710084_INSPECTIONS_20171231

NORTH CAROLINA �
Department of Environmental Qual

x
og- `(
(Type of Visit: t) Com iance inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit: Routine O Complaint Q Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: t Z? Arrival Time: Departure Time: j County: Region:
Farm Name:
Owner Email:
Owner Name: Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title:
Onsite Representative: IT tnn C f k f9 ('0Lr-
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Phone:
Integrator:
Certification Number: 1 71 7 6
Certification Number:
Longitude:
Swine
Wean to Finish
Design Current
Capacity Pop.
Design Current Design Current
Wet Poultry Capacity Pup. Cattle C►apacity Pop.
Layer iry Cow
can to Feeder
Sro 9
Non -La er Iiry
Calf
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Dairy Heifer
Design C*urgent Dry Cow
D . P,ouIta aci P,o Non -Dairy
Farrow to Finish
Gilts
Boars
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Beef Stocker
Beef Feeder
Beef Brood Cow
Other
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes D-IV6 ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes ❑ No
❑ 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 ffNo
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
[:]Yes
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3
21412015 Continued

[Facility Number: - Y jDate of Inspection: L y 21
f
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
[a'lVo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure
6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
No
❑ NA
❑ NE
(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
ENo
❑ 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 environmen l threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes o ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [:]Yes 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 EJ'No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
i
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 YNo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes do ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes 40 ❑ NA ❑ NE
[:]Yes ❑ No ❑ NA ❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes o
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes E] No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes ENo
❑ 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 [�] o
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
❑ NA
❑ NE
Page 2 of 3 21412015 Continued

Facili Number: - Date of inspection: Z
24. Did the facility fail to calibrate waste application equipment as re required b the permit?'
Yes No . NA NE
tY Ppq Y P ❑ ❑ ❑
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 No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No E31 A ❑ 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)
❑ Yes ErNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes CTNo ❑ NA ❑ NE
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
E5"No ❑ NA ❑ NE
El -No
❑ NA
❑ NE
E�
❑ NA
❑ NE
❑ No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
/CefCc> S (0e,h / 00
�0 Ys
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
�c Phone: VIF( 730yF
`
Date: f r f
Z.) / S
21412015

91
Type of Visit 0,C.,00 pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assi's�t nce
Reason for Visit ( Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: 1 3 o$ Arrival Time: I d 36 Departure Time: County: P Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact:
Owner Email:
Phone:
Title: Phone No:
Onsite Representative: &tn_CC4? NZZSaN i5l - dl,l/ aasz&___ Integrator:
Certified Operator:
Bach -up Operator:
Location of Farm:
Operator Certification Number:
Back-up Certification Number:
Latitude: = c = d Longitude: [= ° a 4
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
® Wean to Feeder ZAOO
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ Layer
❑ Non -La et
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
Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ 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 Q No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El NA
❑NE
❑Yes
El Yes
Zo
❑ NA
❑ NE
❑ Yes 2 o ❑ NA ❑ NE
12128104 Continued

Facility Number: — 8 V I Date of Inspection f 3 O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 2/No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: &WaSCQY [ NU'd..SEIt.`i Z Ponsf1Lq 3
Spillway?:
Designed Freeboard (in): '�' / 9i S �9S
Observed Freeboard (in): 3 % 3`j U�
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes /No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �(7No
❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ NA NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) ❑
9. Does any part of the waste management system other than the waste structures require ❑ Yes U No ❑ NA ❑ NE
maintenance or improvement?
Waste Application No
10. Are there any required buffers, setbacks, or compliance alternatives that need ElYes C ❑ NA ❑ NE
maintenance/improvement? ,.,�
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes C No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground El Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs El Total Phosphorus ❑ Failure to incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s)t1GA L G
13. Soil type(s) Gob
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes E3!qo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? es ❑ No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes kJ No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes �VNo
- ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? El
Yes ❑ NA ❑ NE
1S.} SaW.,E t.%E%D �1-�Tn.oL J� bft i6!✓ GfI�SS.
Reviewer/inspector Name 3 -a Phone: (910)1'1
Reviewer/inspector Signature: Date: I i3 0�
12128104 Continued

FacilitykNumber: 71 — $ q Date of Inspection + oS
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes Eff No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 6No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design
g ❑Maps El Other
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes dNo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rain Inspections ❑ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes WNO
�o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ A ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes to ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? El Yes 5 No � ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes E No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes 'I o [3 NA ❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
Ed/NO
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
14 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
L"J 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
El Yes
,��
ETNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
�f
32.
Did Reviewer/]nspector fail to discuss review/inspection with an on -site representative?
❑ Yes
{d No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
N.
Additional Comments and/or Drawings: k
12128104

(Type of Visit QfCompliance Inspection O Operation Review O lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other
Facility NumberEMD-1a=
Date of Visit:
,Permitted 0 Certified 0 Conditionall1v Certified [3 Registered
Farm Name: �%✓� 1� _ _ .__
Owner Name: _— ��fL���D��
Tune:
❑ Denied Access
10 Not Onerational O Below Threshold 1
Date -Last Operar�- /Above Threshold: ^ M�
County: .�L�t°.__.. _.......
Phone No:
Mailing Address:
Facilitv Contact: tie
• _��� Phone No: _
Onsite Representative: USSF L. `v D�� _ . �.�11 tor. ����t --- � .�✓ f _
Certified Operator:
Location of Farm:
Operator Certification Number.
J(Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • Longitude • c Du
Swine - -_
F.
ter
Total Desl€ n Capa=ty
'Total SSLW
eV
MM-
DisChaM & Stream ImDact5
1. Is any discharge observed from any part of the operation? ❑ Yes ZNo
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 ON6
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes VNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ;2rNo
Ture l Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Freeboard (inches):
12112103 Cowed
ter
Total Desl€ n Capa=ty
'Total SSLW
eV
MM-
DisChaM & Stream ImDact5
1. Is any discharge observed from any part of the operation? ❑ Yes ZNo
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 ON6
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes VNo
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ;2rNo
Ture l Structure 2 Structure 3 Structure 4 Structure 5 Structure 5
Freeboard (inches):
12112103 Cowed

Facility Number: — 154
c Date of Inspection '
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes �No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes /No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenanceJimprovement? ❑ Yes ONo
8. Does any part of the waste management system other than waste structures require maintenanceimprovement? ❑ Yes WNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes VNo
elevation markings?
Waste Application
10. Are there any buffers that need maintenancehmprovement? ❑ Yes ]ONo
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes No
❑ Excessive Ponding ❑ PAN !ydrauli Over�loadd__.�+❑ Froze /'mound Copper
or c
12. Crop type �/!?l//1.4 !//�if?1� _ //�[� tllrtl2l�
13. Do the receiving crops differ with those desig&c&d in the Certified Animal Waste lanagement Plan (CAWMP)? ❑'Yes XNo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ONo
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 ONo
16. Is there a lack of adequate waste application equipment? ❑ Yes ; f No
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below j] yes C2rNo
liquid level of lagoon or storage pond with no agitation?
18.- Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ;XNo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes )z No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes M No
Air Quality representative immediately.
❑ Field Copy ❑ Final Notes
)evfw eln07 OVA OS„ ��GZC.4TzPJrt�
/1� eAF]. 5 I"� ,eA S �zGc �u7' �No G- T� �6 C 82,�5. D.✓
�f �T��� ��� �/off w.�s �,� •D,��.� ��fo � s G('��'iv ���
W'w
lei
—121
llnc ;r &a
..Q �
Reviewer/hmpector Name - 2
ReviewerAWspector Signature:
Date:
l2/12m3
rnniraurd

TAT I
Fa ' 'ty NumERGber: — Dspe ate of Inction L/,� T
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. Does record 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?
NPDES Permitted Facilities
❑ Yes No
❑ Yes Yf No
❑ Yes [Z(No
❑ Yes 9No
❑ Yes ;Z No
❑ Yes gNo
❑ Yes ❑'No
❑ Yes No
❑ Yes No
30_ Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes J�fN0
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 7❑ No
32. Did the facility fail to install and maintain a rain gauge? ❑ Yes ❑ No
33. Did the facility fail to conduct an annual sludge survey? ❑ Yes ❑ No
34. Did the facility fail to calibrate waste application equipment? ❑ Yes ❑ No
35. Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After 1 " Rain
❑ 120 Minute inspections ❑ Annual Certification Form
12112103

Type of Visit to Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit O Routine O Complaint (_') Follow up Q Emergency Notification Other ❑ Denied Access
Facility Number Date of Visit: w.n
ime:
oOperational Q Below Threshold
)Permitted 0 Certified Lj Conditionally Certified 0 Registered Date Last Operated o bove Threshold: _
Farm Name:-����� G%IQJ�4�5 County:
�_- ILTa
Owner Name: ��ToNF�l��20D� Phone No:
Mailing Address:
Facility Contact: I Title: Phone No:
Q �
Onsite Representative- �frGL tiCJK?�fr _ Integrator:
Certified Operator: Operator Certification Number:
Location of Farm:'
Swine ❑ Poultry ❑ Cattle ❑ Hot~ Latitude �' 0` �" Longitude
can to Feeder 80 ad ivOQ
Feeder to Finish
❑ Farrow to Wean
Other
Farrow to Finish
Subsurface Drains Present
aste
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gat/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste !Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I S eture 2 Structure 3 Structure 4 Structure 5
Identifier: 0911 Z .41-3
Freeboard (inches): /
0510310I
Field Area
❑ Yes )2rNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes 2No
❑ Yes _J2TNo
❑ Yes ❑ No
Structure 6
Continued

Facility Number: ql= Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
El Yes
El No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
❑ No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
❑ No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
❑ No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ W1JP, checklists, design, maps, etc.)
❑ Yes
❑ No
19. Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
20. is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ❑ No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes XNo
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
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
,pa)-Q 1__4�104115� D,-) 17/7-6/03
21 `mod ;D�xff dF61
Reviewer/Inspector Name j
Reviewer/Inspector Signature:
Ll Field Copy LJ Final Notes
Date: �3

Facility Number: bate of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge allor bc]ow• ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ❑ No
28. Is there am 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. NVere 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
it, Do the animals feed storaL-e bins fail to have appropriate cover? ❑Yes El No
32. Do the flush tanks lack a submerged fill pipe or a permanentitemporary cover? ❑ Yes ❑ No
I C A5
�2%GD. 7
S
do
Z.oq o� RICA-
q5 3° 24S
55
�P l v &I SD A,
17- . /i�
o
-rJo4L W o-r lSocuc.,
.1 rn ©N n! -T OF w -a✓ orz Sr i%
05103101

a
Type of Visit _,,,C Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up () Emergency Notification O Other ❑ denied Access
Facility Number I
Date of Visit-
[3 Permitted © Certified ]0 Conditionally Certified [3 Registered
Farm Name: �+o [ b rt9Q i- r J se,- t QS
Owner Name: O O r aa/e- ; &4u
Mailing Address:
Facilitv Contact: �p f pTitle:
OnsiteyRepresentative-
Certified Operator:
Location of Farm:
[e Time: Z= 657
10 Not Operational 0 Below Threshold
Date Last Operated or Above Threshold:
County: Fe', d e -.-
Phone No:
Phone No:
Integrator: M✓�e.4t_g�a�/n_
Operator Certification Number:
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 0' 0. 0 " Longitude 0' 0
Design . Current Design Current_ DesEga Current �-�
Swtne e:
Ca acii� Po alateon Poii! Ca ac�ty Gst
Pd ulatiou w tle=Ca'sctty -P© utshon
❑ Wean to Feeder
❑ La er
.
❑ Dairy
❑ Feeder to Finish;_=
El Non -La er
i
El Non Da'
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
�i atal Design Capacity
❑ Gilts
,.
❑Boars
- Total=SSLW -
�i+ ru f Lagoons ms ❑ Subsurface Drains Present ❑ L oon Area 10 Spray Feld Area
;HoldtnfPondsJ_Sohd Traps ...L ❑ No Li uid
Waste Mana ement System= i -....e , !
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (if yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste CgIlection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
identifier: I 'r i 2-3
`
Freeboard (inches): 14
05103101
❑ Yes PfNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
�no
❑ Yes
JZNo
❑ Yes �No
Structure
Continued

Facility Number: 171 —
Date of Inspection I
5. Are there any immediate threats to the integrity of any of the structures observed?.(ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes ErNo
❑ Yes I�o
❑ Yes X-No
❑ Yes'O'No
❑ Yes 0
Waste Aunlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes PrNo
11. Is there evidence of over application? ❑ Excessive Ponding�� El PAN [I Hydraulic Overload ❑ Yes �'No
12. Crop ty//
pe e r ✓Gl<t: �r � C S G V e, C r A- Z Q� l' G e of I 'n
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes .t'J No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ,ZrNO
b) Does the facility need a wettable acre determination? ❑ Yes 07No
c) This facility is pended for a wettable acre determination? ❑ Yes FZrNo
15. Does the receiving crop need improvement? ❑ Yes ',07No
16.
Is there a lack of adequate waste application equipment?
❑ Yes Z No
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes JENo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes ,,�No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes OIo
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 ONO
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes "ff-No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ YesNo
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 P140
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments {refer to'questiu t #) . Ezphiin any YES answers and/or. any reeommeo ations�or slay ather`_Commeats
;Use drawings of facility to; better explain-si#uatiotis. iise adtirdoaal pages as necessary) ; ❑Field Cony ❑ Final Notes
S_ well e e t7ou-se grect and Ite
1^0o ong Are weir✓ rma.rr,'!>vreA . -T-�Ie Y'eferds n,,e Lvell
+11c irc rece,v(-\) GraIoS ire well e,s4,qbl;shed. TL,e
- 'o AIA; n► a l' n fh ►� s r<a ,, ,�-, i h good a,-olee q re ev;&Ie n �
, 7
Reviewer/Inspector Name ";
Reviewer/Inspector Signature: Date: I CL111422=
05103101 Continued

•
Facility Number: -- C? Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
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)
24. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any mayor 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?
tldditionAa Couimn nts.andloi•_Dravrings;
05103101
❑ Yes ❑ No
❑ Yes 'O"'Vo
[I Yes o
❑ Yes ❑ No
❑ Yes allo
❑ Yes _4E]No
❑ Yes ❑ No

Date of Visit: 10 f 2 0 1 Time: 1 a 3
Facility Number rj $
Q Not Operational Q Below Threshold
13 Permitted 0 Certified r] Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: ...... Sa�'?'}!.b.'�c F......V / sGr T.fe1........................... County: `I?'1.¢:r.................................
OwnerName:....Tov�e.�.�^ep.... r>f�................................... Phone No:............................................................ . _. _..
FacilityContact:...................................................I.......................... Title:................................................................ Phone No:...................................................
MailingAddress:........................................................................................ n
Onsite Representative: �a ✓t q rt/' D ! v S S Q �. �... ✓ a G.......... Integrator: 315 +"oW " QC---.[,i5 ✓ Q �t .'�AL.... ..
Certified Operator:..........................................................................------•....... ............................................................. Operator Certification Number:
Location of Farm:
i
e
❑ Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude �• �° 66 Longitude • 4 �K
Design Current
S'e =- Capacity Pouulation
== ❑ Wean to Feeder
Feeder to Finish
n ❑ Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
❑ s
Number'.o[ Lagoons ❑ubsurface Drains Present Lagoon Area ❑ Spray Field Area
Ho[ ' Ponds'LSolid:T dmg raps ❑ No Liquid Waste Management system
Discharges & stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-madc9
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: L 3
............
Freeboard (inches): 3q 37
5/00
❑ Yes ONO
❑ Yes J'No
❑ Yes,, RNo
[:]Yes J'No
[--]Yes PrNo
❑ Yes FINo
❑ Yes n No
Structure b
Continued on hack

Facility Number: — $ Date of Inspection
• 5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ONo
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
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? ❑ Yes gNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes j2-No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ZNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes jZrNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ZNo
12. Crop type Grate i k r, e c v e G IIq 22
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ONo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ONo
b) Does the facility need a wettable acre determination? ❑ Yes XNo
c) This facility is pended for a wettable acre determination? ❑ Yes jZNo
15. Does the receiving crop need improvement? ❑ Yes ,dN0
16. Is there a lack of adequate waste application equipment? ❑ Yes '[�No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
l8. 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?
Molatioils;ein dfciencie ire note l dining �h�s;vis}ti Yoa wi�� t ee ipe �iti futtho
• : • correspondence: a�aut: this visit - . - : - ; - ; - ; ' - - ' - ' • • • ' •
Comments (refer to question #} Explain"any'YFS answers "andlor-any recomnteadations or any other comments
Use drawings of facili to better._e tplaia situations. O se additio_ni pages as necessary)
1 Gie POOL Cra?OS� GnoersdfGtS q.-e neelifkef
❑ Yes .,O No
❑ Yes J'No
❑ Yes j2'No
❑ Yes EfNo
❑ Yes ,ONo
❑ Yes J'No
❑ Yes eNo
❑ Yes -Ea'No
❑ Yes �No
A.
Reviewer/Inspector Name
Reviewer/Inspector Signature: /"�4��iL�, Date: /8 [1-4-1a 1 5/00

Facility Nuutber: — Date of Inspection 1 d 2 Q
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes xNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 0 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 10 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 JNlo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes [JNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional — -
ommen an ar Drawings:
i
5/00

Facility Number Date of visit: I
firpermitted 0 Certiified 0 jC��onditionally Certified 0 Registered
Farm Name: �70 r Le If:�d.� N.rY .i L�:f ..............................
................. ............ ... !!__
Owner Name:........�r�h@ Dr�p�....aY...1....`.���.`....
FacilityContact: .............................................................................. Title: ..........................
Mailing Address:. ........................ ...........
Onsite Representative: , Q l.q.., ,,,,rb+l,...
CertifiedOperator: ....................................................... .........................................................
Location of Farm:
KITime: ) S Printed on: 7121 /2000
Not Operational 0 Below Threshold
Date Last Operated or Above Threshold:
Countv: �@'�
................... ..................
Phone No:
Phone No:
........................................................._........../..!.._..r0. ..........................
Integrator:. r?n V, ....0/67 ... /in:!?, ..............
Operator Certification'Number:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 « Longitude • 6 «
DesignCurrent
Desi Current Dent
gn gt4 a: Current.,
Y "Swine Capacity Po ulation
Poultry
Capacity Population Cattle Capadtji.. Population
Wean to Feeder 12 1 g60 I
I[] Layer
I I ❑ Dairy
Feeder to Finish
❑ Non -Layer
L ❑ Non -Dairy
Farrow to Wean
-
Farrow to Feeder
❑Other
=
Farrow to Finish
Total Design Clpacity
Gilts
Boars
Total SSLW''.:
Niihi er of Lagoons 3 ❑ Subsurface Drains Present 110 Lag -on Area I0 Spray Field Area
Holding Ponds/ "A Traps C�. ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon [3Spray Field [IOther
a. If discharge is observed, was the conveyance man-made`?
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure i Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ...............l 2 3
.............................................................................................................................................................
Freeboard (inches): '4 Z qq[
5100
❑ Yes ONO
❑ Yes ONO
❑ Yes ONO
"h' a
❑ Yes R] No
❑ Yes PNo
❑ Yes 14 No
❑ Yes Po
Structure 6
Continued on back 1 �AA

Facility Number: r%l — 8q Date of Inspection f Printed on: 7/21/2000
-5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes 14No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes X No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
ixNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
;gNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
fi4No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
I No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
ElYes
ONo
12. Crop type C5 a y y'1 Ud A erei ze re se e 6f'i Z,e- 5'rL4 / r,• I h
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
gNo
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
ANo
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
PgNo
I8_ Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
❑ Yes
XNo
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
Xryes
❑ 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
§4No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
O No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
`A No
24_ Does facility require a follow-up visit by same agency?
❑ Yes
P No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
�Wo
0: N viulati6iis ;oi- deficiehd� ,s •were nq#ed• during �his:visit: • Y:oir will •receive iio: fui then
,correspondence. about this visit. . .......:........................ ..
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):
12v1ls 14 2 are Cesvue, in FI-xK 6uv PoznsV y berm,,MA in p�'M-JAC �
�v�e plan des �, eld AGa, c;e =,E;lsvre es-FaGti s�, c>z (,�r.•.�.vd�,
oyj dr n+ � +
bas ed or, we able acres oWe_--m;nq�; oh 6
6e sv� 40 VSe aG)rect es - form,, t-o 22 4(e �'c�res p(c,}er'rti�vtig71o�1 Oil ���-� Rg.
So,,n a ev erl+S Ar 4 11a V e been Y'CGorrl e6( o►1 -TKK - I ,S L7ci vc 170l 6z ev
rer-orde4 on �K)2- Z's; Ue sv,-e h rrorc.-1 r7c&o)-d ACl evevrfs Use
waste q►igl SiS dot -fed 60 d4y s
Reviewer/Inspector Name '�) e L.y/o! l %/ ie
Reviewer/Inspector Signature: Date: 5/00

Facility Number: -8 Date of truspeetion Printed on: 7121 /2000
• Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge Wor bglow
Yes
❑ No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
KNo
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
broken fan blade(s), inoperable
or 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 peirnanent/temporary cover?
❑ Yes
No
Additional'Comments and/orDrawings:
CAI&v)eII 1'v-Mf cx IS,
J
5/00

Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream S1ope,xH:1V
Embankment Sliding?
(Check One, Describe if Yes)
Seepage?
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
Lagoon Dike Inspection Report
r
c'f ?-7 Names of Inspectors
Freeboard, Feet
f Top Width, Feet 16
Downstream Slope, xH:1V t V
Yes No
Yes No
Yes No
Condition of
Ve 've Cover f
Trees)( - - - - - - - - - - - -
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow Up Inspection Needed? Yes No
r
Engineering Study Needed? Yes No
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No
Other Comments

Lagoon Dike inspection Report /
Name of Fann/Facility `7 ! -` � ` \/
Location of Farm/Facility Fkv
G,g vC _
Owner's Name, Address &14 e- (/ � 3=4=jG
and Telephone Number 0) 99.�`— 01413 Y
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream S1ope,xH: IV
Embankment Sliding?
(Check One, Describe if Yes)
Seepage?
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
Condition of
V tive Cover
Grass, reel)
3 `Z Names of Inspectors �CJfz,J yu
7 Freeboard, Feet ��
_
lam- Top Width, Feet
Downstream Slope, xH:IV 3 1 !
Yes No
Yes X No
Yes )l _ No
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
Engineering Study Needed? Yes — No
Is Dam Jurisdictional to the Dam Safety Law of 1967?
Other Comments
Yes �,4 No

4
Lagoon Dike Inspection Report
Name of Farm/Facility
1'` �y
Location of Farm/Facility
�. (u/ e&-%— S c i
Owner's Name, Address
/4f_4l�G ��L
I� id e—
and Telephone Number
Date of Inspection
Names of Inspectors _
_4,v56-j_1
C
V-..vo AttZ-
Structural Height, Feet
to' Freeboard, Feet
it
let
1 Top Width, Feet
t s t
Lagoon Surface Area, Acres
•
Upstream Slope,xH:IV
�� (✓ Downstream Slope, xH:IV
(�
Embankment SIiding?
Yes No
(Check One, Describe if Yes)
Seepage? Yes `/ No
(Check One, Describe if Yes)
Erosion? Yes No
(Check One, Describe if Yes)
Condition of C�4
gass:,�?ees)
Cover
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes No
Engineering Study Needed? Yes "�,_ No
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes No
Other Comments

Lagoon Dike Inspection Report
Name of Farm/Facility 7 r `
Location of Farm/Facility _ FF✓�
Owner's Name, Address 1xr�f8- ct�c�
and Telephone Number
o) ?es` a ! 13
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream Slope,xH:1V
Embankment Sliding?
(Check One, Describe if Yes)
`i Names of Inspectors _ L�.J ICA.,
Freeboard, Feet
142- Top Width, Feet
V Downstream Slope, xH:1V
Yes No
Seepage? Yes No
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
Condition of
V tive Cover
Grass, reel)
Yes No
,5
3 H '. 1 EA
Did Dike Overtop? Yes _ No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes _� No
r
Engineering Study Needed? Yes L No
Is Dam Jurisdictional to the Dam Safety Law of 1967? Yes �14 No
Other Comments

Name of Farm/Facility
Location of Farm/Facility
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream S1ope,xH: IV
Embankment Sliding?
(Check One, Describe if Yes)
Seepage?
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
Lagoon Dike Inspection Report
uv�L1 'A S P- / 60
Names of Inspectors �D�i .CsSeT�✓
to Freeboard, Feet
• Top Width, Feet
Yes _ No
Yes X No
Yes )` No
Downstream Slope, xH:IV
A �V
Condition of �� d
gpees)
Cover
_
Did Dike Overtop? Yes ^ No If Yes, Depth of Overtopping; Feet
Follow -Up Inspection Needed? Yes _ No
r
Engineering Study Needed?
Yes '--/, No
Is Dam Jurisdictional to the Dam Safety Law of 1967?
Other Comments
Yes No

Lagoon Dike Inspection Report
Name of Farm/Facility / 1— 94
Location of Farm/Facility 15 7"
Owner's Name, Address
and Telephone Number
Date of Inspection
Structural Height, Feet
Lagoon Surface Area, Acres
Upstream S1ope,xH:1 V
Embankment Sliding?
(Check One, Describe if Yes)
Seepage?
(Check One, Describe if Yes)
Erosion?
(Check One, Describe if Yes)
9113 C Arav�
�f Names of inspectors
fc
Freeboard, Feet
Top Width, Feet
V Downstream Slope, xH:1 V
Yes No
Yes No
Yes No
Condition of
Ve 've Cover
Trees}
Did Dike Overtop? Yes No If Yes, Depth of Overtopping, Feet
Follow -Up Inspection Needed? Yes i` No
Engineering Study Needed?
Yes _ No
Is Dam Jurisdictional to the Dam Safety Law of 1967?
Other Comments
Yes No

RLvistd January 22, 1999
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number - i izoperation is flagged for a wettable
Farm Name: acre determination due to failure
On -Site Represen ative: �.uSsr1 </ Part 11 eligibility item(s) F9 F2 F3 F4
Inspector/Reviewer's Name: l uAc , i kAy%
Date of site visit:
Date of most recent WUP: 11 Jri) 9-7
Operation not required to secure WA
determination at this time based on
exemption E1 E2 E3 E4
Annual farm PAN deficit: —11. 3o_ pounds
Irrigation System(s) - circle #: 1. hard -hose traveler, 2. center -pivot system; 3. linear -move system;
4. stationary sprinkler system w/permanent pipe; 5. stationary sprinkler system wlportable pipe;
6. stationary gun system w/permanent pipe; 7, stationary gun system w/portable pipe
PART I. WA Determination Exemptions (Eligibility failure, Part II, overrides Part I exemption.)
E1 Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D2/D3 irrigation operating parameter sheets, including map
depicting wettable acres, is complete and signed by an I or PE.
E3 Adequate D, irrigation operating parameter sheet, including map depicting
wettable acres, is complete and signed by a WUP.
E4 75% rule exemption as verified in Part Ill. (NOTE: 75 % exemption cannot be
applied to farms that fail the eligibility checklist in Part 11. Complete eligibility
checklist, Part it - F1 F2 F3, before completing computational table in Part 111).
PART 11. 75% Rule Eligibility Checklist and Documentation of WA Determination
Requirements. WA Determination required because operation fails one of the eligibility
requirements listed below:
F1 Lack of acreage which resulted in over application of wastewater (PAN) on spray
field(s) according to farm's last two years of irrigation records.
F2 Unclear, illegible, or lack of information/map.
F3 Obvious field limitations (numerous ditches; failure to deduct required
buffer/setback acreage; or 25% of total acreage identified in CAWMP includes
small, irregularly shaped fields - fields less than 5 acres for travelers or less than
2 acres for stationary sprinklers).
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 Part III.

Re-ised Janvan, 22, 1999
Facility Number 'T
Part Ill. Field by Field Determination of 75% Exemption Rule for WA Determination
TRACT
NUMBER
FIELD
NUMBER',2
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMPFIELD
ACRES
%
COMMENTS3
010(,
l�•1�-�v�v•
Z'7.17G�a�t
1►.��v�e ac eke
w Y v-,e ILL eo
yv. q
+ro&a
Sorg LL
ci l i
WAI
0.-1
C.p
S r
i
D
Iae 0 c
aC
Sv
�.
I
I
-
i
FIELD NUMBER' - hydrant, pull, zone, or point numbers may be used in place of field numbers depending on CAWMP
and type of irrigation system. If pulls, etc. cross more than one field, inspector/reviewer will have to combine fields to
calculate 75% field by field determination for exemption if possible; otherwise operation will be subject to WA
determination.
FIELD NUMBER'- must be clearly delineated on map.
COMMENTS' - back-up fields with CAWMP acreage exceeding 75% of its total acres and having received less than 50%
of its annual PAN as documented in the farm's previous two years' (1997 & 1998) of irrigation records, cannot serve as the
sole basis for requiring a WA Determination. Back-up fields must be noted in the comment section and must be accessible
by irrigation system.

Division of Soil and Water Conservation - O eration Review
;Division of Soil and Water Conservation - Compliance Inspection F
- Divisi6n.of Water"Quality - Compliance. Inspection
Other Agency - Operation Review: -
3-
JQRoutine Q Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
E­_ - Facility Number g Date of Inspection
l-ime of Inspection ti U 24 hr. (hh:mm)
'Permitted ]Certified 13 Conditionally Certified © Registered 0 Not f) erational Date Last Operated:
Farm Name: rr tt,, 5, I Ca�fnty:
�?�iP... Yii('...........V.1.!St.C.1........................ f................. .................. ..- .......................
Owner Name: �45�...................... �.S 5.. ..................
1
Facility Contact: .............. Kv.&xAl............twz .t.......... Title:
Mailing Address:
Phone No:
.............................................. Phone No:...tgV)..7-a'S~.741.�.........
Onsite Representative:............L+t1}�
...)... ........ .......... f�...� � l .Xi!1-.
Intehrator:........ lAikl............................................................
Certified Operator:................................................................................................................
Operator Certification Number:..........................................
Location of Faun:
r.............. ......................... - ...._ -....................................-.. ........................- ---..- —_ ....................... _......• _.................................................r
Latitude 0 4 .6 Longitude 0 c cc
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
Wean to Feeder - ❑ Layer ❑ Dairy
Feeder to Finish ❑ Non -Layer I L 10 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish t Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons a Subsurface Drains Present IFF1 Lagoon Area 0 Spray Field Area
Holding Ponds 1 Solid Traps ILI No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation (If yes, notify DWQ)?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach: ❑ Surface Waters ❑ Waters of the State
c. If discharge is observed. what is the estimated flow in gal/tnin?
d. Does discharge bypass a lagoon system?
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts to the waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: % Z 3
Freeboard (inches): -' 2 7 37 ZS
❑ Yes 0 No
❑ Yes
No
❑ Yes
( No
i)
❑ Yes
EA No
❑ Yes
VNo
❑ Yes
[;R No
❑ Yes 9 No
Structure 6
116199 Continued on back

Facility Number: -11-1g4 I Date of Inspection �
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,-�i--�❑- +Yes No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement? � Yes ❑ No
8. Does any part of the'waste management system other than waste structures require maintenance/improvement? ❑ Yes � No
9. Do any stuctures lack adequate, gauged markers with required top of dike, maximum and minimum
liquid level elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes PgNo
11. Is there evidence of over application? ❑ Ponding ❑ Nitrogen ❑ Yes IM No
12. Crop type ........... .... t ir.C......t..... 41t{'....1✓j` ..........................' ..... !sri....................
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes .0 No
14. Does the facility lack wettable acreage for land application? (footprint) ' W Yes ❑ No
15. Does the receiving crop need improvement? ❑ Yes I)a No
16. Is there a lack of adequate waste application equipment? ❑ Yes No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available? ❑Yes No
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes jANo
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 certified operator in responsible charge? ❑ Yes IM No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes �No
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes �No
24. Does facility require a follow-up visit by same agency? ❑ Yes No
�: N.o.vio]attons .tir. deficiencies .were noted during ttiis:visit:. You �vill.reeeive au further
eorres'Db idefi e; a;bbtif this visit_.: - ' - : :.:.:.:. .:. .:. ...:.: :.:.:.:..:.:.: .
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) 71
�? M v to i�tnr Ina" # 4 - `
,V nQ �4 bare O'Ka ar, oL4W ji kt ,,,,la,l1 a lncorn # 3,
►�. rar+� vi, �� ����c� �v PJA do h m' odicv, v ,k +i-t- t`ry _cur Lot
�rnv►� � Lj� 3/ IYjq�, ��, F-rtA
l�U� �4 ����15 A1I acvc. e 6, WVL&�II__ a� tit� or\ n
S
C IV IV
S S.
Ll
Reviewer/inspector Name n�
Reviewer/Inspector Signature:I-KAtv.- Date: 11/6/99

rf
E3 Division of Soil and Water Conservation 0 Other Agency
Division of Water Quality
Routine O Com hint O Follow-up of D= inspection O Follow-up of DSWC review O Other
Date of Inspection -3n
Facility Number
Time of Inspection E]= 24 hr. (hh:mm}
0 Registered [3 Certified 0 Applied for Permit Permitted © Not Operational Date Last Operated: I
Farm Name: S��, /� _ c.rS cam; �✓ — Count .... _ `e'� ';✓'.,
................... 4...........................i................................... y. ��'�- �..........................................
OwnerName: .............................................................................. Phone Nd...................................
FacilityContact:.............................................................................. Title:................................................................ Phone No:....................................
Mailing Address: ......_-..g....� 3%�:�..Y.r'..r[........ . . ........ Z.$yo3
Onsite Representative ......................... ... Integrator:......
Certified Operator: ...... •j`.�ss�q -J l Operator Certification Number ........... .......... ............................................................. .
Location of Farm:
Latitude r_�• ' 046 Longitude • ' 0"
Resign .� Current �, ;,�, Design E Current.
Capacity :Population Poultry Capacity Population
Wean to Feeder
12,100
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Subsurface Drains Present 110 Lagoon Area J❑ Spray Field Area
C
C
I I❑ No Liquid Waste Management System n
4�
General
1. Are there any buffers that need maintenancelimprovement?
2. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a- If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaUmin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ}
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?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
mai ntenanceli mprovement?
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 O(No
❑ Yes �N0
❑ Yes )dNo
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes �fNo
?(Yes No
❑ Yes ff 0
❑ Yes 0

Facility Number: (-- ,
' 8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (I.Apnoo-n—sMolding Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: .................1.................................Z......_.............-3..................................
Freeboard (ft):.........s�...:.. ..........................1 0 -
........................3................................................
10. is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(1f 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?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type
.................................
❑ Yes 1KNo
❑ Yes tfNo
Structure 5 Structure 6
❑ Yes
00
❑ Yes
ONO
9Yes
❑ No
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
0-No.violations-or. deficiencies.were noted•during this:visit. You;will receive•n6,ftirth�er-: -
:. correspkidehce about this visit:- : :: , ..: :
L, VG,�e_� Ahvz Cwecr5 a f ( 3 Ics�n we ��S
s—_ �ev�c�4 �C wCF; e(d 44 Z
❑ Yes ko
❑ Yes J�rNo
......................................
❑ Yes �No
❑ Yes gNo
❑ Yo
❑ Yes
WNo
❑ Yes
kNo
❑ Yes
)j]"No
❑ Yes
I(No
El Yes )No
❑ Yes X 140
❑ Yes gNO
7/25/97

Animal Feedl6t 00e�ration
Reyii;kr
MD.WQAmrnaLFe'ed1ot. Operation Site,hispection
V-- -2-
7,70Routine OComptaint 0Fo1lGw-upofDWQinspection 0 Follow-up of DSWC revic-,v 0 Other
Date of Inspection
Facility Number E�
1 4 Time of Inspection 1)1,00 Use 2hr. time
Farm Status: A C-e,L; C-; gA Total Time (in hours) Spent ortReAeiv
or Inspection Citicludes travel and processing)
0 1
Farm Name: -5-+,4-- a- I LK county: Fg!,
Ommer Name: -Tin V% PISA ram.. -4 Phone No: 2.1 -LZ--
Mailing Address: jxJ n k t xj I e- Au to- A 1 1 X23; 1 g q t) 3
Onsite Representative: V s, e- xm E, Integrator: 12 r- vt- 0
Cerdfled Operator-. M W r. I Lle---e --- ---- --- Operator Certification Number: ZL220tj
Location of Farm:
Latitude Longitude
1
rat
13 Not OiDeE=0nal Date Last Operated:
r3rpe of Operation and Design Capacity
i!411P lfltryl:� umberr um er N b
Wean to Feeder
Laver ID Dairy
FETT;7ed­erto Finish
❑Non -Laver ❑ Beef
Farrow
='v t
arrow to Wean
Eto
Farrow IF-eeder
-n 'D
Farrow to
arrow to Finish
D Other Type of Livestock �ZQi
Subsurface Drains Present- Z'
1 "Ek ❑Spray C Feld J:
General
1. Are the-c any buffe-.s that need maintenancerunprovement?
2. Is any disc' observed from any part of the operation?
2- If discharge is observedvwas the conveyance man-made?
b. If discharize is observed, did it reach Surface Water? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
Is there evidence of p= discharge from any part of the operation?
4. Was there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the.waste management system (other than lagoons/holding ponds) require
inaintenancz,"improvemcni?
0 Yes B.No
El Yes B NO
Ll yes RN-0
D yes a
lJ
0 yes K11':0
E3 Yes. 13 No
El Yes allo
E] Yes NO,
Continued all 1-ark-

6. Is facility not in compliance with any applicable setback criteria?
7. Did the facility fail to have a ec:tified operator in responsi61 charge (if inspection after 1/1/97)?
❑ Yes 9:•`o
❑ Yes E No
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes allo
Structures (Laeoons and/or Holding Ponds)
9. Is structural freeboard less than adequate? ❑ Yes RNo
Freeboard (ft): La on I i a_oon 2 Lagoon 3 Lagoon 4
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of -the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat; notify DWQ)
13. Do any of the structures lack adquate markers to identify start and stop pumping levels?
Waste ARylicntion
14. Is there physical evidence of over application?
(If in excess of VW, or runoff entering waters of the State, notify DWQ)
15. Crop type
16. Do the active crops differ with those designated in the Animal Waste Management Plan?
I7. Does the facility have a lack of adequate acreage for land application? .
18. Does the cover crop need improvement?
19.- Is there a lack of available irrigation equipment?
For Certified Facilities Only
20. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
21. Does the facility fail to comply with the Animal.Waste Management Plan in any way?
22. Does record keeping need improvement?
23. Does facility require a follow-up visit by same agency?
24. Did Reviewevinspector fail to discuss reviewl'mspection with owner or operator in charge?
[:]Yes BNo
.L ❑ Yes ENO
-Yes ❑ No
❑ Yes ® No
❑ Yes &No
❑ Yes EL\To
❑ Yes R No
❑ Yes . O'so
❑ Yes ® No
❑ Yes ® No
❑ Yes RNo
Ej Yes ❑ No
❑ Yes END
❑ Yes W-No
a �r. . .. r
eomt ien refer to gnestton T=Explain azz YES-atzswe7s and/or any recomfnendaitars o aay_a corriime:tCs.
Lls�drawMp U=—M to better lain sttuahons use-ad$tttonai° ages as ne,�c� '=
....:- -
- .
i2. gars area t ato tie e•+r to oa watt be-. Breve e f-a'(-U
p,-e,•�e^..� c.w-as�a► �,�, add�F��•, tl,e l oo"L waci �ee4X
ZZ Tl, e. m o s E G u r u e.+.. Cs rr. r�C-C, -r( v► e _ b� v-e� � f y 0-4 a �� l a l� C e-
•rpr �'^S�ecti8n.i
j 1
��.�� ►rd o� a� box-
a
Reviewer/Inspector Name
Revirver/Inspector Signature: q r Date: t
cc. Division of Water Ouolin- Wafer Oualitr Secrinn- Fm lin• Assessment Unit I I f l 14 foIC

C.
•
Site Requires Immediate Attention:
Facility No.
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: _ _ 1 —3 , 1995
Time: 6 0 C7
Farm Name/Owner:.JT0 rl 41
Mailing Address: �`701 a2 _ ( t {I X� �a 7is'
County:
Integrator: iar-O sr.D Phone:
On Site Representative:-16LV �J[ L(-n�ti Phone: � ��
Physical Address/Location: 3c2c 5 Z.j ry 0 �2 I Q©[ Qon,s i. 3 _
Type of Operation: Swine: '✓ Poultry Cattle
Design Capacity: oeo s a LO.S Number of Animals on.Site: i . 74 0..-5 4 cv-S
DEM Certification Number: ACE DEM Certification Number: ACNEW
Latitude: 3 I ° �3S�,' Longitude: _7e ° /O5-'- OL" 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) le or No Actual Freeboard:a1b Ft. Inches
Was any seepage observed from the lagoon(s)? Yes or 10 Was any erosion observed? Yes or
Is adequate land available for spray? ' or No Is the cover crop adequate? Yes or (
Crop(s) being utilized: l Alt i pl anN&
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? 'Q or No
100 Feet from Wells? & or No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes or 6)
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes orl)-
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 I Y e f 4 to P I I ev
Additional Comments:
r C�s
Inspector Name Signature
l(r.V
A A> Owrel
W CS
cc: Facility Assessment Unit
Use Attachments if Needed.

Site Rcquires Immediate Attention
Facility Number: Od
SITE VISITATION RECORD - W,1 �
DATE: July 2I . 1995
Robert Phillips,John Burney
Owner. Jack Rissett, ,Bi11y Subten Farm Name:
County: _FAndpr__
Agent Visiting Site: Kenn #h,cook Pender SWCD - Phone: [phone]
C3perator: _ Jay RL=n� _ _ Phone' 91
On Site Representative: Same Phone: Sates
Physical Address: 2 miles West of the intersection of SR 1001 and SR
Farm road is on the left off of SR 1001.
Mailing Address: _ M01= 3 Wright►5; u Q Ave.
Wi lmipZon, NC 28403._.--
Type of Operation,: -Swine x Poultry Cattle
Design Capacity: 4000 sosm,^ Number of Animals on Site: 909 c;mm
Latitude: ° '" Longitude: °
Type of Inspection: Ground X AerW
0
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(appro)dmately 1 Foot + 7 inches) 0 or No Actual F=cboard: 9 Fees _ 5 Inches
For facilities with more than one lagoon, please address the other lagoons' freeboard under the
comments section.
Was any seepage observed from the lagoon(s)? Yes or@ Was there erosion of the dam?: I& or No
Is adequate land av4able for land application? 0 or No Is the cover crop adequate? Yes or N&
Additional Comments:
Zeted; stocked 6/27/95. Operator said a oon dikey have been
but no evidence or vegetation to date.
r
Fax to [phone] Signarure of Agent