710094_INSPECTIONS_20171231

NORTH CAROLINA
Department of Environmental Qual

0
Type of Visit Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Routine Q Complaint Q Follow up Q Referral Q Emergency Q Other [:1 Denied Access
Date of Visit: g d— Arrival Time: /0 3 0 Departure Time: County: ?ENbEk— Region:
Farm Name:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: i_�,, , Title:
Onsite Representative: aA�- kG
Certified Operator:
Sack -up Operator:
Location of Farm:
Swine
Owner Email:
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Latitude: = o = ' = « Longitude: [—] o F—] ' = «
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
ElLayer
6 Q ZX3 ❑ Non -La et
❑ Wean to Finish
® Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other.
Dry Poultry
Pullets
Turkey Poults
Other
Discharges & Stream Impacts
I _ Is any discharge observed from any part of the operation?
Discharge originated at: El Structure El Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
El
Dairy Cow
ElDai
Calf
El
Dairy Heifei
El
Da Cow
El
Non -Dal
El
Beef Stocket
El
Beef Feeder
El
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes 0
❑ NA ❑ NE
[IYes 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 Structure 2 Structure 3 Structure 4
Identifier: (,Q Gao N
Spillway?:
Designed Freeboard (in): ! r
Observed Freeboard (in): �b
5. Are there any immediate threats to the integrity of any of the structures observed?
Oe/ 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 CNo ❑ NA ❑ NE
[I Yes El No ❑NA ❑NE
Structure 5 Structure 6
El Yes V No
❑ Yes WNo
El NA El NE
El NA [I NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmentalthat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes �No ❑ [-INA NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes LJ 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 BIN ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ❑ NA ❑ NE
maintenance/improvement?
L Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drib ❑ Application Outside of Area
12. Crop type(s) C WS (,ado }j
13. Soil type(s) Cat
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
3 No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
EfNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination"
❑ Yes
E No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
�,, NN/o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
E o
❑ NA
❑ NE
ra _'.,, Are 0 va-c.on-+),� L4 o lz- 600b .
Reviewer/Inspector Name �'p �`�;a�7 L� Phone: ^rrv) 714 — 7 aG :
Reviewer/Inspector Signature: Date:
12128104 Continued

Facility Number: 7 — q Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box.
❑ WUP ❑Checklists El Design El mans El Other ,.,_,
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes LIVo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rain Inspectionss,/D� Weather Code
22. Did the facility fail to install and maintain a rain gauge? Cl Yes 7No
El NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ❑ No B NA ❑ NE
❑ Yes 2 No ❑ NA ❑ NE
❑ Yes 04 ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No Li NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes EJNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No Ek A ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ic/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
Utvo
❑ NA
❑ NE
❑ Yes
LJ No
❑ NA
❑ NE
❑ Yes
L'No
❑ NA
❑ NE
❑ Yes
B No
❑ NA
❑ NE
❑ Yes
2 No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
A�drtional,Comments and/or Drawings: ,
12128104

Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 9 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
ty �^� Date of Visit; Time: IV
Facili Number -
O Not Operational Q Below Threshold
Id Permitted © Certified 13 Conditionally Certified © Registered Date Last Operatiopr Above Threshold: _.
Farm Name: - . _ _ _ _ .. _ County:
Owner Name:. _ .--. -. /�r ...» ... ».� ._......_____ .. Phone No: _ -
Mailing Address:
Facility Contact: ... .._ -Title: -...- -_ - Title: _ Phone No:
Onsite Representative: � 4 - _ _. Integrator: &--j6 ,
Certified Operator:
Location of Farm:
Operator Certification Number: ,
U(Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude a 4 46 Longitude • 4 Ac
Desegn
Currt Desegn
Current `,r Demon '4m`reret
Swale
Po ulatian Pony''" i-Po oa.'; Cattle
Wean to Feeder
Layer
k
Dairy '-
Feeder to Finish
Non -Layer
N Non -Dairy
Farrow to Wean
Other
Farrow to Feeder
m
- - w
Farrow to Finish
_
u11t5
z
Boars
m
' Total SSLW `
Rf
Discharges & Strum Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon 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
❑ Yes 10 No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes �j No
El Yes No
❑ Yes Z No
Structure 5
Identifier:
Freeboard (inches):
I2 J2l03 Continued

. Facili Number: s —
Date of inspection // O
5. Are there any immediate threats to the integrity of any of the structures observed? Cie/ 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 swetures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste ARplication
10. Are there any buffers that need maintenanceAmprovement?
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
z
12. Crop type I� IAA r . �0` ( 7 . "-5m - �` vf�H-ZW
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 doting 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.
❑ Field
�2 zC R-7 ZD.J wy ODcJS 464,DEQ A J
Reviewer/inspector Name 9
Reviewer/Lupector Signature:
Date:
❑ Yes PrNo
❑ Yes P No
XYes ❑ No
❑ Yes No
❑ Yes 'PrNo
❑ Yes 0 No
❑ Yes 10 No
❑ Yes to No
❑ Yes VNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ONo
❑ Yes ENo
❑ Yes No
❑ Yes j No
❑ Yes No
❑ Yes �No
Final Notes
12112103 Continued

Fatality Number: q.1 _ Date of inspection !/
Renuired Records & Document-.
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes No
22. 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
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes'gNo
❑ 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? ❑ Yes WfNo
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes FfNo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes PNo
27_ Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes P(No
28. Does facility require a follow-up visit by same agency? ❑ Yes J6 No
29. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes �No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35) ❑ Yes '9No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ 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 10 Compliance Inspection Q Operation Review 0 Lagoon Evaluation I
Reason for Visit 0 Routine () Complaint 0 Follow up ( Emergency Notification Q Other ❑ Denied Access
Facility Number - Date of Visit:
Permitted [3 rtified [3 Conditionally Certified 0 Registered
Farm Name: !\"!' rA R/%ZIr?
Owner Name:���r /\ �l✓trr
Mailing Address:
Facility Contact: Title:
Onsite Representative: T��3
Certified Operator:
Location of Farm:
Time:--L=�—�
Date Last Operated r Above Threshold:
County: Q4 '
Phone No:
Phone No:
Integrator: 0?fl'WR V
Operator Certification Number:
J Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' =' " Longitude 0 &
Wean to Feeder
Non -
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
No Liquid Waste M
Discharees & 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?
Non-
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:
Freeboard (inches):
05103101
❑ Yes P'No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes e_o
❑ Yes XNo
❑ Yes �No
Structure 6
Continued

Facility Number: V — Date of inspection .'V
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes /No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El Yes No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? El Yes IVNo
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 ANo
11. Is there evidence over application? ❑ Excessive Ponding ❑ PAMI+ ❑ Hydraulic Overload � ❑ Yes �No
12. Crop type lQ �J
Af
13.
Do the receiving crops di er with those designated in the Certified Animal Waste Mana meat Plan (CAWMP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
No
X
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
o
rs
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Renuired Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
XNo
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?
El Yes
////VNo
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
No
(ie/ discharge, freeboard problems, over application)
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
'VNo
24,
Does facility require a follow-up visit by same agency?
El
�No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
VNo
0
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
71
I y) V;; L (;-67 ��A_ Gull_7w
Reviewer/Inspector Name
Reviewer/Inspector Signature:
05103101
iifpages:.asnecessary Field Copy El Final Notes
ti
�i✓ �.eo�',� mat: s Gz,� �"
Date:
Continued

. •
Facility Number: -all I Date of Inspection
Odor 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?
OSIO3101
❑ Yes ❑ No
❑ Yes ANo
❑ Yes X No
❑ Yes (_QNo
❑ Yes x) o
❑ Yes Vo
❑ Yes ❑ No

Division of Water Quality
0 Division of Soil and Water C©reservation..
0 Other AgencyY
Type of Visit )Q Compliance Inspection O Operation Review 0 Lagoon Evaluation
for Visit Jl Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number bate of Visit:
(0ermitted Wertified ❑ Conditionally Certified 0 Registered
FarmName: ........... V7.—.6..... ``\.!.........................................................................
OwnerName: ................................................
Facility Contact: ......................................
MailingAddress:..................................................................
Onsite Representative: :...........................
Certified Operator:
Location "of Farm:
G( Time: ® Printed on: 7/21/2000
0 Not Operational 0 Below Threshold
Date Last Operated or Above Threshold: .........................
... County: ...... �............................
Phone No:
Title: ................................................................ Phone No:
....................................................................................... ..........................
Integrator:..... ]"'........
Operator Certification Number: ..........................................
a
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ' 4 46 Longitude • 0` «
Design Current
Design Current Design 'Correa!
She s Po elation
Poultry
Capacity CatleCa" Ca as Po utation
s
to Feeder
Q
❑Layer
❑Dairy
r to Finish
❑ Non -La er y
❑Non -Dairy
w to Wean
w to Feeder
[Farrow
❑ Other
to FinishTotal
Design Capkity
..
Total SSLW
Nr�itt terrof.Lagotins ❑ Subsurface Drains Present ❑ Lagnan Area JE3 Spray Field Area
Htt}dwg Ponds / Solid Tiaps,' ❑ No Liquid Waste Management System - .
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes �j No
Discharge originated at: ❑ Lagoon ElSpray 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? El 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 stonn storage) less than adequate? ❑ Spillway ❑ Yes No
Structure I Structure 2 Structure 3 Structure 4 Structure S Structure 6
IdentiPier: ........................................................................ . ..............................................................................................................................................
Freeboard (inches):
5100 Continued on back

Facility Number: — Date of Inspection 0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over
application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
1.2. Crop type 1.j 1 c
13- Do the receiving crops differ with lose 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 fora wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17, Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie! WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
yiQlatit?tis:op . ciendbg tre noted O(Wing tbis:visit; • Xojk v�dl•reegive nti
coriesuornidence about this visit~ ......::...::....:::...:::::......
❑ Yes N�o
❑ .Yes *o
❑ Yes XNo
❑ Yes ONO
❑ Yes �No
❑ Yes *0
❑ Yes PNo
❑ Yes WNo .
❑ Yes ONO
Z Yes U j No
❑ Yes ❑ No
❑ Yes ONO
❑ Yes JKNo
❑ Yes ONO
❑ Yes ko
❑ Yes [TTo
❑ Yes ONO
❑ Yes MNo
❑ Yes ONO
❑ Yes Rlo
❑ Yes 70 No
❑ Yes. ONO
Reviewer/Inspector Name = y -M
Reviewer/Inspector Signature: Date: 5100

•Facility Number: Date of Inspection s Printed on: 7/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below WYes ❑ 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 ;9No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes KNo
32. Do the flush tanks lack a submerged fill pipe or a permanentltemporary cover? ❑ Yes WNo
5100

- :Q(Drvision of Watei•'.Quality -
�v
Q Diyiston of Soihand Water Conservation
;0 Other Agency -
Type of Visit XCompliance 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-
[3 Permitted FtCertified [3 Conditionally Certified 0 Registered
Farm Name: C. .......^.........`
Owner Name: C { °► -!�' "I
.............................................:I...................................I.................,
Facility Contact:
Mailing Address: .........................
Onsite Representative:..., r , ...,.9� j.,
Certified Operator: ...................................................
Location of Farm:
40 I Time: % 6 Printed on: 10/26/2000
Not Operational 0 Below Threshold
Date Last Operated orAboveThreshold: .........................
County. ...P y:'.,C!k.r.:................................ .......................
PhoneNo:.......................................................................................
.... Title: ................................................................ Phone No...............................
.............. I ............ I............... ...................................................................................... ..........................
........................................... Integrator: ,? t) r r2 i ,�Gr.v� S
........................................... Operator Certification Number:................
❑ Swine ❑ Poultry []Cattle ❑ Horse Latitude Longitude «
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
Wean to Feeder Q JE1 Layer I I ❑ Dairy
❑ Feeder to Finish JE1 Non -Layer I I JEI Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity
❑ Gilts
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present 10 Lagoon Area I0 Spray Field Area
Holding Ponds / Solid Traps JE1 No Liquid Waste Management System
Discha es & Stream Im acts
1. Is any discharge observed from any part of the operation? ❑ Yes [3No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes Y,?No
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes '9 No
c. If discharge is observed. what is the estimated flow in galhnin? H In
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes )6No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes jffNo
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 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ............... ...................................................... I................................................................................................................................
.................
Frechoard (inches):
5100 Continued on back

Faciii i Number: 171 —g Date of Inspection ) D Printed on: 10/26/2000
15. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes *o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ENo
(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 'KNo
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes )5 No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ►AT0
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes F No
11. Is there b evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes gNo
t
12. Crop type ar' 61 L A ed , 5o `9 e-G n S I 1 J G
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes eNo
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 'KNo
16.
Is there a lack of adequate waste application equipment?
❑ Yes IRrNo
Required Records & Documents
17.
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes
gNo
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
Yes
❑ No
(ie/ WUP, checklists, design, maps, etc.)
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
XYes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
RNo
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
;TNo
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 J'No
24. Does facility require a follow-up visit by same agency? [:]Yes ONo
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes XNo
0. �'�1.6 •violatidris ;oT di f cWndt,s •were noted- ilia kil! 4his;visit; - Y;OI.f will -receive Rio further
�cor:respondence: 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)T
AL
18, &yooh cks:�►,�Uafv+-.e CkeCk n1441,61, V aLJ Fkvc,E
Y1 it ►-A be e s �i�cT'n'!G S 1 C-,,M e r qe r1 L y �q c4 i o p/-tn .
lq. Need 4Q 4Avt✓ fCt5+ W Vt54-d qVIC11 S;S i,� feCord�, nleCIA Zbof) soj ICS4.
Use q l.,.ct s4e a..xAly 5 s da-�ed Q p }� cr4,0�
use i+ln�°`1� ►Pl tKi Avt1fe?4' 'tllow.'r`aa Fror"l
Reviewer/Inspector Name S4,T rue w a J j
Reviewer/Inspector Signature: %2 Date: (� O 5100

Facility Number: '? — Date of Inspection Qa Printed on: 10/26/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ,Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ;KNo
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, []Yes ,dNo
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 KNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes -0 No
Additional omments and/orDrawings::
Zq. Use q or. 4e 5ys4er►s ;e eike ,n - sc la)ocnh .
No}e : F{es�a�s:bie �vv�,�►ri� sttoulr� b� d�o�G �s�P �o n�;n�a;►�
-r eC �7 e7Gt r4� MVP .
5100

nservahon
[3 Division of Soil and Wateri.CoyOperation Review
' r r 13 Division of Soil and Water Conserva4an Compiianee Inspection
:;Q;bivisioa of Water, Qdm ality Copliance Inspection -'
Other Agency - Operation Review
j Routine C Complaint O Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility NumberETFD_cl�=
Date of Inspection z-gam
Time or Inspection 3QQ 24 hr. (hh:mm)
© Permitted © Certified 0 Conditionally Certified [3 Registered JE3 Not O erational Date Last Operated:
Farm Name: , �.. . )1.1-V%.........FC ✓^ ^► County: _...... ........................d .................. V..1.. ` .�..........
Owner Name: ................................................... ...... Phone No:.....................
FacilityContact: .............................................................................. Title ........................................ ......................... Phone No. ".....................................
Bailing Address:
Onsite Representative:.........3. v!.. ^......... [�................ lntegrator:.....--!'1SJ'. ^ _ ...........................................
Certified Operator : ................................................... ............................. ................................ Operator Certification Number:..........................................
Location of Farm:
a
..................................................................................................................................................................... _.............. _............... ................................... ..................... ..............
Latitude ' 4 C •Z Longitude ' 6 4i
=� Design Current, ;" es
Current, __' Design Current -
Swine ult
13. CCapacityPopulation Poattle = Capacity Population-.
Wean to Feeder ❑ Layer ❑-)airy
❑ Feeder to Finish ❑Non -Layer ❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder ❑ Other
❑ Farrow to Finish = Total Design Capacity.
❑ Gilts
❑ Boars - Tota1.SSLW
Numberof-Lagoons_ ❑❑
Subsurface Drains Present Lagoon Area ❑Spray FArea_,-.-, Field
Holdtrig.Ponds 1, Solid Traps ,_ ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ YesXNo
Discharge originated at: ElLagoon ❑ 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 )4'No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes YNO
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ONO
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): ................................... .................................................................... .
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ?fNo
seepage, etc.)
3/23/99 Continued on back

Fagility Number: q ( -q Date of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes r 0
❑ Yes WO
❑ Yes a
❑ Yes ❑ No
❑ Yes WNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes No
12_ Crop type �� � w � S� t/ � J-,Z L
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes X
o
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ❑ No
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? (icl 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?
(ief 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: 10 •vi61A tons:oi deft. ciencie5 •were n¢tea• during this: visit: • You will •reeeiye iio further • : - :
corresnoridence: abOU this :visit.
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes W_0
❑ Yes //[1"` o
❑ Yes �No
❑ Yes WNo
❑ Yes fp-No
❑ Yes rMRNo
—
❑ Yes P'No
❑ Yes rwo
❑ Yes (�No
❑ Yes No
❑ Yes No
3/23/99

Favility Number: hate of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes o
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes
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 jNo
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 �CNo
3/23/99

Revised April 20, 1999,
JUSTIFICATION & DOCUMENTATION FOR MANDATORY WA DETERMINATION
Facility Number -21 -!EV
Farm Name: "`
On -Site Represents ve:
Inspector/Reviewer's Name: - `del/
Date of site visit:01
6
Date of most recent WUP: IG�
Annual farm PAN deficit: —35- pounds
Operation is flagged for a wettable
acre determination due to failure of
Part 11 eligibility item(s) F1 F2 F3 F4
Operation not required to secure WA
determination at this time based on
exemption E1 E2 E3 E4
eration pended for wettable a e
determination based on Pg P3
Irrigation System(s).-circle :CEi_nfi vele 2. centerq ivot system; 3. linear move system;
4. stationary sprinkler system wlpermanent pipe; 5. stationary sprinkler system w/portable pipe;
6. stationary gun system wlpermanent pipe; 7. stationary gun system wlportable pipe
PART" i. !A Determination Exemptions (Eligibility failure, Part It, overrides Part 1 exemption.)
El Adequate irrigation design, including map depicting wettable acres, is complete
and signed by an I or PE.
E2 Adequate D, and D21D,,' irrigation operating parameter sheets, including rnaa
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
appiied to fauns that fail the eligibility checklist in Part f 1. Complete eligibility
checklist, .Part 11- F1 F2 F3, before completing computational table in Par 111).
PART H.75% Rule Eligibility -Checklist .and -Documentation -of WA Determination -
Requirements... WA Determination.required because operation Tails -one of tne.eligibiffty
requirements -listedtelo►rv:
_.F1 Lack-oT�c,r=-aaewhicnTesulteddn:overapplicaiionmT-wastewe£er_=(P-AN) onzpray_
field(s):accorriing-io-iarmtiasttvo�yeaszof irrioa onsecotds-.
_F2 Unclear;-jllegible,-ter lack Df infom;ationlmap_ -.
F3 Obvious:fieldiimitationslnumerous�ditchss;�ailureio .deductsequired�.:.-
buffer/setbackdcreage;-�Dr25%--osfotalfcreage dentmeddr _CAWMFI:ztncludes_ _- `-=-
small; jrregulariy:shaped arelds Melds_less�han::5tacres:for�tavelers'�Dr-lessdnan
2 acres-i'orztationary:sprinklers)_-
F4 WA determination Tequired 'because CAWMP. credits zreld(s)'s acreage in excess : -
of 75% of the respective fieid's total acreage as noted in table in Part IIf.

Revised Aan7 20, 1999
Facility Number -
Part [it. Field by HeW Uetermina€1on or tb% txemption
Mule Tor WA weTermination
TRACT
NUMBER
FIELD
NUMBER''
TYPE OF
IRRIGATION
SYSTEM
TOTAL
ACRES
CAWMP
ACRES
FIELD
%
COMMENTS3
I
-
1
I
I
I
I
I
I
I
I
I
I
I
FIELD NUMB_R"- hydrae=,-pull,zone ;-or.point numbers may be t!sed in place-offield numbers -depending on CAWMP - and type of irricationaysterm-1f pulls,7etc: cross-more-thann-one field,-insnectorireviewer will have to combinefields to
calculate 75% field by field determination !or -exemption;-otherwise operation will be subject to WA determination.
tlEL NUMBER2--must be nearly -delineated un-nap_
COMMENTS' --back-.up neids with CAMP_acm-agezexceeding 75% of its totalacresand having Teceived Jess fhan 50%
of its annualPAN as:dpcumentedzn-the'Jarm's:previous:twoyaars' (1997 & 1998)nf ir-iaafiamecords,-.cannot­serveas-the
sole. basis-faxequiringa WA D--L-TTnination=Back-up:fieids-must:bemoted in -1he=mmentze_-fion:andmust:be -accessible
by irrigationsymem.
Part IV. Pending >WA-Determinaiions-
P f Plan JacksJollowinganformation:
o F-- !r
2 PianTevlSion-may.satisry�75%-rule-based onadequate overalI PAN dencitand by
adjusting -all neld:acreagesobebw 75% useTate
P3 Omer (iefin process of installing new irrigation system)_,

Division of Soil and Water Conservation ❑ Other Agency'"
Division of Water Quality
10 Routine O Corn Taint O Follow-up of DW inspection O Follow-up of DSWC review O Other
Date of Inspection
Facility Number
Time of Inspection O : 00 24 hr. (hh:mm)
© Registered Wertified ©ppAppli�e`d for Permit © Permitted E3 Not O erational Date Last Operated: ..........................
Farm Name: ............................ ...b.....1V.u✓,sera ....... Countv:..... �,c��..........._j.,f. o .......................
Owner Name: ..................... ..'' +. ......14. �'1�........ . Phone No: 1C9 - z Z f ...........----......
Facility Contact:...
,. Title: ................................................................ Phone No:
Mailing Address: ............. Z...---.... i 'r...+r3..f ........:......... `..'........ ...C.4 c. e.j+x//V .G..... ... .............
OnsiteRepresentative: ............ `�, 14 7-5
Q `...D
Integrator :...........................
Certified Operator- rw . O erator Certification Number; ...................
p` ..... tjl... �...:........................................... p
Location of Farm:
Latitude • ' " Longitude • ' 46
General
I. Are there any buffers that need maintenancelimprovement? ❑ Yes �No
2. Is any discharge observed from any part of the operation? ❑ Yes kl*-No
Discharge originated at: El Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes
c. If discharge is observed, what is the estimated flow in gat/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes o
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 No
5. Does any part of the waste management system (other than Iagoonsfholding ponds) require ❑ Yes ( o
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes K'.No
7, Did the facility fail to have a certified operator in responsible charge? ❑ Yes �N o
7/25/97

f *ility Number. ! —CI
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?
Structure 1
Identifier:
...................................
Freeboard (ft): .............,-5
Structure 2 Structure 3
10. Is seepage observed from any of the structures?
Structure 4 Structure 5
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 inunediate 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[r runoff entering waters of the State notify DWQ)
15. Crop type 1.....y�..............................................................'........................................................ ........................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
IT 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.vidlatiohs' ,or' deficiencies. were-notecl-iluring this-. visit'. Yoi> 41U receive•iT6Air_ their
eorrespoWOO A out this:vis G : :. . .
t, ee
V etP 5 01 j Ci'Yi �'/ •3 D h 5 1 4 e-
WaS�O_ 40 y-15,12 5"J,.� �e_ do,c-
❑ Yes �NO
❑ Yes No
Struc e 6
❑ Yes No
❑ Yes o
❑ Yes IR No
❑ Yes VNo
❑ Yes tfNo
❑ Yes IgNo
❑ Yes RNo
❑ Yes �No
❑ Yes tNo
❑ Yes "No
❑ Yes WNo
OYes ❑ No
❑ Yes �No
❑ Yes PrNo
❑ Yeas / �o
�0 d1l" �ESf arf0(`Cct-f •off
7/25/97