310042_INSPECTIONS_20171231

-AM
NORTH CAROLINA
Department of Environmental Qual

4 ""�° ,""
` "•`
r
Division of.Water�Resour'ces'
Rieffity NumberDivision
_
oi`$arl and Water Conseryahon : � �.
x
Other Agency
-
type of Visit: Q Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
teason for Visit: O Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: I Z y Arrival Time: ® Departure Time: County: Region:
Farm Name: 1)2i Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative: 1 1 y y,�:S kc ;
Certified Operator:
Back-up Operator:
Location of Farm:
Title:
Latitude:
Phone:
Integrator:
Certification Number:
Certification Number:
Longitude:
_-.�. 3:A.a - s,,;�x„�4 y L •i'r`s.. ..,_�.
Design Current Dest Current y: � , Des gn Curreuf
�.z ?.r
Swine Capacity Pop Wet Poultry Capacity1'op F Cattle Capacity
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
F Design XIJ
�.J jLayerS
Non-L
,lil IPullets
Other I
Discharges and Stream Impacts
Other
Poults
Cow
Calf
Cow
Beef Stocker
Beef Feeder
Beef Brood Cow
1. Is any discharge observed from any part of the operation?
❑ Yes �' No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes Ej No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
[—]Yes �No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR)
❑ Yes No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
[:]Yes ( a
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes ,jNo
❑ NA
❑ NE
of the State other than from a discharge?
_
Page 1 of 3 21412014 Continued

Facili Number: jDate of Inspection: S' %
Waste Collection & Treatment g
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? [:]Yes J�T No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ;2 No ❑ NA ❑ NE
Structure 1 - Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway? rnD
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes J:3'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 .1a"'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 Z No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ZNo ❑ 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 ;2rNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ONo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes J2No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l 0% 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
t2. 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
❑ Yes j2No.
❑ 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 �To
❑ 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 allo ❑ 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 _Lallo ❑ 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 _0 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ;2"No ❑ NA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ONo
25As the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ff No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey El 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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:
❑NA ❑NE
❑ NA ❑ NE
❑ Yes )D No ❑ NA ❑ NE
[:]Yes F]'No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes J� No [DNA ❑ NE
❑ Yes P No ❑ NA ❑ NE
❑ Yes VfNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWIVIP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
Comments=(refer to question #):`Explain any.YES answers and/or any additiopal:recominendationsmor #n ercomments -�
y oth
V
Use drawings of facility -to,betterexplain-situations (use additionahpages-:as necessary) °-,_
31
r'l r 1r, r e cord r 1 C)C�
ly /I&// V
3�,-L_gg, zn(,'�2oICY
Reviewer/Inspector Name:
Phone
ReviewerAnspector Signature: Date:
Page 3 of 3
7 3 23
214,414

Division of Water Quality
Facility Number ©- L!1� O Division of Soil and Water Conservation s
O Other Agency
I'ype of Visit: OCompliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: ORoutine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: ;y$ County: �jf 6 Region: fin/;
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Onsite Representative:
Certified Operator:
Title:
Owner Email:
Phone:
Phone:
Integrator:
Certification Number: QRCO_/Y)
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
[ILa er
on -La er
Other
Poults
Design Current
Discharees 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)
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?
Longitude:
Design Current
Cattle Capacity ' Pap.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes jF!T`No ❑ NA 0 NE
[:]Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes NA ❑ NE
[::]Yes 'RI"No ❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: - Date of Inspection: -� • j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
[] Yes o
❑ 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: G-OO W a
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes .4�!r 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
EINo
❑ 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
VrNo
❑ NA
❑ NE .
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
6No
❑ 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
j7rNo
❑ NA
❑ NE
maintenance or improvement?
(�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
1/No
❑ NA
❑ NE
maintenance or im rovement�
P
11. is there evidence of incorrect land application? If yes, check the appropriate box below. []Yes 4No ❑ 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 direr from those designated in the CAWMP?
❑ Yes
qj'No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
K No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
KrNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
C] Yes
P No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
[?rNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
V No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
KNo
❑ 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 P No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes V1 No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes VNo
❑NA ❑NE
❑ Weather Code
❑ Sludge Survey
❑NA ❑NE
❑NA ❑NE
Page 2 of 3 21412014 Continued

[Facility Number: 1 - Lix I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes +� No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ 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 the 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 Rcviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[0'No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
V No
❑ NA
❑ NE
❑ Yes
[ANo
❑ NA
❑ NE
[] Yes No
❑ Yes No
❑ NA ❑ NE
DNA ❑ NE
Reviewer/Inspector Name: �Wj � Ve, Phone: ')S- 61' 'gip
Reviewer/Inspector Signature: Date: 7K' 15 w j L}
Page 3 of 3 21412014

Division of Water Quality
Facility Number LJ - ® O Division of Soil and Water Conservation
O Other Agency
type of Visit: (Mompliance Inspection 0 Operation Review p Structure Evaluation O Technical Assistance
Eieason for Visit: &Routine O Complaint O Follow-up O Referral O Emergency O Other Q Denied Access
Date of Visit: i31 Arrival Time: Departure Time: County: D �� Region:
Farm Name: C Y- �)Oi, Owner Email:
Owner Name: QwIW x Phone:
Mailing Address: )iq Kwansiz'Ae, , NL 49
Physical Address:
Facility Contact:
Title:
Phone:
Onsite Representative: I,,, Integrator:
Certified Operator: Paw\ �,��.(�, ��` s �Y', Certification Number: ���►� �
Back-up Operator:
Location of Farm:
Swine
can to Finish
eanto Feeder
seder to Finish
crow to Wean
irrow to Feeder
grow to Finish
Other
Other
Certification Number:
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non-La er
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Dischar es 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)
c. What is the estimated volume that reached waters of the State (gallons)?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 6 No ❑ NA ❑ NE
[:]Yes [ZfNo
[:]Yes ZNo
❑ NA ❑ NE
❑NA ❑NE
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 [ZNo ❑ 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

Facility Number: -iA Date of Inspection: -J
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 [�TNo ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1
Spillway?:
Designed Freeboard (in): IC1.15
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
UlrNo
❑ 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
U 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
E2rNo
[DNA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
[—]Yes
[a -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
ff No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ff No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes UNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. 0 Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window
l [] Evidence ofQWind
RDriift ❑ Application Outside of Approved Area
12. Crop Type(s): �yyee 'lp 7 calm W
13. Soil Type(s): Atp c�axjj k
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ZNo ❑ NA [] NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [;TNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ffNo ❑ 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?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑ Checklists O Design ❑ Maps ❑ Lease Agreements
❑ Yes
ff No
❑ NA
❑ NE
❑ Yes
[yNo
❑ NA
❑ NE
❑ Yes
[f No
❑ NA
❑ NE
[:]Yes
❑"No
❑ NA
❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [a 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 �No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes allo [DNA ❑ NE
Page 2 of 3 21412011 Continued

' Facility Number: 11 - Lj I Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
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?
❑ Yes
[n No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
❑ Yes
Q No
NA
❑ NE
❑ Yes Q No ❑ NA ❑ NE
❑ Yes [j No ❑ NA ❑ NE
❑ Yes QNo ❑ NA ❑ NE
❑ Yes [2"No
❑ Yes 1!FNo
0 Yes [a No
❑ NA ❑ NE
❑ NA ❑ NE
NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
Gooc\ Perwe_e��
wli.
1
Reviewer/Inspector Name:
Reviewer/Inspector Signature
Page 3 of 3
Phone:�'��1����-`Ja
Date:
21412011

OtDivision of Water Quality
Facility Number '�j - ® O Division of Soil and Water Conservation
O Other Agency
type of Visit: 3kCompliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
treason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: I Arrival Time: ® Departure Time: J County: L JN Region:
Farm Name: bZ A . t�Ai L V�Tfql;as Owner Email:
Owner Name: �W 2� A J iPhone: f �+ j�
Mailing Address: l /f / w 5 i �- Y C� f) 3 t ` 4 `7(�
Physical Address:
Facility Contact: Title: Phone:
Onsite Representative: P_�)I L.L A �t \J STO/V Integrator^n:
Certified Operator: L WA(zl� �L Q, Certifcatio Number:
Back-up Operator: Certification Number:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
Other
Latitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Design Current
Dry Pnultry C'.anaeity Pon.
La ers
Non -Layers
Pullets
Turkeys
Turkey Poults
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?
Longitude:
1-4 8as
Design Current
Cattle Capacity Pop.
Dairy Cow
Daig Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ NA ❑ NE
❑ 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 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
❑ Yes47No
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

Facility Number: - Date of Inspection:
(� /
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
*o
7�''❑"''1�111No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Q
Designed Freeboard (in):
Observed Freeboard (in): r
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
No
X
❑ 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 No ❑ NA ❑ NE
8. Do any of the structures 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 No ❑ 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. 0 Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window/❑ Evidence of Wind Drift [3 Application Outside of Approved Area
12. Crap Type(s): �..�ce? � � 1 `� C,p" �� L-:�) H E A
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
Q WUP ❑ Checklists Q Design 0 Maps ❑ Lease Agreements
❑ Yes
0,'No
❑ NA
❑ NE
Yes
[] No
❑ NA
❑ NE
❑ Yes
N No
❑ NA
[] NE
❑ Yes
JANo
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
[]Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes 1ANo
❑ Waste Application Q Weekly Freeboard Q Waste Analysis ❑ Soil Analysis ❑'4te Transfers
0 Rainfall ❑ Stocking Q Crop Yield [] 120 Minute Inspections Q 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 No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3
21412011 Continued

Farility•Number: L/ U I IDate of Inspection: C4 Q(p /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ 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? ❑ Yes �tNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No �RNA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No
0
❑ NA
0 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
No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
�] No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
T�
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
No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
Wo
❑ 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).
,_�Mw
D)()--4jjQ
1.9
Cr,06� t'4T/0 IS Sg0/6 foct- �icsl-�
�(,IP�QAVOX pt�G �O!
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �%G ��� ZP1
Date: ��wlg
21412011

r. Division of Water Quality
FacilityNumber - FL4 91 O Division of Soil and Water Conservation
O Other Agency
Type of Visit: Compliance Inspection O Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: (Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: J J J Arrival Time: ® Departure Time: County: L N Region:
Farm Name:_ A} # L a9_07 H CQ S Owner Email:
g1GG-`kilo-
Owner Name: �V•`�� (�� �(�# [v ._... Phone: 9 r b - Oq to - G:) -4a&&
Mailing Address: p 9 S A) L O`4 F V-G/IA/VS 01 LUEENC
Physical Address:
Facility Contact:
Title:
Onsite Representative: �1 LL A
Certified Operator: 1 IQUL
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Phone:
Integrator:
03
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Cflnaeity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
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)
c. What is the estimated volume that reached waters of the State (gallons)? r
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?
Longitude:
Design Current w
Cattle Capacity Pop..
Dairy Cow
Dairy Calf
Dairy Heifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 0 No
❑ Yes ❑ No
[-]Yes ❑ No
❑ Yes [:]No
❑ Yes No
ElYes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
Page 1 of 3 21412011 Continued

Facility Number: -3 ti - 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 i Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: LOCIOLW
Spillway?:
Designed Freeboard (in): q. S
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 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 No ❑ NA ❑ NE
8. Do any of the structures 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? �K
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [:]Yes hj No ❑ 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 101bs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifts �❑ Application Outside of Approved Area
12. Crop Type(s): � C��P� i CnoAt J> LAB),
13. Soil Type(s):
i.-L-41--
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19, Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
0 WUP [:]Checklists [] Design 0 Maps ❑ Lease Agreements
❑ Yes No ❑ NA _ ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No
❑ NA ❑ NE
❑ Yes �9;No
❑ NA ❑ NE
❑ Yes )A No
❑ NA ❑ NE
❑ Yes 10 No
❑ NA ❑ NE
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes26ns
No
El Waste Application Q Weekly Freeboard Q Waste Analysis 0 Soil Analysis ❑Haste ers
❑ Rainfall ❑ Stocking [] Crop Yield 0120 Minute Inspections 0 Monthly and 1 " 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 7�� N
❑ NA ❑ NE
Q Weather Code
Q Sludge Survey
❑ NA [] NE
o ❑ NA [] NE
Page 2 of 3 21412011 Continued

Facility Number: L-j Date of ins ection: 4 1 /
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �4 No [DNA ❑ NE
25, is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes VkNo ❑ 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
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 No
❑ Yes j No
❑ Yes No
❑ Yes �No
❑ Yes Pq No
❑ Yes No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
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 No ❑ 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.comments.,
�r
Use drawings of facility to better explain situations (use additional pages as necessary).
1111-40
'fQ(.jc7lau
f" "-TIC>
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
aV/a
Phone:
Date: W 1 S 1 I
21412011

r lip
Facility Number 3 Ll
I
Division of Water Quality
0 Division of Soil and Water Conservation
O Other Agency
Type of Visit XCompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit ,M Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: *� f0 Arrival Time: ® Departure Time: County: (AA/ Region:
Farm Name: �lgt`J . �s A 1 aq Q'T a Ee g Owner Email:
Owner Name: nW�_a �A 1 L— Phone: 9/0-Dqa-a3a3
Mailing Address: Atoiln
VC a(Lie K&AAS V)LLP, Nc V3 (-4g
Physical Address:
Facility Contact: Title:
Onsite Representative: t-t- aces ) 0N
Certified Operator: PAkL po'_� 1 L JQ -
Back-up Operator:
Location of Farm:
. Design Current
Swine Capacity Population
❑ Wean to Finish
❑ Wean to Feeder
91 Feeder to Finish 155M
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Phone No:
Integrator:
Q-01 o i �a5
Operator Certification Number:
Back-up Certification Number:
Latitude: [= o = Longitude: = o =' 0
Design Current
Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
..Dry Poultry
Non-L,
Pullets
Other
Poults
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?
e.. E
Design Current
Cattle Capacity _ 'Population:.°
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:'
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes )ANo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
5�No
❑ NA
❑ NE
❑ Yes
X�No
❑ NA
❑ NE
Page I of 3 12128104 Continued

gacility`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: rzAQ F_(L
Spillway?:
Designed Freeboard (in): , S
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes tANo
❑ Yes ❑ No
Structure 5
❑ Yes 0 No
❑ Yes 9No
❑ NA ❑ NE
[I NA El NE
Structure 6
El NA ❑NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 9 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 [KNo ❑ NA ElNE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA ❑ NE
maintenance/improvement?
11.
is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% 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) _ ` , C-, �j��-� t�� co" S V_s�' Lli�oe 4 J
13.
Soil type(s) _ NQe,-OUC
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
VNo ❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
4No ❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
,] No ❑ NA ❑ NE
,g\
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
ONo ❑ NA ❑ NE
Comments (refer.to question #): Explain any YES answers and/or any recommendations or any ather comments
Use drawings of facility to better "explain situations. (use' additional pages `as necessary);;
�
Reviewer/Inspector Name ES"
Q
:, Phone:
Reviewer/Inspector Signature:
Date:
Page 2 of 3 12128104 Continued

Facility Number: 3 1 —L� 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 No ❑ NA [INE
the appropriate box. 0 WUP ❑ Checklists
0 Design El maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
0 Waste Application ❑ Weekly Freeboard ElWaste Analysis ❑ Soil Analysis ❑ Waste Transfers0eX611al Certification
0 Rainfall ❑ Stocking ❑ Crop Yield 0 120 Minute Inspections ❑ Monthly and 1" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes V No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes '9No ❑ NA ❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
ElNA
ElNE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El
No
El NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
No
ElNA
ElNE
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
9No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P 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
t4 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
El NE
General Permit? (ie/ discharge, freeboard problems, over application)
'' \\
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
IX No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
kNo
❑ NA
❑ NE
12128104

. W<
Facdkty'Number
bivision of Water Quality
d iyision of Soil and Water Conservation
Q;`Ofher Agency
Type of Visit x Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit oRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival
Time: Departure Time: County: Ll Region:
Farm Name: 1--sQ r l �� I �-- C S-- Owner Email:
Owner Name: one:
bt�AC�� DAIL- cello- qo-oa3
�/ Phone:
Mailing Address: �aS A/C 0 H F1, GW6WS UtLLZ � / C_ �g3y9
Physical Address:
Facility Contact: Title:
Onsite Representative: �t-� �a�S�lS! Integrator:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Boars
Other
❑ Other
Phone No:
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 0 0 1 = Longitude: = ° = `
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
I ] 1❑ Layer
❑ Non -La er
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes XNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
No
A
❑ NA
ElNE
❑Yes
-'
No
❑ 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: L4G00nl
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): [p
5. Are there any immediate threats to the integrity of any of the structures observed?
(iel large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes �(No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes A No ❑ NA ❑ NE
$. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 2(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 [INE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes O�No ❑ NA ❑ NE
maintenance/improvement?
11.
Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes]
No
-`
❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 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) c' 0 e, g LUWr_A-! 5f -
13.
Soil type(s) F(aw<
14.
Do the receiving crops differ from those designated in the CAWMP? ❑ Yes
JKNo
❑ NA ❑ NE
15.
Does the receiving crop and/or land application site need improvement? ❑ Yes
In'No
❑ NA ❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[--] Yes
1 C No
❑ NA El 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
NNo
❑ NA ❑ NE
C*ommentsl(referto quest,an #)Egplain�anyYES answers and/or anrecommendations ar an other comments.
Use drawuigs of facility to.better. explain.situappnk. (use additionaltpages.,as necessary_,)•
s. � � ° � _
I . a
S{gl jo8 I • (i -S
LReviewer/Inspector
er/Inspector Name �C}//1(— S Phone:
Signature: n -BQ4=22 Date: L/ fa�JQ9
Page 2 of 3 12128104 Continued

• i
Facility Number: '31 —LID_ Date of inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
A No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yes XNo
❑ NA ❑ NE
the appropirate box.
❑ W UP 0 Checklists [I Design 0 Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below,
❑ Yes
❑ No
❑ NA ❑ NE
[1 Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Yaste Transfers
❑ Iinual Certification
El Rainfall 0 Stocking ❑ Crop Yield El 120 Minute Inspections 0 Monthly and 1" Rain Inspections El
Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes]
No
❑ 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
No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes]
No
0 NA
❑ NE
Other issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
gNo
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
KNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
,,No
❑ NA
❑ NE
Additional Comments and/or Drawings:
CAE i C C�XYF / o9 (:�!) I G c_A6?S� *FLIt1 w fcca2�g _ GIc G3!►� s al C� •
pc- o e_
Page 3 of 3 12128104

, . 4'
Facility Number 3�
0 Division of Water Quality
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit 01Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit A Routine O Complaint O Fallow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: -` `17 Arrival Time: Q Departure Time: 2 County: p4229 Region:
Farm Name: _ 4 r ,DA.;�G Ro i fi��� s Owner Email:
Owner Name: '/6? )4zi2 �� Phone:
Mailing Address:
Physical Address:
Facility Contact: 9 Title:
Onsite Representative: �GL L c�S7D�
Certified Operator: !Z
Back-up Operator:
Location of Farm:
a°
Latitude:
Phone No:
Integrator: //ll/�f�il���/�%
Operator Certification Number:
Back-up Certification Number:
Longitude:
0
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish cgQ
El Farrow to Wean
❑ Farrow to Feeder
El Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other I
❑ Layer
❑ Non -Layer
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharees & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: a
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?
Page I of 3
❑ Yes
�INo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Cl Yes
X No
ElNA
❑ NE
❑ Yes J[J No ❑ NA ❑ NE
12128104 Continued

f • tt �
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 S cture 2 Structure 3 Structure 4
Identifier:
Spillway?: �O
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes ONo
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ YesXNo
❑ NA ❑ NE
❑ Yes &No
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental t reat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes _,(No ❑ NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑Yes- J[� 1 El 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/ZNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes] No ElNA El 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 Acce tab /e Crop Window ❑ Evidence of Wind Drift [:]Application Outside of Area
S /3
12. Crop type(s) Win/ �On1S'
13. Soil type(s) IIVD
14. Do the receiving crops differ from those designated in the CAWMP? El Yes No
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination, El Yes No
17. Does the facility lack adequate acreage for land application? ❑ Ye [INo
18. Is there a lack of properly operating waste application equipment? ❑ Yes VNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Name Phone: D —
Reviewer/Inspector Signature: Date: Q
12128104 Continued

Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
XNo
❑ NA
❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
J6 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
V(No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
YfNo
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
PyNo
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
26. Did the facility fail to have an actively certified operator in charge?
❑ Yes
❑ No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
;dNo
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
XNo
El NA
El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
El Yes
�No
❑ NA
ElNE
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
ElYes
No
El NA
El NE
Generai Permit? (ie/ discharge, freeboard problems, over application)
/,
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
JCJ No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes/
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Oils.'
12128104

Division of Water Quality
Facility Number O Division of Soil and Water Conservation
-- Q Other Agency
rType of Visit 9' Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
IReason for Visit Qf Routine O Complaint 0 Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: ArrivaaTime2:1t'1V Departure Time: ECounty: LZRegion:Farm Name: 6AA Owner Email:
Owner Name �i�W/� !> _;2(_ Phone:
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
Onsite Representative: D iJ Integrator:t� cal ►�
Certified Operator: Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Back-up Certification Number:
Latitude: = e ❑ d = A Longitude: = ° = ' 0
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er �
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
Feeder to Finish]56BO
ID
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars_
—
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turke Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: Eil
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?
Page I of 3
❑ Yes �No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
[--]No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes 7
No ❑ NA ❑ NE
12128104 Continued

Facility Number: 13 —
Date of Inspection 13T
Waste Coiiection & 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?
❑ NA ❑ NE
❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: —
Spillway?: & zvo-
Designed Freeboard (in): 11 5 Rs
Observed Freeboard (in): ! ,5 2
❑ Yes �No
❑ Yes ❑ No
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
IINo
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
/No
❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
thrept, notify DWQ
7. Do any of the structures need maintenance or improvement? Xyes
MVo
❑ 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?
10
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
Pr
El NA El 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 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) 5 '
13. Soil type(s) ,4 v No
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[ tNo
❑ NA
❑ NE
❑ Yes
/�No
❑ NA
11
El
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes ZI No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes No El NA El NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes XNo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Z5 FX�s�y�� ���-�r,�� Za�►f /�v� L.9-,c-vo.� % GVirs �� �i'
�'�aafc Sw vF� o , )jtkDalt
V-j t r-Av c�-coop) Z.
- RRza ov7 rd,a R4 OU T t9r- C� f�crod�J �2,
Reviewer/Inspector Name Phone:
Reviewer/Inspector Signature: Date:
Page 2 of 3 12a8/04 Continued

Facility Number: �� Date of Inspection Z O
Reauired Records & Documents
19. Did the facility fail to have 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 0 No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑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 t" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
ONo
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ANo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
ONo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
YJ No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
ElNA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
ElYes
)dNo
ElNA
❑ 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
ElNA
❑ 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
XNo
❑ 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
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
roP ��P�v �z, 3
3 -z%
w
�0�� �i(J�h2 ��A-�i✓!�-� �SSu.G 5
1�,d �- Y/ OuS�. ��DOI�� / !.>l/✓�✓/1'G S �y 1(/R�} z/vP21 mil' S
IVI
Page 3 of 3 12128104

Division of Water Quality
Facdrty Number �f ?i O Division of Soil and Water Conservation
O Other Agency s
IType of Visit j0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Z✓ OS Arrival Time: Departure Time: County: . Region:
i
kw Farm Name: D7/} +�� � "er Email: 'n 1-.A
Owner Name: �� F11JiQ Phone: ZIQ fttJ
Mailing Address:
Physical Address:
Facility Contact: Title: Phone No:
1
Onsite Representative: C15�0� Integrator:dC�a;
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Other
❑ Other
Operator Certification Number:
Back-up Certification Number:
Latitude: [= c [= A = Longitude: = ° = d 0
di
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ urkey 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
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes /No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
xNo
❑ NA
❑ NE
12128104
Continued

Vacilitymber:
Date of Inspection 5
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes ONo
❑ 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 jo 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
El NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? Yes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) 10
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN [--IPAN > 10% or ] 0 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)
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
'0
VNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination,
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
//] No
❑ NA
❑ NE
�f - �.P�� �i✓O .SF�L' � DNS �2P� ... _. Cz�.-� �v � . n� ov�� �� L�„dD
Reviiewertinspector Name Phone:
Reviewerlinspector Signature: Date:
1212814 Continued

racilityNu
mber: — Date of inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes VNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
'V
21. Does record keeping need improvement? If yes, check the appropriate box below.
Yes ❑ No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual
Certification
❑ Rainfallxstocking Crop Yield ❑ 120 Minute Inspections Xmonthly and V
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?
�0
❑ Yes No
❑ NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
ElYes A 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?
,Vj
❑ Yes ;&
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes No
❑ NA
❑ NE
Other Issues
to
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
ElNA
ElNE
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?
T
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes No
❑ NA
❑ NE
Adiiitional Coinmenttss'and/or.Drawings &� s. r { "
khF ���� �,t,�N�,/u, C�iTai� e�7�p,-� F•a.�, 0;Zrr n 5
W)d,,;z &z_wc, 7� liiy)�iQ�✓� j/ 'i� ��D iJ
12/28&04

�' _� -��� �, � .,,. °- • .�'. Dlviston�f Soil and WS�Er CQI'VSttOn � � r � �' �"
�j
O Utlter Agency
�-
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit /Routine O Complaint O Follow up O Emergency Notification, O Other © Denied Access
Facility Number Date of Visit: 7 Time:
O Not O erational Q Below Threshold
$ Permitiec�eCeertiified 0 Conditionally C�efrdfied 0 Registered Date Last Operated or Above Threshold:
/Farm Name: ....Ll}1...`...�._._.i........_ ..__............... County: ...... �P..... _ .W... .._...._..........
OwnerName:.._ .� _...._ ........................._..... �_.... _._ .._ .........._............ Phone No:... .
MailingAddress: .................................... ----------....................................... _._ ...
FacilityContact: ........ ...................... _.................................... Title:...... __.. ........................._ .. Phone No:.......� _._.. .
Onsite Representative:. �u^. --4..f.?4S�N Integrator: �.._.T_1?ZL... .......................
Certified Operator: ._....... _....... ............... ....... .......I. ...... _........._............................. Operator Certification Number:..........................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • 4 44 Longitude 0 4 44
i Design -,,,current,.--,-,, 3 Design \s Current �"r DeStgn Current
sl?oWtry aci:Po 'nlatiosf_ Cantlek.Ca act ;s=Po-elation
_Ca
s ❑ Layer ❑Dairy
❑ Non -Layer Non -Dairy
❑ Other
4- 3
Total Dest�gn CaPac><ty
e.
El
�� .Total§ssLwr
Number of LagOonS
ao
Swine "-
.-_,illation
-
❑Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Discharges - Stream Impacts
L 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) El 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 91 No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes dN0
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes [J No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: _.1... ..................... ...... .............. ........ _.. ._..._......_....... ....... ..............---•......
Freeboard (inches): 27
12112103 Continued

Facility Number: -- 2_ Date of Inspection 7
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 maintenancetimprovement?
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? If yes, check the appropriate box below.
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type 190.�1C A d W AT
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?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
❑ Yes EX0
❑ Yes LQ N o
Rr/yews ❑ No
Q�Yes ❑ No
❑ Yes []/No
❑ Yes J�No
❑ Yes dJ No
❑ Yes [?rNo
❑ Yes
❑ Yes FNO
❑ Yes
❑Yes �N
❑ Yes No
❑ Yes No
❑ Yes VNo
❑ Yes
❑ Yes No
Commits {refer to�giiest,on #} piin any"YF.Ss o a
aad/ay recommendatzous orsay er comments . , ,
_1iii
i1se drawings of fa it' t4 lietter-exp situations. {use addrtrona! pages as necessary) r : []field Copy ❑Final Note
_
7) vflt" of PT t,EAS-1 Sz-x TXVi-tES Vi.,o*n the,
Q3� 1.R.rL a6CORDS �� I jzvo3 -� 4�z�ozs3 lJ o Tv t.. r+� d carLOs,
3Ctz.oQ t TtL C> F00mS +-YEbt> To GE U P DA i-tJ
APR ~ SE4''T Loc> (L p N�A� 6UE N`�'5 N%6� Tv (3E yaz l ( C4(LV
��16P z o� A4'tEfZ- l RA=r1 Nit Pic [ySEM'
z tj I.-rrA(-S Fes-
CZ0—T3 *=6A_TX111j PC 1i> ru Dad► , A&)b s6A)`r _x_d ,
ANMt A L
SLUOGRE SOPWC-4
CAL'=6 V-fliSotj To k wric f3`; Ape_, _L'L,ZAq. LAST G)o1X -L,j Za&-Z.
. .
--� - -- x -
Reviewer/Lrs ector Nawe
Reviewedlnspector Signature: - Date: (4-7 LOq
12112103 Continued

Facility Number: 3 — Date of Inspection I yl 7 /DY I
Required Records & Documents
21 _ Fail to have Certificate of Coverage & General Permit or other Permit readily available?
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
23. Dord keeping need improvement? If yes, check the appropriate box below.
Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
NTDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32. Did the facility fail to install and maintain a rain gauge?
33. Did the facility fail to conduct an annual sludge survey?
34. Did the facility fail to calibrate waste application equipment?
35. Does record keeping fbr51jPbES required feed impro ent? If yes, check the appropriate box below.
❑ Stocking Form Crop Yield Form Rainfall Inspection After I" Rain
❑ 120 Minute Inspections [Annual Certification Form
❑ Yes No
❑ Y No
Yes ❑ No
❑ Yes Ncy
❑ Yes vl�
❑ Yes
❑ Yes Wy o
❑ Yes
❑ Yes /No
Yes FIN
ElYes❑ Yes
❑ Yes ❑ No
❑ Yes ❑ No
Yes ❑ No
12112103

Michael F. Easley, Governor
William G. Ross Jr., Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
January 14, 2004
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
EDWARD & HENRY DAn.
825 NC 24 EAST
KENANSVILLE NC 28349
Subject: Notice of Violation and Revocation for Nonpayment
DBA: Dail Brothers
Permit Number: NCA231042
Duplin County
Dear Edward & Henry Dail:
In accordance with North Carolina General Statute 143-215.1OG, all animal operations who receive an animal
waste management system permit will be charged in each year of the term an annual permit fee. Annual permit fees are
billed following the issuance of the permit and then annually thereafter on the anniversary of that date. Your animal waste
management system permit was issued on 4/9/2003.
Your annual permit fee for the period of 4/9/2003. - 4/8/2004 is $150.00. Your payment was due 111812003.
Because this fee was not fully paid within 30 days after being billed, this letter initiates action to revoke the subject permit,
pursuant to 15 NCAC 211.0205 (c) (4). and G.S. 143-215.1 (b) (3).
Effective 60 days from receipt of this notice, the subject permit is hereby revoked unless the required Annual
Animal Waste Management System Permit fee for your animal operation is received within that time. Operation of an
animal waste management system without a valid permit is a violation of North Carolina General Statute 143-215.1 and is
subject to the assessment of a civil penalty of up to $10,000 per day. Your payment should be sent to:
N.C. Department of Environment and Natural Resources
Division of Water Quality
Budget Office
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
If you have any questions, please contact Fran McPherson at [phone] ext. 210.
Sincerely,
Alan W. Klimek, P.E.
cc: Non -Discharge Branch Compliance/Enforcement Unit
Wilmington Regional Office
Duplin County Health Department
Permit File
1617 Mail Service Center, Raleigh, North Carolina 27699A617 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled 110% post -consumer paper

s
�,Dtvtstott of Water Qttal[ty a'F -Ai
Dtvrston ofSo�l and'Water Conseiyatioo,
O, Other`Agency
Type of Visit 0 Compliance Inspection 0 Operation Review Lagoon Evaluation
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facility Number Date of Visit: Time:
WrOQ Not Operational 0 Below Threshold
Permitted ©Certified [3Conditionally Certified L3Registered Date Last Operated o bove Threshold:
Farm Name: County:
Owner Name: APhone No:
Mailing Address:
Facility Contact: Title:
Onsite Representative:
Certified Operator:
Location of Farm:
Phone No:
Integrator: L
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a 4 u Longitude & 6 «
Design Current Design Current Design Current
Swine Capacity Population
❑ Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Finish
Gilts
Boars
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons f U Subsurface Drains Present JjU Lagoon Area JLJ Spray Field Area � I
Holding Ponds / Solid Traps J❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation? ❑ Yes 10No
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 ONO
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 ONO
t
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches): so
05103101 Continued

I
`Facility' Number: 31 — Z Date of Inspection / Z /
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below o
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 R1 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 91 No
M 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? o
�_
Additional dmments`an or° . rawings -,-.
.. .... ... ... _ ..
3
WCfIGIfJf GC✓CS !/1�'TCf w� r`Gl'�%dLt
W4l 6C
C4,-r1a+C G/44:sn T4I'S
l ✓� 4 0.-
tJ..�IST�n/ Sar+-,Pig s�-,o��G( C^�
-�c,ken •
L,Jgs�-� AKa�1�s;s qfe good �`pr
�Q d e, l3 C (0", AO&-,d 'A.&C r 4 �r-
OWC 6PI
A11,31 y s. s ,
Also) 6e sure 4o Use 'PAN leekd;") ,-aics A "d gr;reali-irr''`t
Ferro 5i4c is wc�� v►-,Rvic,�c0� Av70�
�� 9a�G1*
Gor,G����'an.
3/23/99

Type of Visit 7Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reasoir4or Visit Routine 0 Complaint Q Follow up Q Emergency Notification . O Other ❑ Denied Access
r
Facility Number Date of Visit: Time:E3TDIZ�
O Not Operational Q Below Threshold
Permitted Q Certified 13 Conditionally ertified 0 Registered Date Last Operated Above Threshold: ... . .
Farm Name: ............ �.C,Ct� LrC.�- _ Flhqlkl, County:?/
OwnerName: . PI„"..� Phone No:
Mailing Address:
FacilityContact:. ...................... . ........._. ......... Title:.............................................................. hone No:...................................................
Onsite Representative:.... .. r ' Q .. Intearator: �OLL
-- - ........_....._.�........... a ..............I.._............
Certified Operator.
Location of Farm:
Operator Certification Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 4 ` " Longitude • L
Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area
-: -.- ......... -
No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
[-] Yes INO
Discharge originated at: ❑ Lagoon ❑ Spray Field El Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes [l 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? El Yes No
Waste Collection &Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ZNo
Structure// 1 Scture 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ......... ...._1...... W. ..... — ,.... _....... - — .............
Freeboard(inches): ...........�i................ ...... !l..... ........................... ...... ...................................

Facility Number: — Date of Inspection
5. Are there anv 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 El No
{If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notifi' DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ❑ No
8. Does any pan 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 (CANt'MP)? ❑ 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. Pail 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.) ElYes ❑ 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 notifp- regional DWQ of emergency situations as required by General Permit?
Oel discharge. freeboard problems, over application) ❑ Yes ❑ No
D. Did Reviewer,gnspector fail to discuss reviewAnspection with on -site representative? ❑ Yes ZTNo
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
1O No violations or deficiencies were noted during this visit You will receive no further correspondence about tliis visiLNo violations or deficiencies were noted during this visit You will receive no further correspondence about tl;is visit.
Comments; refer io nesaon .. E ]am.an 3tl;S snswers.and/ot as recommendstmtts or auv oilier cummetrts.
Use drawings of facility to better explain situations. {use additional pages as necessary) -'� ❑Field Copy ❑Final Notes
9 CreT e4elir)
Reviewer/Inspector Name:._I
Reviewer/Inspector Signature: Date: / O
05103101 Condmued

Facility Number, — 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?
t (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/unprovement?
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 maintenancelunprovement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type
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 or other 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 reviewfmspection with'on-site representative?
24. D oes facility require a follow-up visit bysame agency?
:25. Were any additional problems noted which cause noncompliance of the Certified AWMP? .
❑ Yes INO
❑ Yes 2 No
1yes ❑❑No
❑ Yes P(No
• Yes VNo
❑ Yes IV,
❑ Yes �No
❑ Yes VNO
El Yes /VNo
El Yes ❑ No
❑ Yes ❑ No
❑ Yes No
ElYes IV,
❑ Yes IyNo
❑ Yes Q(No
Yes /❑ No
0 Yes o
❑ Yes No
❑ Yes X,o No
ElYes
El Yes o
0 Yes /No
E3 Wo violations or deficiencies were noted during this visit You will receive no further correspondence about.this visit. i
- ... _. .::: .v.v:v:: � _:. .tiv :: .. ..: '`.-:.�._ � :.::rr:+_.-': ">4:: `:Y'tw +�c:'c{i:'-`.` �,.:isw...,•:::�::::".,,;::,x,::;:�:,Yr`.Yt.'a',,:::.:i. �:::.•'Q'.Ar:,�µ�..ks
Field C x
,:{.?::........:. ....... <u yFinalNo
tj
Aa'aF/✓Ts Y�4,d lox sam� ��;-�n,9�
kp-
Renew r1lns ect rNam y.;: .. :� ��.� �:: �� �.:� �.-.;...:.....;;>< -
P
`
Reviewer/Inspector Signature: Date:

Facility Number: Date of inspection
Qdor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
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.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
1q) A%FFD 0 '5'r c- .2�SPh'Fow
FaR F11Rr#6J-2ka- (V C-"
COnI�l�7S
❑ Yes ❑ No
❑ Yes o
❑ Yes No
❑ Yes dNo
❑ Yes o
❑ Yes No
❑ Yes ❑ No
0,4P'O We
460 i�T 4CO/-e ,n
F-44Z2-J- Z,290��
05103101

Type of Visit qkCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: ® Time:
Not Operational Q Below Threshold
$Permitted [3 Certified [3 Conditionally Certified 13 Registered Date Last Operated or Above Threshold: .........................
1
Farm Name: .....!!' ... .............�................................ ......... ... County: ..L�'1,...........
Owner Name:
Phone No:
FacilityContact: .............................................................................. Title:............................ .................. Phone No:
MailingAddress:.......................................5............................................................................................................_................. ...........................
e
Onsite Representative......... �t.-,> �:'��A.. .............. Integrator:....... ...................................
Certified Operator: ................................................... ................................................ Operator Certification Number:................................
Location of Farm:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude �• �� ���
Design Current Design Current DestgA Current
Swine Capacity � Population Poultry �Caaci Po elation Cattle Capacity-`:. Po elation
❑ Wean to Feeder ❑ Layer ❑ Dairy
eerier to Finish d ❑ Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Ca diy
❑ Gilts -
❑ Boars Total SS.LW ; _
Number of Lagoons ._ ❑ Subsurface Drains Present ❑ iLagooe Area 10 Spray Field Area
Holding Ponds / Solid -Traps ❑ No Liquid Waste Management System f
llischar es & Stream Impacts
L Is any discharge observed from any part of the operation?
❑ Yes
PrNo
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
DdNo
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes
MNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
�00
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: .................................... ....... .Dw'--?......... ...................................
....................................
Freeboard (inches): 1-to �3
5100
Continued on hack

FacffityNumber: Date of Inspection Printed on: 1/9/2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes '(Na
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes XNo
(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 mairttenancelimprovement?
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
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, frceboard 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 A"P?
4%-*i0 a(i0hs.oe- dfidjet 6bg -wire noted• i (t&g �h}s:visit;. Yob 3 idj. -ecgiy� cio fgftilgr. -
cori•es cience: a3aut this visit. ........ • . .
14Yes ❑ No
❑ Yes [�'No
,'Yes ❑ No
❑ Yes gNo
❑ Yes D(No
❑ Yes WNo
❑ Yes KNo
❑ Yes UrNo
❑ Yes CZNo
❑ Yes allo
❑ Yes D(No
❑ Yes IN�No
❑ Yes E�No
6(Yes ❑ No
❑ Yes Mo
❑ Yes EJ No
❑ Yes ((No
❑ Yes ONO
❑ Yes Q[ No
❑ Yes ,� No
r
tommeats { efer to:ques#Eon `Fxplaln "y.YFS answers andlor any<rerootmeadation.� or�any other ¢pteiimea�.�;
Use, of+faeilr to better ex lain sitaahons useadrLtional wings ty =
p ( pages as :neces?ac9)
sl 7) ti �.. is -��1t�
JS� , t••- �� .-�v�G`��� 1�12+1C-�(d.2 (nI�
T,_ 1'rl �s � ►pia-li{.J�� �,'t�J'��CO� ���'"� ' �C?'U-es � ��dOL^v ��
[
rep N
Reviewer/Inspector Name Q' "a-
Reviewer/Inspector Signature: Date: __0 5100

Fatality Number: a Date of inspection Printed on: 1/9/2001
j Odor issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below KYes ❑ 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 RNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes `` wo
Additional, Coxnxnents-andtor swung :,
LIZ-
Veer
CJ
k)�f I Fx
,� VVI
r w (`\-•.'2�� h_
1l
r6- � � �y - 1Y' FF�''"'es'
5100

Rcvised April 20, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number 3 1 - 4 Z
Farm Name: George_
On -Site Representative:orv✓ppd
InspectorlReviewer's Name: -S
Date of site visit:_
Date of most recent WUP:
Annual farm PAN deficit: 19.75 pounds
Operation is flagged for a wettable
acre determination due to failure of
Pa 11 eligibility itern(s) F1 F2 F3 F4
Operation not required fo secure WA
determination at this ti based on
exemption E1 E2 E3 E4
Operation pended for wettable acre
determination based on P1 P2 P3 .
Irrigation System(s) - circle #: 1. hard -hose traveler, 2_ center -pivot system; 3. linear -move system;
4. stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system wlportable pipe;
fi. stationary gun system wlpermanent pipe; 7. stationary gun system wlportable pipe
PART I. WA Determination Exemptions (Eligibility taiiure, Part II, overrides Par I exemption.)
E1 Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D21D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
�E3 , ap depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part 111. (NOitt:75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part li_ Complete eligibility
checklist, Part 11- F1 F2 F3, before completing computational .table in Part III).
PART 11. 75% Rule -Eligibility Checklist and .Documentation of WA Determination
Requirements. WA Determination required because operation faiis mane of tne.eligibiiity
requirements listed:below:
_F1 LackkLo zc.reageiwhicnTesulted]n:ove::anpiication:0fmasiew, er_(PAN) on:spray-
field(s) �ccoraingzo�arm'sdasttwa�ears ��rrigafion�eovrdG.-. .
F2 Unclear jlleaible,-or lack of'inform ationlmap.
F3 Obvious -field -limitations -(numerous itches;3aiiure:ro_deductTequire d_..
bufferisetback�a crege;�r25° n jcf taiacreageddeniified n�AWMP::mcludes - -
small;-in-equlady-shaped fields = fields'iess-fhan-5 zcres-Tortrvelers :Dr.less-than
2 acres-Tor.-stationary7sprinklers).
F4 -WA determination required because CAWMP credits field(s)'s acreage -in excess
of 75% of the respective field's total acreage as noted in table in Par 111.

Revised April 20, I999
Facility Number Y / - q z
Part Ill. Field by Field Determination of 75% Exemption Rule for WA.Determination
TRACT
NUMBER
FIELD
NUM13ERt'2
TYPE OF TOTAL CAWMP
IRRIGATION ACRES ACRES
SYSTEM
FIELD
0/1
COMMENTS3
I
FIELD NUMBER'- hvdr2nt, pull, zone, or:point numbers Tnay be used in pl2ce of field numbers depending on CAWMP
and type of irritation -system. - If pulls, etc_ cross more#nan one neid, insnectorireviewer will have to combine fields to
c2lculate 75% field by field determination for exemption; -otherwise operation will be subject to WA determination.
FIELD NUMBER= - must be cieariy de€ineated on map_ — -
COMMENTS' - back-up fields with CAWMP acmaoaexcendinc75% of its total -acres -and havinaze_e?ved lass then 500,c
o; its annual PAN as-documente_ in the farm'sprevious-two yeas' (1L97 i� 99 of irrigationTecores,-cannot serve as the
sole basis-forreauirinn 2 WADS--,min2tiOn::B2ck-UDfl2lCisTnL''S:te'noted in the-commentsecaon:2nd mustbE 2CMES Ie
oy Imaationsystem.
Par t 1V. Pending WA Determinations -
Pi Plan lacks -following lnfomnatron:
P2 Plan Tevision -may.-satisy-75% rule based on adequate overall PAN deficit acid by
adjusting all field -acreage-to below 75% use rate
P3 Other Ciefin process of installing new irdoation system):

I•
13 Division of Soil and Water Conservation :operation Review,
r - Divdsion of Soil and. Water Conservation Compliance Inspection r
Nx t Division of Water t altty Connpl "ce Inspection r
ri O.Other Agency
14BRoutine 0 Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection tZ 15 5
Time of Inspection �Q 24 hr. (hh:mm)
W Permitted © Certified ❑ Conditionally Certified [3 Registered 113 Not O erational Date Last Operated:
Farm Name: .......� e D re�C-..t7.fli!'St. r.... �o �.+.. County:.... L�_!. f .'.''� ...........................
Owner Name:.... 2 �•-,1'77, $ e ...................q.'�.'? c!~........_.........- Phone No: _............... .............................................................................
Facility Contact: .............................................................. .................................. Title: ......... Phone No:
MailingAddress: .......................................................................................................................................................................................................... ..........................
Onsite Representative: E/ 1oGl G n� Integrator: ..Ga+rrd'S....................................................
.... .4 o..................... ..... r..................................................I.......
Certified Operator: ................................................... ............................................................. Operator Certification Number:..........................................
Location of Farm:
..................................................................... .............................................. ........ _
Latitude 0 6 1 Longitude =• 4 Ct
L
Design Current Design Current: Design Current
Swore Ca acity Population :. Poultry ; Capacity Population Cattle ` - Capacity Population
❑ Wean to Feeder
® Feeder to Finish
�5—,6 t7
SS A Q
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Number of;Lagoons- i Subsurface Drains Present ❑Lagoon Area C3 Spray Fieid Area
r�
Holding;PofidsI Solid, Traps No Liquid Waste Management System _
Discharges & Stream Impact
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? 4,
d. Does discharge bypass a lagoon syste,n'? (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 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
Identifier: 1
Freeboard(inches): ........ ..!5-.................... ....... ....................... .................................... ........................ I.......... .............................
5- Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
3/23/99
Structure 6
...................................
❑ Yes 9 No
Continued on back

'IF acility tuber: / — Z Date cif Inspection
i
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?
H. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type 13e r1-\UA-1L 611J'-AtA 61,1ee i 8C1--i 4 8%
13. Do the receiving crops differ with those designated in the Certified Animal
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?
sic Management Plan (CAWMI
1Z IS 9�fi
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:violatigris or• di f eiene es were pbted during Ois:visit: • Y:o6 ;Wii1-reeei*i6 iio further
rorresponc eit .. a.& f this visit. . . _
❑ Yes 10 No
❑ Yes $J No
[]Yes No
❑ Yes ® No
❑ Yes No
❑ Yes ® No
cei ►'jS
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes No
❑ Yes 99 No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes 0 No
Comments (refer to°:question #) Explain aiiy YES answers sind/or any"reconiEneniations or any other comments: z
UwArawings of facilrty to better explain situations (use,add�ttonal pages'as-necessary",)
►t�. 1'►']✓. 6zj ✓teY seh 5 44%c.Sot-( and w4jr-r lno,s.dot.ic A L,)e�cae _._. ..
f ` blaloe
OIC+erm,no� ar or Tit, -1i• tor,,, - 41m 7e et SSGr%di a c ole er Tte
Li c, 16 )0 w,'4In +Ac- t-/t14cA At,cs 61e�er�,ir�ol�;o� �i.C• Cl-,a��S/ S
we eA Qc reS) �o w+c n+
N G DFAj< -D tj
/Z,7 Gr,-d;441
�..1;1r",-�fu�t�P�L 28445
Reviewer/Inspector Name ->ht ✓cL Y, �Q'
3.
Reviewer/Inspector Signature: _ Date: z I S A
3/23/99

Division of Soil and Water Conservation 0 Other Agency
0 Division of Water Quality
Routine 0 Coni laint 0 Follow-up of D«' ins cation 0 Follow-u of 1)SWC review 0 Other
Date of inspection / $
Facility Number
Time of Inspection 8 24 hr. (hh:mm)
13 Registered 13 Certified M Applied for Permit 0 Permitted Not Operational Date Last Operated
Farm name: a.lv«'5......... ...-.�c .thr.................. County: ........h (:!..................................... .......................
T......._....................................
OwnerName: .............Gcpu`' ..........................Cr.x.-!� Y................................................. Phone ............................................
Facility Contact: .mac C0A................GVS.1'-4' . .. Title: Phone No:
Mailing Address:....``S .1.....6Vf_M :P1 ........POWSl.l........ F.0..................... j ......1 " 4+-s vAkt.tJ.t................................... .. 3` ......
Onsite Representative: ......... z6 1?ft...... 6V-1:.41�.......................................................... lntegrakor:......... s..�l ....5<................
Certified Operator;............................................................................................................... Operator Certification N€lmber;................
Location of Farm:
�,...rw........��.....a......�.........o.,...gL... inJ.
.....�ec.:............................................ :.......................................
------------------- --- -- - ............................................................ ..
Latitude =• 6 44 Longitude 0• =f ="
Design : - .Current
:Design Curren ,Design ; : Current
k'
Swine '. < Capacity` -Population
Poultry Capacity Population Cattle Capacity Population u
❑ Wean to Feeder
Layer
El
Feeder to Finish
S,S- d
❑ Non -Layer
='
❑ Non-Dairy
;Y
❑ Farrow to Wean
El Farrow to Feeder'
❑ Other
❑ Farrow to Finish
f
Total Design Capacity„
❑ Gilts
❑ BoarseeTota155LW
Number of 11 agoons 1 Holding i'onds T
❑ Subsurface Drains Present
❑ Lagoon Area
10 Spray Field Area
u
No �...�
Liquid Waste Management System
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes M No
2. 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 ET -No
b. If discharge is obsen-ed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
[ No
c. If discharge is observed, what is the estimated flow in gal/min?
N
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
( No
3. Is there evidence of past discharge from any part of the operation?
❑ Yes
No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
Q No
5. Does any part of the waste management system (other than lagoons/holding 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
W No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
CO No
7/25/97
Continued on hack

F`,aci tv;tNumber: 3 z,
8. Are there lagoons or storage ponds on site which need to be properly closed'?
Structures (Lal oons,Holdine fonds, Flush Pits, ete.1
9. is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure ? Structure 3 Structure 4
Identifier:
.....................................................................................
Freeboard (ft):........... i:..t.
10. is seepage observed from any of the structures'?
❑ Yes IM No
J9 Yes ❑ No
Structure 5 Structure 6
L� Yes ® No
Is erosion, or any other threats to the integritN of any of the structures observed'? El Yes [RNo
12. Do any of the structures need maintenance/improvement?
Yes
❑ No
(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
C No
Waste Application
14. Is there physical evidence of over application'?
❑ Yes
[g No
(If in excess of WMP, or entering waters of the State. notify DWQ) _
runoff
15. Crop type fi!�.V.fA-...............1 ars<<..... ot]<A.........._.................... (; flt....................................... ............._
"
lb. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW,v1P)?
❑ Yes
[Y No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18. Does the receiving crop need improvement?
aYes
❑ No
19. Is there a lack of available waste application equipment?
❑ Yes
® No
20. Does facility require a follow-up visit by same agency?
NYes
[I No
21. Did Reviewed]nspector fail to discuss review/inspection with on -site representative?
r
❑ Yes
WNo
22. Does record keeping need improvement?
Yes
Ij No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
® No
24. Were any additional problems noted which cause noncompliance of the Certified AW,MP?
❑ Yes
No
25. Were any additional problems noted which cause noncompliance of the Permit'?
❑ Yes
No
3 No -violations or de'ficiencies'were noted -during this:visit.- .You.will receive no further
correspondence about this.visit.-
Comments(refer to;question #):,;Explain any YES answers and/or ant recomneendatzons or any other comments
Use.drawings.ol' facility to better explain situations. (use additional pages'as.necessatr•v)
R. Lt�eOYnSf tLias c�ooa.1-�, ooc\ UVJ ioVU (n¢S I&Otw r`v� a r1eS�nsi�}i 4 �:i►uE� tnatlx�GY
�
1 1
f2. Rees on acTt�� a:�{t Wei� S"WvIU Le- v "ve)- �u-- ovt�3,�L& wlAl 51ltdA l6e .,owea,
lt�. �+xu�E cast),;vim S4WJ�u lot rLtnnove� ��• tie�� 4�t- 4.MkocJ 17e,"rW4� ,Fo grne� �ernwt�r s id b,
J
Svc ►�-bn,x. Wae� (i t �l � �33 - �'S K .5az. �,r
Copy{ o� Coe- -Y
7/25/97
Reviewer/inspector Name
Reviewer/Inspector Signature: Date: -T1,0A

State of North Carolina
Department of Environment,
Health and Natural Resources
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
November 13, 1996
George Garner
Garner's Hog Farm
551 Gurman Powell Rd
Kenansville NC 28349
SUBJECT: Operator In Charge Designation
Facility: Garner's Hog Farm
Facility ID#: 31-42
Duplin County
Dear Mr. Garner:
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form'must be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our office.
Examinations have been offered on an on -going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this requirement please
call Beth Buffington or Barry Huneycutt of our staff at 919/733-0026.
Sincerely, i
A. Preston Howard, Jr., P. ., Director
Division of Water Quality
Enclosure
cc: Wilmington Regional Office
Water Quality Files
P.O. Box 27687, NA
�� FAX [phone]
Raleigh, North Carolina 27611-7687 An Equal Opportunity/Aifirmafiive Action Employer
Voice 919-715-4100 5M recycled/10% post -consumer paper
l�

❑ Division of Soil and Water Conservation ❑ Other Agency a
v €�RDiviston of Water Quality'
Routine 0 Complaint 0 Follow-up of DW2 ins ection 0 Follow-up of D.S1VC review 0 Other
Date of Inspection
Facility Number j Z
Time of Inspection E 24 hr. (hh:rnm)
13 Registered © Certified p Applied for for Permit Ji Permitted 113 Not O erational Date Last Operated:
Farm Name :..... 6z,G.xUCS.....40...........(.4rr?............... I ............................................... Countv:..�`�1S} `lea. .......................................
Owner/........................................................................... Phone No: ..C91t)� .. . I&..t?ar.........................................
Facility Contact: ...&Cvr5G...... .L�P aeut .............................. Title:.......A.W.tub...................................... Phone No: 610.21G.:.. .........
Mailing Address: —5-5 16urftpan.,.....Nuld.t......k2� ......................................... ... tt [fin ttR -..... v....1s............................... ... M-441.....
Onsite Representative: ...... jGWIV........ l.:J.rrstr......................................................... Integrator: ....... jcanmij 5......................... ...............................
p . Operator Cert�cation Number;....... 7 ° l
Certified O erator:......................... ..................
.........................
Location of Farm:
Y�..... .... iatS.......fxz" ..... .. �13#I�..lr'�. ..... .tta-n..... �A :..4Yt... ��....i��.:.....�~f11X1. ..... ekk...olz.. ..............
�
.'......JAn-T........ la ...... q'..4....M..,A ��....... .1!�.A---.ntr..�'�...�` ......... if-.IT�.r................................................................................................
Latitude ' 0' " Longitude ' 4 "
r Design Chrrent N ; ;; t Design x' Curren#r IJesign Current '
-
z
Swme Capacity Populate©n Poultry Cagacaty Population Cattle r' { Capa0 P 0116tion,�
❑ Wean to Feeder ❑Layer r ❑ Dairy
® Feeder to Finish 55 ❑Non -Layer I 1 ❑ Non -Dairy
;
❑ Farrow to Wean t:
El Farrow to Feeder ❑Other
❑ Farrow to Finish Total Deli nCa aCit
❑ g p Y Sr S� u
Gilts
❑ Boars Y .` 3 �� s" Total SSLW� -
- _A
z. Number of Lagoons / Holtltng Pontls Subsurface Drains Present ❑Lagoon Area Spray Field Area jk
' ❑ No Liquid Waste Management System
�4 _m_:
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Dischargebriginated 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?
A. 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?
❑ Yes
EffNo
❑ Yes
1W No
❑ Yes
No
❑ Yes
JA No
N
❑ Yes
PE
fZ No
❑ Yes
ErNo
❑ Yes
Ef No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7_ Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes RrNo
❑ Yes VNo
❑ Yes WNo
Continued on back

0
Facility Number: 31 — y
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,Holding Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes F�( No
❑ Yes KNo
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
r
Freebnard (ft): .............Zak........................
10. Is seepage observed from any of the structures? ❑ Yes WNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes 56 No
12. Do any of the structures need maintenance/improvement?
IRYes
❑ No
(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
9No
Waste Application
14. Is there physical evidence of over application?
❑ Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ............ ...............ay.-U4....r�ra.itch ......................... .......1 <:Rax.......................... .........................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
%No
17. Does the facility have a lack of adequate acreage for land application?
❑ Yes
.N No
18. Does the receiving crop need improvement?
❑ Yes
UNo
19. Is there a lack of available waste application equipment?
❑ Yes
No
20. Does facility require a follow-up visit by same agency?
❑ Yes
'� No
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
®.No
22. Does record keeping need improvement?
94 Yes
❑ No
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
Q No
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
®,No
25. Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
O(No
No.violationsor. deficiencies: were noted -during this'visit:- Yoii.will receives i6liirltheir-
: ctirres f)b ideh6e vibout this visit.
1L. lnit P;Qas �^ lncco., sk*vO be ex1We3 oA-vos6r, ewtas bacl'-4iJuj w+k- c1 aY,oi rrTe��•
Racl�s;t}c O VkA- wakk Le YMWI-J a41j i-tfes nrnovtJ• IfOr-
a�ss
zz- �.a�aun dpsi�n, eh�,�ay►ct� .cr,�iat• ��an1 :nset,'� �ador C:ov��t'aI ovrtJ vno�ai�4y- G�eri(.y1� sha�I�
to �e1'm�1}t� ��°'�" IR(l-Z ivrm SG.oult) ioe t}Strj i'a>r ;yJividva cm�
7/25/97
Reviewer/Inspector Name
Reviewer/lnspector Signature: NA,:— /_ _ �/tL4 Date:

State of North Carolina
Department of Environme
Health and Natural Resou
Division of Water Quality
James B. Hunt,, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
August 22, 1997
George Garner
Garner's Hog Farm
551 Gurinan-Powell Road
Kenansville - NC 28349
&LT.K;WA
14
E)EHNF1
Subject: Farm No. 31-42
Additional information Request
Garner's Hog Farm
Animal Waste Operation
Duplin County
Dear Mr. Garner:
The Permits and Engineering Unit has completed a preliminary engineering review of the subject
application. Additional information is required before we can continue our review. Please submit two
copies of the notarized land agreement as part of the Certified Animal Waste Management
Plan required in item I (3) 'of the General Permit Application Form by September 22, 1997.
Please -reference the subject farm number when providing the requested information. All
information should be signed and submitted to my attention at the address below. Please note that failure
to provide this additional information on or before the above requested date can result in your application
being returned as incomplete.
If you have any questions regarding this request, please call me at [phone], extension 363.
Sincerely,
J.R. Joshi .
Soil Scientist
State' Engineering Review Group
cc: Wilmington Regional Office, Water Quality
Permit File
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled110% post -consumer paper

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
A. Preston Howard, Jr., P.E., Director
August 14, 1997
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
George Garner
Garner's Hog Farm
551 Gurman Powell Rd
Kenansville NC 28349
Farm Number: 31-42
Dear George Garner:
&MI.WYVA
14
IDEHNFi
You are hereby notified that Garner's Hog Farm, in accordance with G.S. 143-215. IOC, must
apply for coverage under an Animal Waste Operation General Permit. Upon receipt of this letter, your
farm has thirty (30) days to submit the attached application and all supporting documentation. In
accordance with Chapter 626 of 1995 Session Laws (Regular Session 1996), Section
19(c)(2), any owner or operator who fails to submit an application by the date specified
by the Department SHALL NOT OPERATE the animal waste system after the specified
date. Your application must be returned within thirty (30) days of receipt of this letter. Failure to submit
the application as required may also subject your facility to a civil penalty and other enforcement actions
for each day the facility is operated following the due date of the application.
The attached application has been partially completed using information listed in your Animal
Waste Management Plan Certification Form. If any of the general or operation information listed is
incorrect please make corrections as noted on the application before returning the application package. The
signed original application, one copy of the signed application, two copies of a general location map, and
two copies of the Certified Animal Waste Management Plan must be returned to complete the application
package. The completed package should be sent to the following address:
North Carolina Division of Water Quality
Water Quality Section
Permits and Engineering Unit
Post Office Box 29535
Raleigh, NC 27626-0535
If you have any question concerning this letter, please call J R Joshi at [phone] extension
363 or Dave Holsinger with the Wilmington Regional Office at [phone].
Sincerely,
Preston Howar , Jr., P.E.
cc: Permit File (w/o encl.)
Wilmington Regional Office (w/o encl.)
P.O. Box 29535, Raleigh, North Carolina 27626-0535 Telephone [phone] FAX [phone]
An Equal Opportunity Affirmative Action Employer 50% recycled/ 10% post -consumer paper

•
Site Requires Immediate Attenti
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT *WAQ
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD`
DATE: o , 1995 ry1
Time: /'/4 5�_
Farm Name/Owner: ems, -
Mailin Address:If
g � ws� - J Gl 9 ka N ,� , )14 , j2 ! /
County:
Integrator: (�'!l� - Phone: (93 31-13 L/
On Site Representative: bo Phone: .9 76 06 3 S—
PhysicalAddressAocation: Me%?- 1-703U! jc-144o)(`lu ,,,gdf 'rP,*, •--S��'� --
Type of Operation: Swine �ultry Cattle
CD!� mod - % cuJA-et
Design Capacity: 5_fW Number of Animals on Site: S"k'
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: �'`� ° 7 Longitude: `?'7 ° _5� L)" Elevation:- Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Ces r No Actual Freeboard: — -5,_Ft. a Inches
Was any seepage observed from the lagoon(s)? Yes or oo Was any erosion observed? Yes or6
Is adequate land available forspray? e or No Is tli`e cover crop adequate? or No
q� P q
Crop(s) being utilized: �n i'�'^" 4
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? e r No
100 Feet from Wells? 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 No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or ' If Yes, Please Explain.
Does the facility maintain adequate waste management records (voltirnes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No
Additional Comments:
r
InspectorNarhe
Signature
cc: Facility Assessment Unit
Use Attachments if Needed.

Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT t12
ANU AL FEEDLOT OPERATIONS SITE VISITATION RECORD �I
DATE: 1995
• Time: /0 '
Farm Name/Owner 02rc7ii'/J P�
Mailing Address:
County: -
Integrator. d Phone:
On Site Representative: Phone:
Physical Address/Location: Zq` Q0+ 4 V 'j K e rt' + cA S12 CGSQ i eff
Onto n2,0 fw, imed. oA ie-{"• r
Type of Operation: Swine Poultry Cattle
Design Capacity: Number of Animals on Site:
DEM Certification Number. ACE DEM Certification Number: ACNEW
Latitude: Longitude: Elevation: Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) E>sr No Actual Freeboard. Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or(9Was any erosion observed? Yes or No
• Is adequate land available for spray? Yes r No Is the cover crop adequate? Yes r No
Crop(s) being utilized: _ �J P� Yr1� j C2 +�
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? Yes or No
100 Feet from Wells? Yes 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 No
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? Yes or& If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)? Yes or No 2
Additional Comments:
L C e,4,.5
Inspector Name
Signature
cc: Facility Assessment Unit Use Attachments if Needed.