....._ .... _�.... ......
�cs 7
Land Owner Name:.. S_^^..Q� ...� � ..... _....... ....... Phone No:.......��C� _.... �.�Z. �..............��.....,....._...
Facility Conctact:...—. 1n_ d{�... _ Title: � .... _.... / .... _ Phone No:...._ ...._ .. , .... ......
Mailing Address: r!.�1..... L �c� e! ._......,trf.'-!:`'..1��.'_7�..��.................. ..........................
Onsite Representative:.. ..... -...ae Integrator: ._,1`,--------------.......
....—. .�_....
Certified Operator-....2 �^_^..d��. �^ "0.v' Operator Certification slumber
Location of Farm: t
Latitude 0 4 46
Longitude ' �.
Type of Operation and Design Capacity
ClirreQt " De51gn,<" rg.saDeSl O� CuCCCII[ '
ry Swine �' Ca `act;. Po ulat;on Poultry Ca Capacity Po utahon :: ,:_Cattle 1;
Ca aci ,. Po ulation.t
,{ ❑ Wean to Feeder r: La er ❑ Dairy -
Feeder to Finish E- [I Non -Lay er sx ❑Non -Da'
-,�
Farrow to Wean mw- w �;rnwa&,•,�'-ax�i r Farrow to Feeder =4Totai Design Capacity x Y
rl i Farrow to Finish
r •..
❑ Other >
..�, .,. c,:a ...�,..M u::: �eo-� f• � '� w[w, ..�,'''c =,�� 45ota;.;ra� x N'C�S �<
' Number�o-s!�agq l,,Boldijjg1LP0jnj4jN Subsurface Drains Present
f��;, ���� ❑ Lagoon Area 4 ❑ Spray Field Area
t
�� :::
General s
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharbe originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface` Water'? (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)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
S. Does any part of the waste management system (other than Iagoons/holding ponds) require
4/30/97 maintenance/improvement?
❑ Yes D�No
❑ Yes flit1Vo
❑ Yes KNo
❑ Yes IgNo
❑ Yes CkNo _
❑ Yes J9 No
❑ Yes A[No
Yes ❑ No
Continued on back

Facility Number:....Z.?_
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
MrNo
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
PQ No
8. Are there lagoons or storage ponds on site which need to be properly closed?
[:)Yes
Wo
Structures (Lagoons and/or Holding Ponds]
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
P No
Freeboard (ft): Strucuile 1 Structure 2 Structure 3 4 Structure 5r
iy
Structure 6
^Structure
10. Is seepage observed from any of the structures?
❑ Yes
RNo
11. Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
RNo
12. Do any of the structures need maintenance/improvement?
❑ Yes
JWNo
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
67RY No
Waste Application
14. Is there physical evidence of over application?
❑ Yes
RNo
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type �-t'4...... - ^.... _ .. _. ...�
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes XNo
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes RNo
18. Does the receiving crop need improvement?
Yes ❑ No
19. Is there a lack of available waste application equipment?
❑ Yes XNo
20. Does facility require a follow-up visit by same agency?
r�Yes ❑ No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑YesAVNo
r Certified Facilities
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
XYes ❑ No
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
24. Does record keeping need improvement?
XYes ❑ No
Corn ients (refer rA'cjuesttoix' Explain any YES'answers and/or'any recommeiidatiotis or any other comments
Use drawings of facility to iettei explain situattons.` use addrttonal pages'as necessary}: y r
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13, �.�q.b..1 a�o�'- ,/0 �. - 7`7t /Ur;•��..JIL �,v C� �%zr
t�_ ..
Reviewer/Inspector Name : .:
t
a,,,w..
Reviewer/Inspector Signature:
Date:
/
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97

.. '--+w- yr_ .. •� — a - w i.4r - _ .. � Y.,.y. " - �. .r. �...�� X.,y., :... n --. - .,,,; i=
Facility Number:
6. 1s facility not incompliance with any applicable setback criteria in effect at the time of design? ❑ Yes allo
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes No
8. Are there lagoons or storage ponds on site which need to be properly closed?
= Structures (Lagoons and/or Holding Pond
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structu_Te 1 Structure 2 Structure 3 Structure 4
-. �.. �v . _ ._ .. _ .. ....... .... .........
_ .. _ .
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-I2 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type.......A �C-.--.-,-k"...................—............. ----.......................---........... ..... __....,-..............
........._..
❑ Yes Mo
❑ Yes P No
Structure 5 Structure 6
❑ Yes R No
❑ Yes RNo
❑ Yes XNo
6iY>No
❑ Yes RNo
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
FQr Cerfified Facilities Only (t,,c, �� ��s yor.€.�/ih��lA.�f�rsvc/.�.Ec.• }
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes )Q No
❑ Yes No
AYes ❑ No
El Yes No
' \ es ❑ No '
❑ Yes"q No
AKI-Yes ❑ No
❑ Yes �W No
j Yes ❑ No
,Comments,{refer to question #) Ekplarn any YES answers and/or any, recommendations`6r'any oth' ' 'mments:
co
..
Use drawings:offacility to better explain situations. (use. additional pages as necessary)._'
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�_ /(/OPJ9—� Ce/.Q r ,�/,ate/�A'/f• /,t�-/,.,,r U��.�-`��� I?'/i-+ _
s
Reviewer/Inspector Name " ..y 4 _ .
° Reviewer/inspectorSignature: Date:`
i
,b
cc: Division of Water Quality, Water Quality Section, Facility Assessment Unit 4/30/97
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Report: A ronomicDvision 4300 Re Creek Road Raleigh. -NC.' 27607A465' 919 733-2655: r+
Grower: Spell, M ice Cubes 1'v; County � xterrsioo Direcror rn
1317 Chancey Rd. USDA•NRCS-Samcson R
r e'� Clinton, NC 2832E rnviro Ag. Comploim
WasteAnalysisRp"'Ort Farm
3112/97 Sampson County
Sam lg Infa. Laboratory (Results arts r.million unless otherwise noted).',
Ser►�plelt3: rV_ _ P K a fA fe fir,, 1rr... (_. i' 1
L504 �liNa? - 483 M F>3.8 516 111 35.; 70.1 4 31 4f 063 rJ J0 J:BT
Waste Code: I ?N •1d M IV,M 1. V! ! M I ,M.
i 5S I OR•N No Ni Cd Pb - A?' Sr? I i , PH SS C-N.._ „yM� ca%
UtNsaipti0rt: 12c _ _ 7.48
RecomrnenMior?s; : tVutrients Aid ilable'for:First Croy' ` lbsJt_0_A4 g8lkhtS :` OtiierEierhonS !bs_110UUgallorrs
tipplicsti4n Lr tlxxf. N :.. P2t�$ ..: Kai:. C'4Mr " ` S' fP. Al $r'c 1,
Irrigataj.
n 1 4':.:.[1.85 ...: 1 G;b5 0.21 0.12. ... 0.03 T' •1 .. `, r
mn
�
m
�
o
m
OF
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0

�'. CI?�x D sit► � b"�=. NG 'z R"2Ral� •2 ti� �
�->�3
1 u' $�, 11
Grower Spe , Mi c
Copies to: County Extension Dimelor
1317 Chancey Rd.
Enviro Ag. Comphance
a
C1int(m, NC 28328
So
Test Report
Envim Ag. ComplianceParyn.�
G L
PU Box 918
Clinton, NC 28329
1 1 7 SERVING N.C. CITIZENS FOR OVER 50 YEARS
SwEgn Coun
Agronomist Comments:
iiloript'
IMP-liii`"
f trtr�dat�lnie
sample No. Last Crop
Yr TIA
Crap or Year Lime
N PXIs ISO
Mg Cu
Zn
B Mn See Note
01 Berm liay/Pas,E
r
1st Crop: Henn H2y/Pa.,;,M AT
180.220 0 40 6i1
0 0
0
0 12
god Cro :
Test Results
5oti Clum NM% W/j' CEC BS%
Ac pfl P-1 K-1 Ca% Ng%
Mn-1 Mn-AI (1)Mn-AI (2) Zn-f
Zn-Al
CwI
S! SS-1 N(b-N NI&N Na
MIN 0.36 1." 4 3.5 8t).0
0.7 6A 248 82 53.0 14.0
- 8 178
I78
10
2 0.]
Si�pr�t fQllla`,:
_,1J��CCI)E11
_
SQmple No. Last Crop
o Yr r/A
Crop or Ye4r Lime
N boy- 0s AO
Mg Ca
'Zn
B Mn_...
See Note
02 Sogbeans
Ist Crop. }ferny liay/Pas,M .5T
180-220 0 100.120
0 0
0
0 12
2nd
Test Results
Soil Glass HMS W1Y CEC BS%
Ac pH P-1 K-1 C % dfg%
Mrs -I Mn-Al (1) Mot -At (l) Zn-I
Zx-Al
Cu-1
S-1 SS-1 fflb4 Ar&N Na
MIN 0.6 1.37 .I. 7TO
0.7 6.2 220 5 55.1) 14.0
65 48 14
14
77
2 0.0
-?it�e�°'tiFv. '�filU
,w:.1fi�.f�:�II['
i ':�o�,nn�in "'tloil� ''
`�a�ry�-
r•
•�
-.
Sample No. Last,Crop
o Yr 77A
Crop or Year Lime
N P2O5 AO
Mg Cu
Zn
B Mn See Note
03
r
1st Gmp: Berm Hay"Pas,M AT
1811.220 0 100.120
0 0
0
0 12
, 2nd Cr
Test Results
Soil Class HX% W/V CEC BS%
Ac pH P-1 K-1 Ca% Mg%
Marl N#-A1(l)Mn-Al (2) Zn-I
Zn-Al
Cu-1
S-1 5S-1 h(b-N N1-N Na
MIN 0.41 1.38 2.8 79.0
0; 6.3 214 51 56.0 15.0
64 48 142
142
75
22 0.0

IRRIGATION RECORDS
FARM NAME
Mike Spell Farms
FIELD NUMBER
1
FIELD SIZE (ACRES)
10
FARM OWNER
Mike Spell
IRRIGATION OPERATOR
Jim McGill
OWNER'S ADDRESS
1317 Chancey Rd
OPERATOR'S ADDRESS
508 Woodrow St
Clinton, N.C. 28328
Clinton, NC 28328
OWNER'S PHONE
910-590-3474
OPERATOR'S PHONE
910-592-2807
CROP TYPE
Coastal
RECOMMENDED P.A.N.
200
NO. OF
FLOW
PAN
NITROGEN
START
END
TOTAL
SPRINKLERS
RATE
TOTAL
GALLONS
P.A.N. PER
APPLIED
BALANCE
DATE
TIME
TIME
MINUTES
OPERATING
(gal/min)
GALLONS
PER ACRE
1,000 GAL
(lbslacre)
(lbslacre)
3119197
300
1
300
90000
9000
1.4
12.6
187.4
3/20197
300
1
300
90000
9000
1.4
12.6
174.8
3/21 /97
300
1
300
90000
9000
1.4
12.6
162.2
3/22197
300
1
300
90000
9000
1.4
12.6
149.6

WAISTL UTILIZATION Pi AN
iii w - — ..a I rii d_i F`ti E'i i''E L_L.- [. i1 u f-; t : SAPriF Si_IN'
NC
TvpF _of' ;_;`o,: u c t i an ur, i t----.FIN'I'_3HI NG
Type =T Lr',asto fac t I i ty----- ;Ariaet- i s Ldori
Your an i ma I Waste management fat I I i ty has beers des i 3ned fur a
giver: s or-aSe c a p a c i tv. When the ,. as:.e reaches the chest;fined
I eve I , I'4 frius t be I Arid c,pp I i eu at a +sr,e'Z 1 f I ed rate to prevent
p„_ I I ut 11:=„ c,f s.ur--"ace grid/ur 9r-ound w s e.-. i hfc F, I ant r,LI'Lr- i erits
i ri th:L, al"I i U."a. i Waa'! ;_. Chou I d be 1.3sPd tc t-e+Juce the `a[roc,ur, t of
cor,.imet-c i ;a 1 fer-t i I i zer reu i r`ed f:_ir- the s_t-ops on the f i e i ds
where the waste i s to be app II i ed. This waste ut i I i zat i on plan
uses r: i tr-=.=;der, as the I i m i t I n3 rrutr- i eri'L. Waste should tie
aria ly"-e1:3 Liefor--_ each appI icat ion c"yc I and annual so I tests
at-e anc,_ILrcajed so chat all F,1ar,t nutr
t = L i, ients car, he GaIanced for-
e a 1 iI c y l e 1 d s j' t h e c r cIII
e t / t c: t, e r I_e W rf .
5ever-a i -Fac tors ar-e i r, portarit i r, i rr,I err,ent i ri; your waste
Lit i I i u at i !,ri p i ari i ri +:+r"UPt- tct roax i rr, t L the f er-t i I i zer" value of
thie way:, L+_ and to trtsuve that it i s :i.I.,F' I i e,d i r, ar:
er,v I r 4:1T 7cent�a ! -v zaaf e ir,anrfek, . A f i_ja � jjpp I y LJaStE+ t,h5@U �+n the
needs =4 the c:r.i_�p "tc, ic,e :3vown and".he nutrient content of thfe
Waste . T).-. I, CI v a p p 1 y rric,r- e rF i tt—ogert tr';ai'i the crop car, Lit i I i i.e .
So i i cyp s ar"=e iron _sr -'tar, ; as the-v ha-'.:e 14 i f f er-ent i rif i I te-at i 0ri
r a il— e ri. 4 11� I C ac h I� t:' U C-1 FI i J. 1 M! u� `, :i i cl. 1 I rl Cl t L, e a F: Fe I led t +:,
I and E:r- iJfate."" thf7r, 5. Lori5 I"I � FIeer" year-. Do i,ot
�: ij i = <:,, t..LI iSf.'L i� := i E S ur fi ! ?i j when the surf aC fe i s
f r-oLe I-: .. L I Li oE- :J- t -ie�e c =end it i ,.,ii rri:i. �` r,esu I t i rt Y t.j:,of f -1.f 1,
s Li r ';,.c e tn' Ci. t (�' i_. W1 i ri :Z r c, rf '_, i iL } -, r, F, s 1, �_' u I d a I� C, tie c o ri s 1 der e d t o
r-lvis' c'tiid :J=,wr,WII-,,J _ :fit- F,Y-iJb E, rij T o T,a;<1frlr.:e the 'va-1t Ee
11 t I "I L i_ -, L. `, r c= r, "i r- it >_ i, i o r, a is � � r " L, H u c e t h e P o t e i
% C
:.i I t:1 : i r:i .:' i i f' . i 1 3 r' Cow I r, S c r F` o r"
Ua'•y'5 Fir i ��r- 'I; f F` I a.i-Ii:Ct,jec'c I n;� 'i:i:E wa�'%e
c,:,riSer-'Je t: er,%S a,',I u C e ,_,dC;r Fi ir,tiierilS.
a� i i L` �. e afI l I.,j,a c;.5 I s , a S e d ur,: i VF, I � a
e a j
�ijL,, I .,<-_, ri wise 'vas"fie aria 'V5 t v
t- L, 0 7 - 7 r Cii'I s r ii. 'L e : it e n 'a ::t e f'f T Fl i_ i -C. v .
£ Ll: iio_ t' ii:ci-rlc =Erti .: f i= i . : y 1 = based oil i;I"fe
Af c,-u is _If r':c,�- �- Pr _ dLlcedi L, 'Yi_-rir-.
-
:..-..__ ;:I.iifi"L.
,

^
^
Pa�6 e �
Ann our.t of P|anL Avai�ab|e Nitro9 &o Produced Per Year:
-----------------------------------------------------
2880 aoima|s x 2'3O |by. N/anima|/year = 6624 |bi�./yr
Avai|ab|e �'%l
App|yiw� the �bove amwunt of ,�asm s a bij Job. You shau!�
p!41 1 time avd I`ave appropriate equipment to aPply the waste io
a tifie }y manoerYour faci!ity is desi8ned for 180 days of
sto,a8e' T�e,efore, it wi I need to Lie pu�ped every 6
mooths.
Tract F i e j c" Soi} Crop Yip|d s' W Acres Lbs. IN Month to
No. No. Type Code Per A . Used App|)/
----- ----- ----- ----- ----- ----- ----- ----- ------
6337 2 Wa8 � 7 Too� �00 4.0 1584 MAR-AUG
6337 � WT 45.5 62 --- 12 MAR-AUG
----- ----- ----_ ----- --\--_ ----- _-- - ---_- ------
Tota} 19.5 7796
Avai|ab|e INi;Grogeu 6624
�urpius [Ir Eneficit -!172
Crop codes: l=Cerea} Srain3Fescue; 4=Ran8o Gr. Bermuda
51=Contna| Grazed Bermuda; 6=Hay|and Bermuda
��rrative af Ooeratio
�o`i aud ater C":unservat�vo L;/stric� 'Of TFice after you
rece�ve ��s�� aua/ysis rep"rt to u�t�in the amount per acre to
apply and �ppiicat/o* ra�e �,ior tm app|yinS
ste.
�rE!p�,ed b�` _0- ~�� -- --- ------- ��
Name Titie Date
�
C^/.curre�
(L�Z:, L o�uce~ CLod c:py

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ViIR
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or
o r
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k il" 'f ilif gV;2V
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41 4
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-VA

Facility Number- 39R
Division of Environmental Management
Animal Feedlot Operations Site Visitation Record
/ rD Date:
C� Time: az'
General information_
Farm Name: �_ 3�.'� County:__
Owner Name: �^ �. � v� s� 0� _ Phone No: S9 g 7 ,5—
On Site Representative: Integrator: P
Mailing Address:_A I G C Q.h cep P-.A- - --
G (�"Av= , . Nc -6-83z-p
Physical Address/Location: AJ S,,�o /i [_y w�
Latitude: 1 / Longitude: !
Operation Description: (based on design characteristics)
Type of Swine No. of Animals Type of Poultry No. of Animals
0 Sow ❑ Layer
❑ Nursery ❑ Non -Layer
❑ Feeder
OtherType of Livestock Number of Animals: w,
Number of Lagoons:`_ (include in the Drawings and Observations the fi
2
�ility Inspection:
Lagoon
Is lagoon(s) freeboard less than 1 foot + 25 year 24 hour storm storage?:
Is seepage observed from the lagoon?:
Is erosion observed?:
Is any discharge observed?
D Man-made ❑ Nor Man-made
Cover Crop
Does the facility need more acreage for spraying?:
Does the cover crop need improvement?:
( list the crops which need improvement)
Crop type: Zell Acreage:
Type of Cattle No. of Animals
❑ Dairy
0 Beef
cboard of each lagoon)
Setback Criteria
Is a dwelling located within, 200 feet of waste application?
Is a well located within 100 feet of waste application?
Is. animal waste stockpiled within 100 feet of USGS Blue Line Stream?
Is animal waste land applied or spray irrigated within 25 feet of Blue Line -Stream?
AOI - January 17,1996
Yes 0 No l'
Yes 0 No U'
Yes ❑ No 0----
Yes 0 No El ----
Yes ❑ No a --
Yes Q. NoPC
Yes a No
Yes ❑ No G�
Yes 0 No 0`
Yes ❑ No 0-

Maintenance
Does the facility maintenance need improvement? Yes Cl No ❑
Is there evidence of past discharge from any part of the operation? Yes ❑ No ❑
Does record keeping need improvement? Yes ❑ No 13
Did the facility fail to have a copy of the Animal Waste Management Plan on site? Yes ❑ No ❑
Explain any Yes answers -
cc., Facility Assessment Unit
Drawings or _Observations_
t
AOI -- January 17,19%
Dater —N. .
Use Attachments if Needed

Site Requires Immediate Attention: � I
Facility No. g
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: 7 " ! 6) , 1995
Time: /6)
Farm Name/Owner: J • - AI4 ✓ ,&
Mailing Address: M _ A d.Y( ^ p W C,44Kvv, .v c
County: �A�hl R5"
Integrator: ET lf."V I P{c.st�.� _ Phone:
On Site Representative:_ f-rO__ 1{'�✓ g _ Phone:
Physical Address/Location: Ftoo ,,. r-I•`Yf6-v t 76 l SG fJ
— G*ll M .'Is AV&- M .Yd 0^- Me -
Type of Operation: Swine V Poultry Cattle
Design Capacity: 7/1 _ _ Number of Animals on Site: �Y !7y
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 0Longitude: 0 ' " d fP d' �3 ,-
Circle Yes or No
Does the Animal Waste Lagoon h;
(approximately 1 Foot + 7 inches) '
Was any seepage observed from the
Is adequate land available for spray?
Crop(s) being utilized: rA
sufficient freeboard of 1 Foot + 25 year 24 hour storm event
i,or No Actual Freeboard: L G Ft. 0 Inches
oon(s)? Yes or �o Was any erosion observed? Yes or IV
s or No Is the�cover crop adequate? �s1or No
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? YLestor No
100 Feet from Wells? Ves or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line: Yes or DO
Is animal waste discharged into water of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or 6' 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)? �e or No
Additional Comments:
Inspector Name
J.
Signature
cc: Facility Assessment Unit Use Attachments if Needed.

Illez g 2—
WMTS CAROLIIM DSPARTlMqT OF , HEAD A HATMAL P S==
., . s• . r 4 r r e:a is
Fayetteville Regional Office
Animal Operation Compliance Inspection Form
q+ti- '�„1 .p •;y,'.� .r w:�..c(%.� ...,J• _- w:<.Ja-.: ..fit- .Y.a..w. .U'.
N<Y .'A<.'Au /T''>�5 �:/�¢,-�»C�T.
�•«,R -V+n .�wQM�- � i�-r'i^.:..: +rr
'-��riw:��
i mcn i
---.. ...-� ,o„p,,,� y,;�,,;,.«.,.�.�.�-+.-....�: �_�Q.�p....�Y r�+�-," _�-y.�q��•4oyr,
�,�;+,,..�a�a,:�■�..Y�y;.�:c�r��v�/,p;y��.,p..Y��.:..��.:�w�,y�;yw„r�..:a�+.��/.���:.Y ',:.y±+::
-
.-Boy- q4 A Clintz)n 2303
CQ+n San.• a9-75
All questions answered negatively will be discussed in sufficient detail in
the -Comments section to enable the deemed Fermittee to perform the appropriate
corrections:
SEMON I
Animal Ozaration : hni Sh
Horses, cattle swine poultry, or sheep
SECTION IT
MEM
1. Does the number and type of animal meet or exceed
the (.0217) criteria? (Cattle (100 head),
horses (75), swine (250), sheep (1,000),.and
poultry (30,000 birds with liquid waste
2. Does this facility meet criteria for
Animal Operation HECISTRATION?
3. Are animals confined fed or maintained
in this facility for a 12-month period? -
4. Does this facility have a C3ItTIP�VQ AMMM
WASTE MANAGENEW PLAW
5. Does this facility maintain Waste management
records (Volumes of manure, land applied,
spray irrigated on specific acreage Kith
specific cover crop)?
6. Does this facility meet the SCS minimum
setback criteria for neighboring houses,
wells, etc?

�UW XI
held Site JLanagsaant
1. iO animal waL W sLuckpilM OP iagoon
construction within 100 ft. of a OSCS
Map Blue Line Stream?
2. Is animal waste land applied or spray
irrigatad .;thin 25 fto of a U900 Bap
Blue Line Stream?
3. Does this facility have adequate acreaQQ
on which to apply the waste?
4. Does the land application"site have a
cover crop in accordance with the
MTIFICATIOli VLW?
5. Is animal waste discharged into craters of
the state by man-made ditch, flushing system,
or other similar man-made devices?
5. Does the animal Waste management at this
farm adhere to Rest Management Practices
(BMP) of the approved 00TMIC TION?
7. Does anima, waste lagoon have sufficient ��
freeboard? How much? (Approximately . i'4 )
8. Is the general condition of this CAFO facility,
including management and operation,
satisfactory?
5RCTION IV
r,Ments

2==GI STR.ki= IN - QIRM FOR ALNIMAL = E-EM 07 Qg=�ATT_ONS
Department of Environment, Health and Natural Resources
Division of Eavircnmental Management
Water Quality Section
If the animal waste management system for your feedlot operatior. is
designed to serve more than, or equal to 100 head of cattle, 7=
horses, 250 swine, 1, 000 sheep, or 30, 000 birds that are served by
a IJau4it waste system, th en t-':is _oral must be cut and :!Tailed
by 0ece=a-_er 31, ? 993 pursuar._ to 15A NCAC 2H..0217 (c) i:: order to be
deemed permitted by DE.`i. ?, ease print c? ear? y.
Farm Name: lr�Crl�c�l_y
Mail_Za Address i- + y ��
y14
Ccunc v : �r2.�r� - ?hone NO.
Owners) Name: i
Manager (s) Name:
Lessee Name:
Farm Location (Be as specific as possible: road names, direction,
milepost, etc.):es (' ros1�r7i�r, +a4(e `TS-l�h('rr-
-i rn F
Lat_tude/T_cng:.tude if known:C�)2,0al-oa-CG -o
Desicn capacity o+ animal waste management system (Number and type
c= con=;ned an_.may (s) ) __L4`TC) _Feeder t;Z �P7,!. 3j; -,
Average animal population on the farm (Number and t•_rpe of annual(s)
-raised) : rnC' o r
Year Production Hegan:,<�-)e-KASCS Tract � 7,r,r►+ L-1-
Type of Waste Management System Used: La -ZrricC.+i
Acres Available for Land Application of Waste:
n _
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