030013_INSPECTIONS_20171231

_504-Q] KjA5rt
Division,of Water Resou'�e
Facility Number Fj�3 - O (Division of Soil and Waterservation , P m
O Other Agency
Type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: d ounty: At { Qnegion: 11� �✓
-i'i`� bo-�t'�f , (s 1� l�l Owner Email: Farm Name: 6o k ky 8 va�(32 �Ocl/�$ LQ S {e- u be-5
Owner Name: B Q b b y F'1 & h_5 Phone: H 3 7.7- -'R 7 f .S
Mailing Address: 3 oZ3 PIeA 5ax,+ +M e _. Cat, rt' h Q Jt� 1 a--� �z c�5 (� 7
Phvsical Address: ,V
Facility Contact: ?)n j`Qu E awn Title: Phone: j 3 � d-00- l )-q (o
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Integrator: -
C'a EErS w � IzI3t/!�
Certification Number:
Certification Number:
Latitude: 3& 0 ,3 3 W '1 Longitude: 113 1 0V11 5 .3 t
L-�-t N y 1 16 NJ P1eA5a_4qf tinrn� .; 3 . q M tez Gh
a�
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Dry Poultry Canacitv Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
Cattle Capacity Pop.
Dairy Cow
1370
'19-
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
gNo
❑ 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
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑Yes
No
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
YNo
❑ NA
❑ NE
of the State other than from a discharge?
Page 1 of 21412015 Continued

Facility Number: - Date of Inspection: $
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
N;,o
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
�2
1 Structure l Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
1
�ldentificr:
vjaQ5temsrSpillway?:
& S
Designed Freeboard (in): 12/
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
rS;KNo
❑ 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
CR No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental
threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
26 No
❑ NA
❑ NE
S. Do any of the structures lack adequate markers as required by the permit'?
❑ Yes
�o
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
�SrNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
mamtenance or improvement.
1 l . Is there evidence of incorrect land application? If yes, check the appropriate box below. es ❑ No ❑ NA
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
XPAN ❑ 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):
❑ NE
13. Soil Type(s):U Ala,'
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 ONo ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ❑ No [�a'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?
Reouired Records & Documents
❑ Yes CR'No ❑ NA ❑ NE
❑ Yes 0 j No ❑ NA ❑ NE
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes jN No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes pKrNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. oes record keeping need i rovement"' iF}e�sl�ecl ❑ Yes �No ❑ NA ❑ NE
r
ste Application [�eekly Freeboard Waste Analysis oil Analysis E ' 31;:�; ❑ Weather Code
infall Stocking [Crop Yield _ Monthly and 1" Rainfall Inspections
22. Did the facilityiail Foinstall and maintain a rain gauge? ❑ Yes Cff No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No Q-NA ❑ NE
Page 2 of 3 21412015 Continued

Facility Number: 07 - 1 Date of Inspection:
24. Did the facility fail to calibrate waste appllation equipment as required by the pe
25. Is the facility out of compliance with permit conditions related to sludge? If yes, the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a PO
❑ 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 cha
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or docu
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.
rmit? 1W
❑ Yes
� 'No
❑ NA ❑ NE
check
[:]Yes
❑ No
]EQ'NA ❑ NE
A for sludge levels
rge?
❑ Yes
No
❑ NA ❑ NE
❑ Yes
No
❑ NA ❑ NE
ment
[:]Yes
+`mil -
❑ NA ❑ NE
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes D(No ❑ NA ❑ NE
❑ Yes OKNo ❑ NA ❑ NE
❑ Yes D4"No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 'VNo ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 0 No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 'IRNo ❑ 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).
3
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.�/lC
Reviewer/Inspector Name:
Reviewer/Inspector Signatui
Page 3 of 3
65 � d l 5 �� a ►lo - 3 . 0 a- 5. l�
r
Phone[33 6q
Date: 5 a D l 7
21412015

ivision of Water Resourc0-servation
..
Facility Number © - 0 Division of Soil and \Water
0 Other Agency
Type of Visit: ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Arikoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: `"T Arrival Time: Departure Time: County: �D,ftegion: W s N-0
11 top
Farm Name: �f�1��V �,>� V I �� Yai�S_-- . _ 1/ �G1-i(- }Owner Email: q ! e�� m
I_ yy� -
Owner Name: Y3 �V �. y- Al V i n F�&-n5 Phone: v`1 372- — t'4o ^"�
Mailing Address: 3 `T 3 P � eas n Y NQ me 0/1i1_ • � S�j��-. rf�� a - (-7s~
Phvsical Address: V/
Facility Contact: ]32bb1 F \f Title: Phone: ate' vZ yr/
Onsite Representative:
Certified Operator:
Sack -up Operator:
Location of Farm:
Integrator: �)js
Certification lumber:
Certification lumber:
`f
Latitude: -3 (off 3 �!1 6 t Longitude: '50
e -0� s3 t
7/� 1n%` IV At is env the,
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
Layer
]Non -Layer I EEEd
ury ro
Layers
Nan -La
Pullets
Turkey Poults
Other
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes"No ❑ NA ❑ NE
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'? (Ifyes, notify DWR)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
ZNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
9No
❑ NA
❑ NE
of the State other than from a discharge'?
Page I of 3 21412015 Continued

Facility Number; - Date of Inspection: $ ii
Waste Collection & Treatment MV
4. 1s storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: wi 6-LV, PUu
Spillway?: �5
Designed Freeboard (in):
Observed Freeboard (in): 30
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes > No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes o❑ NA ❑ N E
8. Do any of the structures lack adequate markers as required by the permit? ❑ YesAc�o ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 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. 1s there evidence of incorrect land application? If yes, check the appropriate box below.
❑ ,Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu,Ln,
etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate
Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of"Wind Drift ❑ Application Outside
of Approved Area
12, Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes [�o
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ❑ No
D�.NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes CQ'I�o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes CN<o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available'?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes VNo ❑ NA ❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21 oes record keeping ne�rweekly
'provement? If yes, check e appropriate box below. ❑ Yes No NA ❑ NE
ste ApV�_tockin
on
Freeboard Waste Analysis Soil Analysis s eather Code
Rainfall ❑ 120 Minute Inspections Monthly and I" Rainfall Inspections
Its
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No ❑ NA ❑ NE
23. if selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No JEZNA ❑ NE
Page 2 of 3 21412015 Continued

Facili ]Number: - � Date of ins ection: �
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes MNo Q NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No jj�NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey []Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes F_) o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes V� No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes kNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes ONo ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Application
Yes
❑ No
❑ NA
❑ NE
Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
�No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
LN-Vo
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
jNd'No
❑ NA
❑ NE
]Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawines of facility to better explain situations (use additional oaiies as necessarv).
(' I as la 5o'I fesf cotwp �e�ed 2 C& -`
• W UP Up t'" +0 & u r r,e to -t PAN r U�i-e5 ? r
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y Pa8
Reviewer/Inspector Name:
Reviewerdnspector Signatur
Page 3 of 3
Phone:'4 �_ 7 &—1 b rf (�
Date: -3
21412015

Division of Water Quality
Facility Number - Division of Soil and Water Conservation
O Other Agency
Type of Visit: ompliance Inspection Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: , Q9 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: IZ$ Arrival Time: Oa Departure Time: County: Region: W6 R 0
Farm Name: ��2x4 +I VI++Ea�qbAh �
fM Owner Email
Owner Name: go`Dl'ti Pl 4}— t't tlIb, e7t/a Phone: CvjJ 37 z _ Stoll
Mailing Address: .31 Z3 �rey,j��— � - (�,wl 1\d , , 1 � [ 2�(o'r 6
Physical Address: I t
r 3'7 Z' -?%/T-
Facility Contact: d b ri UA V,j Title: Phone: (GS '.FX —1 -2�}k,
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: 3`" 33 �'(p Longitude: �� ° Q2_/,53
U vj� rg 4.1 K 'Fen atr (t Ficc�oed, 4uM o., Pat
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
HE] I I Layer
Non -La er
Design Current
Dry Poultry Capacity Pon.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Design Current
Cattle Capacity Pop.
Dairy Cow
90
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes [:]No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) [—]Yes [:]No ❑ NA ❑ NE
2, Is there evidence of a past discharge from any part of the operation? ❑ Yes No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No [] NA ❑ NE
of the State other than from a discharge?
Page 1 of 3 21412011 Continued

j Facility Number: - • Date of Inspection: y
Mow
Waste Collection & Treatment XNo
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ 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.) 77��
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes ko ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, nodfy DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes tNo
o ❑ NA ❑ NE
8. Do any of the structures 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 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? if yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Pondmg ❑ 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 g t Window ❑ Evidence of II } Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s): ,orA 511-eqC_ , t I 4rX�11
- v
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes No
NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists [:]Design ❑ Maps ❑ Lease Agreements
❑ Other:
21. Does record keeping need improvement? If yes, ch ck the a ropnate box below.
El j No
❑ NA
❑ NE
❑ Waste Applicatio / ❑ Weekly Freeboar Waste Analysis Soil Analysis' ❑ Waste Tran fers
❑ Rainfall ❑ S y g ❑ Crop Yield ❑ 120 Min to Inspections ❑ Monthly and V Rainfall Inspections -
❑ Weather Code
� dge-6at�ey--
-rl
22, Did the facility fail to install and maintain a rain gauge?
❑ Yes No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes ❑ No
I (NA
❑ NE
Page 2 of 3
21412011 Continued

1 FacilityNumber: 0.3 - • Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes WNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ NoNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No D. NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No [DNA ❑ NE
Other Issues
28. Did the facility fail to property dispose of dead animals with 24 hours and/or document ❑ Yes No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes I YI No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond IN Other: 6;
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes No ❑ NA ❑ NE
(Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawings of facility to better explain situations (use additional pages as necessary).
4. So;) am f�s's nfk� J' b y M."� Z o 1 �
a f� 1444UA 67(lwhl 61 b4o.1k,, J
zo)Ll rjgAe fp;e m - 44 r + %4vp, A ,,,�, e a�tyss. ►�1`�' /ldw
s(tm 4-0 6a IPG4-
3
2 l+tiPi l l"�Tt�:S 1'1 4Z
lnf1�5� �� AVis�s
3 zol�= �,�7 lb►�
10/xoly � 3, 0 7 ib
s )�� �s�c S k � 44- -�k�, --- Etr&4 w-11 o k-6,1, W 4 �, ,Be- silne, -� c�I/��f s�� 1� w/,k+��o
lr- i
ReviewerllnspectorName: c�'1`I't'?.k MS � d'- j1l�. rj1n4�p4�CAd hone: 334 "
Reviewer/Inspector Signature: /�--� Date:
Page 3 of 3 21412011

_ Division of Water Quality
Facility Number D 3 - O Division of Soil and.Water'Cod`servation x
0 Other Agency
Type of Visit: C_ompliance Inspection 0 Operation Review Q Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine Q Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 30 Arrival Time: nc�0 ar, Departure Time: j Z:OD County: Region: WSk 0
Farm Name: n�bt�I 1 A I v n ✓a f 1)A1 Firm Owner Email:
Owner Name: gob 64 T , Al,i^ �_a?tiS Phone: C"'� 3 r72
Mailing Address: 3 �f �3 !P /Metj +i vMe, 4! itLcl i -1 r"A , i� G Z$6 75r
Physical Address: t E I
I II N 3 7L - F'71�
Facility Contact: ►1S _Title: Phone: (G) 2-00— r -2—
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator:
Certification Number:
Certification Number:
53
Location of Farm: Latitude: 36 " 33 � 67 Longitude: 8/ c 02 r ""
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Non -La
Pullets
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Design Current
Cattle Capacity Pop.
Dairy Cow
Igo
96
Dai Calf
Dairy Heifer
Dry Cow
j
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes XNo ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? [:]Yes R�o ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3
21412011 Continued

Facili Number: 63 - 3 • Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4
Identifier: 1n1 S D
wa ?
S illp y .: � GS
Designed Freeboard (in):
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., 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?
❑ NA ❑ NE
❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? X,
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ 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): 6. rn 3 r7�- gA , e_
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �No
❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑ Yes No
❑ Yes I
No
❑ Yes No
❑ Yes X No
❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes A'N
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑Rainfall ❑ Sto k ng ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 9No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [] Yes [] No
Page 2 of 3
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
o ❑NA ❑NE
❑ Weather Code
❑ NA ❑ NE
NA ❑ NE
21412011 Continued

Facili Number: 3 - 3 Date of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? [—]Yes WNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No INI NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
XNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
Yes
❑ No ❑ NA ❑ NE
r
❑ Application Field ❑ Lagoon/Storage Pond 0 Other: �eka'f �u t
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
No 0 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).
M�J, zC_> 16,
24; wj+s RPPq' wl�focn� { -{an nek> ILtit~ �� vck�
LI-A r2�1S
7 �[-�it�-- 4�C d s / W (,a i�D+t . � K f � ,
{_CMS
SLV� 1
+��� oe't"1 � i,
Sl
y
zQ1�f a�oliU. .. eb"Pan1L 4J�s>4 r l�i1� r;t �l�G, � sfran, *GHv.K n11r ►73rr*
W�� AtJ44V_5
——/11-01Y- 7.061 116 N
1e/2013 = Z.Q'f /b n!
Reviewer/Inspector Name: �R AA ,`TZIa, I I
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 53(E72J" -�Zf-5—
Date:-712OZZ
21412011

Mivision of Water Quality
Facility Number - ivision of Soil and Water Arvation
0 Other Agency
Type of visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: [ Arrival Time: : / R.n Departure Time: 1 '3P1 County: Region: WSRO
Farm Name: T b + 4 Xk : VAA A 1 tdr+ Owner Email:
Owner Name: �{. Yin �%/"j Phone: Cw� /Z O ty t�
Mailing Address: 3 T 2—.3 RMG d-,61l PU , Spy N C sfos__
Physical Address:
r 7 71-e7/ Facility Contact: p �c, V�lh_f Title: Phone: Cc-) zCO—IZL/iv
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude: 0 2—
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -Layer
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turke Poults
Other
Discharees and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
t?
Dairy Calf
Dairy Heifer
D Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes XNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [] No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes kNo
o
Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3
21412011 Continued

f\
Fa6li Number: 03 -13.10 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 j Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: b�k 4A d
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 2
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., 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 A No
❑ Yes kNo
❑ NA ❑ NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
S. 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? ►7�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ 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): 69rk 41 S;e::�: . 6 ra'A
13. Soil Type(s):
14, Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable [] Yes No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes [ No ❑ NA ❑ NE
I & Is there a lack of properly operating waste application equipment? ❑ Yes No ❑ NA ❑ NE
Required Records .&_Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections 96dgoSu=L4
22. Did the facih ' to install and maintain a rain gauge? ❑ Yes X No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 9NA ❑ NE
Page 2 of 3 214122011 Continued

jFa6lity Number: 63 - :3 I& I Date of Inspection: j i 10
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
�No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No
NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes0�1
No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
X No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
/!!///��TTTT
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
krNo ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
WNo❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check appropriate box below.
� Yes
❑ No ❑ NA ❑ NE
�the
❑ Application Field ❑ Lagoon/Storage Pond �J
Other: unIr "14,cL,
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
[:]Yes LE No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. I
Use drawines of facility to better explain situations (use additional paves as necessary).
�%JUP t�P�►,�el� �/3�/z�l1, l�,l�� �� �,
I I kSiZ:- M act YJrf =
7�07 �T z 3,7 ihnl
®�Is , ! ;
lId3II3 51 is
�51-p�13 ; 3, 3 0 A At
f Wz3A3 = 2.05 le A/
Reviewer/Inspector Name: ��j (�t ll 1V r'WIt f
Reviewer/Inspector Signature:
Page 3 of 3
/ _ ,4 ZT l6 .
,{
ly
Phone: (774 '
Date: I' 05— ZO13
24,2011

1 Division of Water Quality
Facility Number D3 - O Division of Soil and Water Con ervation
Q Other Agency
jType of Visit: A Compliance Inspection O Operation Review Q Structure Evaluation Q Technical Assistance
(Reason for Visit: Routine O Complaint O Follow-up O Referral p Emergency Q Other O Denied Access
Date of Visit: Arrival Time: Departure Time:[ � 1 S County: ,Nl Eh�tct ny
Farm Name: ' 3, G Li` , l v i n 5 V4rjf DM J:� (61 Owner Email:
Owner Name: A Iy, ?ii l' ols Phone:
Mailing Address: 3 �/ 23 l e_AwyL d161rGi1
Physical Address:
Facility Contact: FZ l 47 ' �Vq V1 s Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Region: [-VS90
(P.J 3-72_ —
Phone:(-') Ze3o —
Integrator:
Certification Number: 4 / Z t31 7-o1
T
Certification Number:
Latitude: 3� a 3 ! •� R/ o 6 2" 5- �•
_ 3 �L•• Longitude: 3
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Non-L
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes )26o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes VNo ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3
21412011 Continued

acili Number: d - 3 Date of inspection: 3 J
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 36
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo ❑ 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 )gNo ❑ 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 environmeen�tal threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �J No ❑ NA ❑ NE
�ttC
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes ��J"'��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 XNo ❑ 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
r
12. Crop Type(s): Corn f� ttiryc, t - J 7 -A- .
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
WNo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yeso
tNo
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design [] Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? ❑ Yes No ❑ NA ❑ NE
3'Waste Application aweekly Freeboard aste Analysis 2r§oil Analysis Weather Code
ERainfali tocking []<r­op Yield onthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [:]No NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: 63 - J.3 Date of Inspection: 773
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes XNo
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes ❑ No
[�NA ❑ NE
the appropriate box(es) below.
�T
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes No
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes No
❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
y�
❑ Yes )j No
❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
/�
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes XNo
❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
XYes ❑ No
❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond [Other: (A " --"e, -1 Sr 1
a
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes No
❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes No
❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ANo
❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drawines of faci€itv to better explain situations (use additional oaees as necessarv).
-k 5-3 lVdV+4- Dom 4W- Lj �P c1 -e� �V31/zD
2/. zalz s617 �^4 jJ ��
r
32,
re z'(� co M►�� i ��'1 � ��
'�� e�
Reviewer/Inspector Name: 54
Reviewer/Inspector Signature:
Page 3 of 3
Phone: 671 771
Date: ZZ 31 Z-OI Z
21412011

T Division of Water Quality 00servationFacility Number ©- 0 Division of Soil and Water in
0 Other Agency
Type of Visit: T Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: X Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: $ 5 Arrival Time: Departure Time: County: R ( an Region:
Farm Name: ap b bu 4 A Itfiyh Fy"i J Fo—y-M Owner Email: 7
Owner Name: Ao 6 h U R -,' A i vt r1 F, 1f6i­1'�LS Phone: IW I
Z
Mailing Address: 3 iA3 of eGl.SCtYi1 oMe- LburC41 , S'QQL-Qa NG a h
Physical Address: SCE m
I 3-72t -191
Facility Contact: p V V6L-h Title: Phone: C) -1w — 42
_ Z
Onsite Representative: Integrator:
Certified Operator: Certification Number:
�a�3�/ram
Back-up Operator: Certification Number:
Location of Farm: Latitude: 3 663 31 Leto t ' Longitude: a Q a1
!3 S 2 0
� � 16 N . from 5 ' "Q , Lei'+ o n+o Plegsant Pome- church ► d .
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Non-L,
Pullets
Other
Poults
Design Current
Discharp,es and Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Q
10
Dairy Calf
5
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes �A No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
Page 1 of 3 21412011 Continued

Facili Number: Q 3 - 1 jDate of Inspection: 5 j/
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 0 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? D Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: +e_ or
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 9No ❑ 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? ``TTTT��
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 KNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes XNo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes 9No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes XNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):
13, Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Inj No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
lNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
X No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other: ,�,/
�a21. D es record keeping need ' provement? ❑ Yes ? No ❑ NA ❑ NE
[ste Applica 'on �/Wwejkly Freeboard Waste Analysis Soil Analysis 7C �eather Code
Rainfall StockingCrop Yield ❑n`9 Iaiisr�te-Frssp�eEiorr�— Monthly and 1" Rainfall Inspections ey-
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes D�'No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes [:]No NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: -IAN& Date of Inspection: Oil
24. Did the facility fail to calibrate waste app ation equipment as required by the permit? Yes O No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No PNA ❑ 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 M No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Wo ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes XNo ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �6 No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes D No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond IXI Other: Ayenfl, S1�0
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes CgNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes 0 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).
aao 0,0-116rQ4i0n ?-3131aOtL,4 13
�2, 1 aLU I d 501 eSt re oT ?
317/11 coa-4t!g 5AAqVe N/160o
LK-1up _7� -4 __& U104_AJed L,-�>/
f �N 0 3p6 �hru W0 70 .
O
Reviewer/inspector Name:
Reviewer/Inspector Signature
Page 3 of 3
Phone: ] ^ S C 1
Date: S�Sf a
21412011

A
Type of Visit gD Compliance Inspection Q Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit Routine Q Complaint Q Follow up Q Referral O Emergency Q Other ❑ Denied Access
Date of Visit: I-S/;Z611A Arrival Time: Departure Time: County: Region: (AI-Yr. d
Farm Name: Owner Email:
Owner Name: Phone: (W) 3 -7a
Mailing Address:
Phvsical Address:
N 3-7a- B-7IS-
Facility Contact: Title: Phone No: j2 ' Oel -- 1j_ U i
Onsite Representative: Integrator:
Certified Operator: qz Operator Certification Number:
Back-up Operator:
Location of Farm:
l!K
S' ne.
❑ Wean to Finish
J� ❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
'a ❑ Gilts
❑ Other
Back-up Certification Number:
a
Design Current Design Current Destgit ` `Ci
Capacity Population Wet Poultry Capacity 'Population Cattle` ` Capacity Pop
❑ Laver Dairy Cow
❑ Non -Layer _ Dairy Calf
❑ Dairy Heifer
l Drv-Poultry ❑ Da Cow
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ TurkeX 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?
U Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Numher"of St c
7�.
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes iNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: D3— . Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall).less than adequate? El Yes El NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
tStructure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: WQ Si
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes dNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ NA ❑ NE
through a waste management or closure plan? ///���
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes L'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 Oj No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes NNo ❑ NA ❑ NE
maintenance/improvement? X
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ElYes No ❑ NA ❑ NE
ElExcessive Ponding ElHydraulic Overload ❑ Frozen Ground ElHeavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
4No ❑ NA ❑ NE
evi
❑ No jaj NA ❑ NE
9No ❑ NA ❑ NE
kNo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/inspector Name
ReviewerAuspeetor Signatu
Phone: l ��
Date:
Page 2 of 3 . 1 12128104 Continued

Facility Number: Q — lbof Inspection •
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps El Other
21. Doe ecord keeping nee7Wp
vement? ❑ Yes No ❑ NA ❑ NE
Waste Application
Freeboard Waste Analysis Soil A lysis L1JIWaste Transfers
Lid Rainfall �o king 120 Minute Inspections Monthly and V Rain Inspections El_, eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes X o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comments and/or Drawings:
�� IEOo-a000a
a�
a�3�io
All j6(0
> N/ /006
❑ Yes ❑ No
❑ Yes # No
El Yes ❑ No
❑ Yes �o
❑ Yes to No
gNA ❑ NE
❑ NA ❑ NE
XNA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
Nc
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
Page 3 of 3 12128104

i'V1s10n of Water, Quality
Facility Number D_jj Division of Sod and4'atcr Corvation
—� Q,Other Agen'cy :�_ . �
Type of Visit
ompliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
outine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: QFIT a - Arrival Time: Departure Time:: County: � Region: �4
Farm Name: Fj6h h U L A 1 v i nt:,V '_n 5 bat r w rat- M Owner Email:
Owner Name: B6 6b ^^ T" V 1 n eya n.�_ Phone:
( a —
Mailing Address: _ 4 a 3 1 �.S �j L 0 me_ Lh u rc,b �d ,
Physical Address: )D-me -�
Facility Contact: DQ� Title: Phone No• 7 �� J
e, 0-tia
Onsite Representative: Integrator:
Certified Operator: - - Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: �° �� Longitude: ©°
-Fron( !S pa r-[a . Lp_ � A- orrr6 W [_6L5vu^\f n e
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
1 ❑ La er
❑ Non -Layer
1
Other
❑ Other`
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
`
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
%Dairy
Cow
Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number.oUStrtictures:r'4
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 gNo ❑ NA ❑ NE
El Yes
❑No
El NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes eNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes No
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
Structure Structure 2 Structure 3 Structure 4
❑ Yes No
Structure 5
❑ NA ❑ NE
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes [ No
❑ NA
❑ NE
through a waste management or closure plan?
111
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 4No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? El Yes
Yes ffffffNo ❑ 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 ElNE
maintenance or improvement?
Waste Auplication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes (NNo ❑ NA ❑ NE
mai ntenance/improve ment?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop types) =jA4j
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
No ❑ NA ❑ NE
No El NA ❑NE
❑ No 0 NA ElNE
No ❑ NA ❑ NE
&No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name I I Phone:
Reviewer/Inspector Signature ,[_d4A_ Date: � 11
12128104 ' Continued

9
Facility Number: — Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
0-
13 Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ YesNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists (( �N
❑ Design El Maps El Other
21. Does "ecord keeping neeWip,ovement'� ,_-be}ew-- ❑ Yes No ❑ NA ❑ NE
Does
Applica oneek Freeboard ►L]' Waste Analysis Ly S�Zthly
ysisaste-asf�rs-(((��n ^^^� ^l rgh f «:m4
pQ Rainfall Stocking Crop Yield ns and V Rain Inspections L1d"Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
IL1i No
El NA
El NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
/❑ No
[)(NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
{�l No
El NA
El NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
(❑ No
[PtNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
gNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
XNo
❑ NA
❑ NE
Otherlssues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
111111���,��, No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
{
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
ElNA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
(P(No
❑ NA
❑ NE
12128104

Facility Number
[
7-
otckivision of, Water Qualilq
ivision of Soil and Water
D Other Agency
I
Type of Visit C mpliance Inspection 0 Operation Review Structure Evaluation Technical Assistance
Reason for Visit Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region: 4:�Salo
Farm Name:-'- a U` ~V r 1 U. 'r}er Email: ' ' . o3m
Owner Name: kbV '4 191yi+')-Jan_5 Phone: o� `
Mailing Address: s� p��a�5t'�I11� qdww-- �� Qi_ t\3c a
Physical Address:
Facility Contact: Title: Phone N 2
Onsite Representative:
� __ y Integrator:
Certified Operator: S Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm: Latitude: t�o [DI Longitude: ® o i� i E�fy6
1�w 11 N �Irwn . -5 �ar.�a . L&R oin+o Pf eaS"f rne--. Ped -
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
1❑ Non -La yer
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ urkey Pouets
❑ 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 I
Cattle Capacity Population
Dairy Cow
El
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
4njo tph Ferree
2
❑ Yes KNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes �No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: . Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes % No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
tructureP Structure 2 Structure 3 Structure 4
Identifier: e O
Structure 5 Structure 6
7V Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes �6No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental) threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes �(No ❑ NA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes hfo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > l0% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) C�NO � I 4C111 (0nkWf. -C—Izrn C
13. Soil type(s) V
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?[] Yes
❑ No
9NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
*o
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment'?
❑ Yes
XNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
6
pz
T
Reviewer/Inspector Name ` (\� Phone:
If 1 E4 - 11 �*� 1, ) -n
tv Hi
Reviewer/Inspector Signatur; ho d., A L Date: a
` - 12128104 Continued

12

Facility Number: — gate of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes C o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes *0 ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does cord keeping need i provement? I ' Ayes ❑ No ❑ NA ❑ NE
['Ry aste Application Week Freeboard aste Analysis Soil Analysis "'� `�T-�iQR
ainfall j.j�'Stocking Crop Yield onthly and V Rain Inspections Weather Code
IWL
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes ANo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No VNA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes N>("No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No [>(NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ANo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes XNo ❑ NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes *o El NA N NA E
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document El Yes
!%%!!!XNo ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately �j
31. Did the facility fail to notify the regional office of emergency situations as required by El Yes No ❑ NA El NE
General Permit? (ie/ discharge, freeboard problems, over application) /
32. Did Reviewer/inspector fail to discuss review/inspection with an on -site representative? ❑ Yes RNo ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes Wo ❑ NA ❑ NE
Add' ' nal Comments and/or Drawings:
Ss . T F- 1 e-1 . C�a � c,�r�i�� ova revtsr�n `
o� f a 0� 7 5o t I ►r' s v 7 S I ne —
Ca t t b ca'%i o rn Joe ® � oo g •
12128104

In Division of Water QualitW
Facility Number Q :11 00 Division of Soil and Water Censervation f p
Other Agency I
Type of Visit Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit O(Routine ( Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: I I ! ArrivalTime: ® Departure Time: County: 1q haij1✓� Region: to'
Farm Name: 80 h \ AIV � n rl JQ� S r 14 f f� h'1 Owner Email:
Owner Name: t-©�b III P. I V 'Ia n5 Phone:
Mailing Address: 23 d• 7� 1 1 NL '-??6 7,5�
Physical Address:
Facility Contact: Y��____ 11+5 Title: Pho e N 3 �S
Onsite Representative: Integrator:
Certified Operator: a EYa.y)S Operator Certification Number:
Back-up Operator:
Location of Farm:
Nort%1 0 � S pax+ p`
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Back-up Certification Number:
Latitude: as I 0 Longitude: $ i ° �
on H--w, 119. Le--F+- o n f o P 1 ea6a.n t Nm me (2d
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current
Cattle Capacity Population
Dairy Cow
I _
Daia Calf
❑ Dairy Heifet
❑ Dry Cow
❑ Non-Dai
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes L�1 No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ) ❑ Yes ❑, NNo ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes -� No ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑ Yes J No ❑ NA ❑ NE
other than from a discharge?
12128104 Continued

Facility Number: o — 13
1 ! Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus stone storage plus heavy rainfall) less than adequate?
❑ Yes
VNo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure 2 Structure 3 Structure 4
ta Structure 00y)
{�
Structure
5
Structure 6
Identifier:
l Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes
�No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or
environmental thr at, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
NNo
❑ NA
El NE
8. Do any of the stuctures lack adequate markers as required by the permit?
ElYes
0;� o
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
EYNlo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[]Yes
No
❑ NA
❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
❑ Yes
[N/No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or i0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
o
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
XNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
❑ No
NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ NA
El NE
18. Is there a lack of properly operating waste application equipment`?
❑ Yes
VNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Isl I `1 / () -7 = (0. O-L wCzst�
`Reviewer/Inspector ;`lame
\•viewer/Inspector Signa
rp
Phone:
Date:
12128104
- sa

f
4Facility Number: ate of Inspection
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ YesVNo
El NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
ElYes
❑ NA
❑ NE
the appropirate box. WUP ❑ Checklists ❑ Design El Maps El Other
�No
21.
Do record keeping need impr vement.❑
Yes
❑ NA
❑ NE
aste AnalysisVSoil"An*alysis s
ste Applica ' n Wee y FreeboardWV"
Rainfall Stocking Crop Yield M7�'Monthly and V
Rain Inspections
Weather
Code
22,
Did the facility fail to install and maintain a rain gauge?
❑ Yes
X No
ElNA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
VNA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
M No
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
❑ No
[YNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
9 No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
)Ys
No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
`
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes]
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
/
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
N/No
❑ NA
❑ NE
Additional Comments and/or Drawings:
Fa 4 c CLI 'i b ra_i 10 n due_ a� a'I n 0 ci . a o nz'
v? I aoo (P St"I IS o-V
0-n r�v.d ma zLj T J F- j e 1_ jaf,e
Ch-ulJ not l ol- afe- i n
e-5 e-.P-- A e�GA 5�eci a 1 iS+
boutPor r)r1
A
04-C re-5) I
12128104

Division of Water Quality
Division of Soil and Water Conservation
❑ Other Agency l--I
Facility Number : 030013 Facility Status: Active Permit: AWC 3 013 !! Denied Access
Inspection Type: Compliance- nspection Inactive or Closed Date:
Reason for Visit: Routine_ County: Alleghany _ Region: Winston-Salem
Date of Visit: 12/05/2006 _ Entry Time:10:00 AM Exit Time: 10:45 AM Incident #:
Farm Name: Bobby& Alvin Evans Dair Farm Owner Email:
Owner: Bobby P Evans Phone: [phone]
Mailing Address: 3423 Pleasant Home Rd _ _ NC 286759054
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant
Location of Farm:
Integrator:
Latitude: 36°3 '46"
7 miles north of Sparta Rd. 18 left on Pleasant Home Road. Dairy is 2 miles on left.
Longitude: 81°02'53"
Question Areas:
Discharges a stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Bobby P Evans
Secondary OIC(s):
Operator Certification Number: 21399
On -Site Representative(s): Name Title Phone
On -site representative Bobby P Evans Phone: [phone]
24 hour contact name Bobby P Evans Phone: [phone]
Primary Inspector:
Inspector Signature.
Secondary Inspector(s):
Inspection Summary:
21 _ Keep an eye on zinc levels. Currently at about 900.
9/29/06 waste analysis=5.8 lbs. N/1000 gal
Records look real good.
Phone: /
Date:
Page: 1

Permit: AWC030013 Owner - Facility: Bobby P Evans Facility Number : 030013
Inspection Date: 12/0512006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
Cattle -Milk Cow 150 100
Total Design Capacity: 150
Total SSLW: 210.000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
aste Pond WASTE POND 42.00
Page: 2

0 0'
Permit: AWC030013 Owner - Facility: Bobby P Evans Facility
Number:
030013
Inspection Date: 12/05/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts
Yes
No
NA
NE
1. Is any discharge observed from any part of the operation?
n
■
n
❑
Discharge originated at:
Structure
❑
Application Field
❑
Other
❑
a. Was conveyance man-made?
❑
■
❑
❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■
❑
❑
c. Estimated volume reaching surface waters?
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 Waters of the State other than from a
❑
■
❑
❑
discharge?
Waste Collection, Storage & Treatment
Yes
No
NA
NE
4. Is storage capacity less than adequate?
❑
■
❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.eJ large trees, severe
n
■
n
n
erosion, seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management n
■
❑
n
or closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■
❑
❑
B. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits,
❑
■
❑
❑
dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
■
L
❑
improvement?
Waste Application
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or
❑
■
❑
❑
improvement?
11. Is there evidence of incorrect application?
n
■
❑
n
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
Page: 3

Permit: AWC030013 Owner- Facility: Bobby P Evans
Inspection Date: 12/05/2006 Inspection Type: Compliance Inspection
Facility Number: 030013
Reason for Visit: Routine
Waste App ication
Yes No NA NE
PAN?
Is PAN a 10%110 lbs.?
n
Total P205?
fl
Failure to incorporate manure/sludge into bare soil?
n
Outside of acceptable crop window?
n
Evidence of wind drift?
n
Application outside of application area?
13
Crop Type 1
Small Grain Cover
Crop Type 2
Fescue {Hay, Pasture}
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management
n
■
n
n
Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
n
■
n
El
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
n
■
n
n
17. Does the facility lack adequate acreage for land application?
Cl
■
n
n
18. Is there a lack of properly operating waste application equipment?
n
■
Records and Documents
Yes
No
NA
NE
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■
n
n
20. Does the facility fail to have all components of the CAWMP readily available?
■
n
n
If yes, check the appropriate box below.
WU P?
❑
Page: 4

0 •
Permit: AWC030013 Owner - Facility: Bobby P Evans Facility
Number:
030013
Inspection Date: 1210512006 Inspection Type: Compliance Inspection Reason for VisIt: Routine
Records and Documents
Yes
No
NA NE
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
Cl
■
❑ ❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
Cl
Transfers?
❑
Rainfall?
❑
Inspections after > 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
❑i
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■
❑ ❑
23. If selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■
❑ ❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
❑ ❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑ ❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑ ❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
E)
■
❑ ❑
Other Issues
Yes
No
NA NE
28, Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
■
❑ ❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those
❑
■
❑ ❑
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air
❑
■
❑ ❑
Quality representative immediately.
Page: 5

• o
Permit: AWC030013 Owner - Facility: Bobby P Evans
Facility Number:
030013
Inspection Date: 1210512006 Inspection Type: Compliance inspection
Reason for Visit: Routine
Other Issues
Yes
No
NA
NE
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
■
Cl
D
32. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
Q
■
D
D
33. Does facility require a follow-up visit by same agency?
Cl
■
D
D
Page: 6

Division of Water Quality
Facility Number d f Division of Soil and Water Conservation /Of+M
- Q Other Ageney
Type of Visit
Compliance Inspection
0 Operation Review 0 Structure Evaluation
0 Technical Assistance
Reason for Visit
XRoutine 0 Complaint
0 Follow up 0 Referral 0 Emergency
0 Other ❑ Denied Access
Date of Visit: Arrival Time: 00 Departure Time: County: altOQ Region: 1_L) SPU
Farm Name: f'ik U ( n Ekftw slbo' 1 f U -Eqr h/} Owner Email:
Owner Name: C, LI P- I V t h F 1J(am Phone: `1 7 oZ ` W L- -- - -
Mailing Address: 3 fte_a� khow 1 d . -f4 NX__ o� � 6 7
Physical Address:
Facility Contact: Title: Phone No: 02 — $ 71S jH
Onsite Representative: �(.-ri _ - Integrator:
Certified Operator: O ��- Operator Certification Number:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Back-up Certification Number:
Latitude: o � F0 Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
^ I1 10 Nan -La er
Other
❑ Other T -
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Pouets
❑ Other
Discharizes & Stream Impacts
1. is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
Dairy Cow
Lj Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: 1
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
El Yes
No
❑NA
❑NE
❑Yes 0No El NA El NE
Page 1 of 3 12128104 Continued

03'
Facility Number: — I* Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
I
a. If yes, is waste level into the structural freeboard?
t� Str
ucture 1
Identifier:
'C Spillway?: en
Designed Freeboard (in):
Observed Freeboard (in):
Structure 2 Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes No
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes VNo ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes CIo El NA ❑ NE
maintenance or improvement? / ``
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA ❑ NE
maintenance/improvement?
11. is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes XNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s) v
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
*o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No
0
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
1.
yl NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
9jNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
t�No
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name j SSQ �s� ['(,� � Phone: 77 — S It
Reviewer/Inspector Signature: Date:
Page 2 of 3 112128104 Continued

0-:3! •
Facility Number: —1:3 41te of Inspection `
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 9No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ yes VNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Does cord keeping need improvement? El Yes �<No El NA El NE
FS Waste Application L1� Weekl Freeboard aste Analysis Soil A Isis tm
�' PP Y Y
1�/J Rainfall Stocki Crop Yield ec tons Monthly and V Rain Inspections Bather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �VNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No V NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes A No ❑ NA ❑ NE
❑ Yes ❑ No N NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No VNA ❑ NE
❑ Yes D No
❑ Yes XNo
❑ Yes XNo
❑ Yes 4No
❑ Yes �No
El NA El NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
El NA El NE
Page 3 of 3 12128104

w
I
• •
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency _
Facility Number: 030013 Facility Status: Active Permit: AWCQ�0013 _ ❑ Denied Access
Inspection Type: Compliance inspection Inactive or Closed Date:
Reason for Visit: Routine County: Alleghany Region: Winston-Salem
Date of Visit: 0411812005 _ Entry Time:12:50 PM Exit Time: 02:15 PM Incident #:
Farm Name: Bobby & Alvin Evans Dairy Farm Owner Email:
Owner: Bobby P Eva s Phone: [phone]
Mailing Address: 3423 Pleasant Home Rd Sparta NQ 286759054
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36"33'46" Longitude: 81°02'53"
7 miles north of Sparta Rd. 18 left on Pleasant Home Road. Dairy is 2 miles on left.
Question Areas:
0 Discharges & stream Impacts Waste Collection & Treatment 0 Waste Application
Records and Documents Other issues
Certified Operator: Bobby P Evans Operator Certification Number: 21399
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
On -site representative Bobby Evans Phone: [phone]
24 hour contact name Bobby Evans Phone: [phone]
Primary Inspector: ji saM Rosebrock
Inspector Signatur
Secondary Inspector(s):
Inspection Summary:
21. Went over new permit requirements with Bobby.
24. Operator calibrated application equipment in April 2005 (5,373-9,705 gal per acre).
4/11105 waste analysis=3.5 lbs. N11000 gal.
Phone: [phone]
Ext.383
Date:
Phone:
Phone:
Page: 1

Permit: AWC030013 Owner - Facility: Bobby P Evans Facility Number: 030013
Inspection Date: 04/18/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
© Cattle - Milk Caw 150 111
Total Design Capacity: 150
Total SSLW: 210,000
Waste Structures
Type Identifier Closed Date Start Date Deslaned Freeboard Observed Freeboard
Waste Pond WASTE POND 90.00
Page: 2

0 •
Permit: AWC030013 Owner - Facility: Bobby P Evans Facility Number: 030013
inspection Date: 04/18/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Disrhar4Pe R Stream Imparts Yes No_NA Nt
1. Is any discharge observed from any part of the operation? Cl 0 ❑ ❑
Discharge originated at:
Structure ❑
Application Field ❑
Other ❑
a. Was conveyance man-made? ❑ 0 ❑ ❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ) ❑ ❑ ❑
c. Estimated volume reaching surface water$?
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 Waters of the State other than from a discharge?
❑
Yes
N ❑
No N6
❑
NE
Waste Collection. Starage & Treatment
4. Is storage capacity less than adequate?
❑
N ❑
❑
If yes, is waste level into structural freeboard?
❑
5. Are there any immediate threats to the integrity of any of the structures observed (I.e./ large trees, severe erosion,
❑
M ❑
❑
seepage, etc.)?
6. Are there structures on -site that are not properly addressed and/or managed through a waste management or
❑
0 ❑
❑
closure plan?
7. Do any of the structures need maintenance or improvement?
❑
■ ❑
❑
8. Do any of the structures lack adequate markers as required by the permit? (Not applicable to roofed pits, dry stacks
❑
0 ❑
❑
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
0 ❑
❑
improvement?
Ygs
No NA
NF
Waste Applicat9on
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
0 ❑
❑
11. Is there evidence of incorrect application?
❑
■ ❑
❑
If yes, check the appropriate box below.
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
PAN?
❑
Is PAN > 10%/10 lbs.?
❑
Total P205?
❑
Failure to incorporate manurelsiudge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Corn
(Silage)
Crop Type 2
Fescue (Hay)
Crop Type 3
Timothy, Orchard,
&
Rye Grass
Crop Type 4
Crop Type 5
Page: 3

Permit: AWC030013 Owner - Facility: Bobby P Evans
Facility Number: 030013
Inspection Date: 0411812005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Crop Type 6
Yes
No -NA—NE
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management Plan(CAWMP)?
❑
■ ❑
❑
15. Does the receiving crop and/or land application site need improvement?
❑
■ ❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
❑
■ ❑
❑
17. Does the facility lack adequate acreage for land application?
❑
■ ❑
❑
18. Is there a lack of properly operating waste application equipment?
❑
Yes
■ ❑
No NA
❑
NE
Records and Documents
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■ ❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
■ ❑
❑
If yes, check the appropriate box below.
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
■
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
❑
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
❑
Transfers?
❑
Rainfall?
❑
Inspections after > 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual soil analysis?
❑
Crop yields?
■
Stocking?
❑
Annual Certification Form (NPDES only)?
❑
22. Did the facility fail to install and maintain a rain gauge?
❑
■
❑
❑
23. if selected, did the facility fail to install and maintain a rainbreaker on irrigation equipment (NPDES only)?
❑
■
❑
❑
24, Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
■
❑
❑
Page: 4

0 ' •
Permit: AWC030013 Owner - Facility: Bobby P Evans Facility Number: MOM
Inspection Date: 04118/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other Issues
28, Were any additional problems noted which cause non-oompliance of the Permit or CAWMP?
Yes
❑
No NA
0 ❑
NF
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those mortality
❑
0 ❑
rates that exceed normal rates?
30, At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air Quality
❑
❑
❑
representative immediately.
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
❑
❑
❑
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑
0
❑
33. hoes facility require a follow-up visit by same agency?
Cl
❑
❑
Page: 5

Permits Issued 06/14/05
Permit
Issued
Effect
Expired
Number
Owner Name - Facility Name . - -
Owner Type
Permit Type
County
Date
Date
Date
Primary Reviewer
_ Region__
W00001147
Annette G Barker - Annette Barker SFR
Individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
04/21/04
04/21/04
03/31/09
toni.wyche
Winston-Salem
W00006038
Bobbie Ludd - Bobbie and Rase Ludd SFR
Individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
08120/04
08/20/04
07/31/09
toni.wyche
Winston-Salem
W00013533
Bradley Hill - Bradley Hill SFR
Individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
05/14/04
05/14/04
04/30/09
bennie.goetze
Winston-Salem
WQ0009280
Elwood Dodson - Elwood Dodson SFR
Individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
04/28104
04/28/04
03/31/09
toni.wyche
Winston-Salem
WQ0011672
Herbert Marange - Marange Herbert-SFR Spray
Individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
02/26/96
02/26/96
01/31/01
kim.colson
Winston-Salem
W00004809
Kenneth R. Struchen - Ken Struchen SFR
Individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
04/26/00
04/26/00
03131/05
kristin.miguez
Winston-Salem
W00014589
Mark Lee - Mark Lee SFR
Individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
04/23/04
04/23/04
03131/09
toni.wyche
Winston-Salem
W00016849
Mike Terrell - Mike and Rhonda Terrell SFR
Individual
Surface Irrigation- SFR (Single Family Residence)
Caswell
10/29/04
10/29/04
09/30/09
toni.wyche
Winston&
W00004216
Richard Goodson - Richard Goodson SFR
individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
05/21104
05/21/04
bennie.goetze
Winston-Salem
WQ0024301
Timothy S Gilbert - Timothy S. Gilbert SFR
Individual
Surface Irrigation - SFR (Single Family Residence)
Caswell
01/03105
01/03/05
12/31/09
miranda.wiltiams
Winston-Salem
Record Number 10
1
•

'x_ 1. llt�nsion of Water Quaht� s ` 3°
�Fibli&. NumberU 3 Dtvtsion of Soil and Water Co„�ervatioti
"I
Other Agency
Type of Visit Compliance Inspection O Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit 106 Routine O Complaint O Follow up 0 Referral O Emergency O Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: 1012 ounty: e
Farm Name: 1/ 1C k J Far-DIOwner Email:
Owner Name: P., A V i n iE Jan Phone: 02 ��, l�
Mailing Address: 3 J t f �' G
Physical Address:
Facility Contact: �j 1 �ya n � _ Title:
Onsite Representative: O Ub1A E\rQ-Vi5
Certified Operator: v f)5
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Integrator:
Region: i�R0
Phone No: y TP
Operator Certification Number: _
Back-up Certification Number:
Latitude: c �' L Longitude: ®o
Design Current Design Current
Capacity Population 'Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
f
Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: IT
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes 'ANo❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

t
Facility Number: is Date of Inspection 0
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes *o ❑ NA ❑ NE
i a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No NA ElNE
r Structure Structure 2 Structure 3 Structure 4 Structure 5 tructure 6
Identifier: O
Spillway?: �-
Designed Freeboard (in):
Observed Freeboard (in): 0
5.
Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
o
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
II
6.
Are there structures on -site which are not properly addressed and/or managed
❑ Yes
No
❑ NA
❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental
threat,
notify DWQ
7.
Do any of the structures need maintenance or improvement?
❑ Yes
�No
❑ NA
❑ NE
8.
Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
No
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9.
Does any part of the waste management system other than the waste structures require
❑ Yes
J No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[-]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drifl ❑ Application Outside of rea
12. Croptype(s) /l/NX1 14AUQAJ I �.CX14�1� - Jo
13. Soil type(s) i t v
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination',[] Yes ❑ No eNA ❑ NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
❑ Yes No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
I Comments (refer to question #):: Explain any YES answers and/or any recommendations or any other comments.
!I Use drawings of facility to better explain situations. (use additional pages as necessary).
IReviewer/Inspector Name �a� Phone: %3I
Reviewer/Inspector Signatur A"_ �IA. Date:
12128104 Continued

Facility Number: —) 3 D�f Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Dj(No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design ❑Maps [I Other
21. D�orecord keeping need i rovement? If yes, check the appropriate VsoilAnalysis
elow. ❑ Yes )dNo ❑ NA ❑ NE
aste A licat' n Yee and Waste Anal sis 11IIIIPP Y
L1d'Rainfall Stocking Crop Yield ns ❑ Monthly and I" Rain Inspections ❑ Weather Code
ovZ
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �6 No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
[�NA
❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
o
❑ NA
❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
ElYes
tN
NA
El
26. Did the facility fail to have an actively certified operator in charge?
El Yes
��,,((0
*o
1
El NA
El NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
[-IYes
No
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
No
❑ NA
❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
[] Yes
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
,
No
El NA
El NE
If yes, contact a regional Air Quality representative immediately ,
31. Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
VNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
No
❑ NA
❑ NE
33. Does facility require a follow-up visit by same agency?
❑ Yes
No
❑ NA
❑ NE
Additional Comments and/or Drawings:
q
4/I a dos wa4te��000 3� S I las- Nllooc� rl-
j1'o�- it n = 3. (0 II�s N�r000�Q
12128104

ical Assistance Site Visit Re
Dion of Soil and Water Conservatiol
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number Date: 1012$IQ4 Time: 1 10:30 j Time On Farm: 90 WSRO
Farm Name Bobby & Alvin Evans Dairy Farm County Alleghany Phone: [phone]
Mailing Address 3423 Pleasant Home Road
Sparta NC 28675
Onsite
Representative Bobby Evans integrator
Type Of Visit Purpose Of Visit
Operation Review
Compliance Inspection (pilot only)
Technical Assistance
Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse
Op Routine
O Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
Q Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current Design Current
Wean to Feeder
Capacity Population Capacity Population
Feeder to Finish
❑ Layer
❑ Non -Layer
❑
❑
❑ Farrow ko Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
® Dairy 150 112
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached
® Dairy 150 112
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached
❑ yes ® no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees,
❑ yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding
❑ yes ® no
requiring DWQ notification?
6• Is there evidence of improper dead animal disposal that poses a threat to the environment
❑ yes ® no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure?
❑ yes ® no
Structure1 Structure 2 Structure 3 Structure 4
Structure 5
Identifier WSP
Level (Inches) 42
CROP TYPES Corn, Silage Small grain silage
SPRAYFIELD
SOIL TYPES CeC HaC HaE WaE
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

Facility Number 03 - 13 Date:
10/28/04
PARAMETER
0 No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
25. Waste Plan Revision or Amendment
El
El 10. Level in structural freeboard
Waste Amendment
❑
❑
❑ 11. Level in storm storage
26. Plan Conditional
27. Review or Evaluate Waste Plan wlproducer
❑
❑
❑ 12. Waste structure integrity compromised
El13. Waste structure needs maintenance
28. Forms Need (list in comment section)
❑
❑
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
El
❑
El15. Over application < 10% or < 10 lbs.
30. 2H.0200 re -certification
❑ 16. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
❑ 18. Late/missing waste analysis
33. Organizelcomputerization of records
❑
❑
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
❑ 21. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22. Crop inconsistent with waste plan
36. Sludge removallclosure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
❑ 24. Deficient sprayfeld conditions
38. Structure Needs Improvement
❑
❑
39.Operation & Maintenance Improvements
❑
❑
40. Marker check/calibration
❑
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
Irrigation designlinstallation
❑
❑
❑ Other...
43. system
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45. Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluationlrecommendations
❑
❑
2.
49. Drainage work/evaluation
❑
❑
50. Land shaping, subsolling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs5.
❑
❑
55. Waste operator education (NPDES)
❑
❑
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
6.
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/ 10/03

r�
u
I Facility Number 03 - 13 Date; 10/28/04
COMMENTS:
Waste analysis: 8/02/04 LSD 3.4 Ibs.N/1000 gals. B, 4/01/04 LSD 5.0 Ibs.N/1000 gals. B
Soil samples dated 9128/04 looked good.
#57. 1 reviewed some of the new permit requirements with Mr. Evans.
Facility and records looked good. Good farm.
AL
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 11/5/04
Entered By: [Rocky Durham
03/10/03

ision of Water Quality
- a
Q ivision of Soil and Water. Conservation
O Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Fallow up O Emergency Notification O Other ❑ Denied Access
Time -
Facility Number 03 13 Date of Visit: 5/11/2004 Time: 1000
O Not O erational O Below Threshold
® Permitted ® Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .........................
Farm Name: A.bllx.s9rr.�LY.IAI. x�tls [?ai�CJ. rt1a..................................................... County: AllfgUay ........................................ W.SRQ........
Owner Name: flAbl1y..E.I.Al.yin................ Ey.."S..........................
Mailing Address: 2.�1e0s,dt.9>Alt<.A.ail......................................
Facility Contact: IlAblly-Exams.................................................. Title:..
Onsite Representative: JD.Qhby..Ey.Aw...................
Certified Operator: Qbbx.�,............................. Emas.....................
Location of Farm:
Phone No:h-.7.2-.f11.�W.l.................................................
S.Parta... NC............................................................. 2B.6.73 .............
................................... Phone No: 33.6,.3 2� ...............
Integrator:
Operator Certification Number:11399
F miles north of Sparta Rd. 18 left on Pleasant Home Road. Dairy is 2 miles on left. t
IV
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 33 46 Longitude 1 81 • 02 53
Design Current Design Current Design Current
... Swine Capacity Population _.
'Poultry Capacity
Population Cattle
Capacity: Population.
❑ Wean to Feeder
❑ Layer
® Dairy
150
111
❑ Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
El Farrow to Feeder
❑Other
❑ Farrow to Finish
Total Design Capacity
150
❑ Gilts
Total`SSLW
2101000
❑ Boars
Number of Lagoons 0
Discharges & Stream Impacts
1. is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (if yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑ Yes ❑ No
2. is there evidence of past discharge from any part of the operation? ❑ Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ®No
Waste Collection & Treatment
4. is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes. ® No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...... W stc.l'wid.....................................................................................................................................................................................
Freeboard (inches): 72
12112103 jV ,q7 ej Continued

Facility Number: 03-13 0 Date of Inspection 1 5/11/2004 0 ,.
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ® No
closure plan?
If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® 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 ❑ Yes ® No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ® No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Corn (Silage & Grain) Rye
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement? ❑ Yes ® No
16. Is there a lack of adequate waste application equipment? ❑ Yes ® No
Odor Issues
IT Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes ® No
Air Quality representative immediately.
Comments -{refer to question #): luxplain..any YES answers and/or any recemmendationsor any other eontments.:
Use drawings offacility to better'explaid,sit' uations. (use addrtional pages:as necessary)': ❑ Field Copy ® Final Notes 1. -
3. 2004 soil samples to be taken this Fall.
�►
11104 waste analysis = 5.0 lbs. N/1000 gal.
Records look good.
! operator's request, DWQ to mail copy of NCSU operator continuing certification courses.
kl
Reviewer/Inspector Name 3MehsRose rock - - E
Reviewer/Inspector Signature: ill Date:
12112103 Continued

Facility Number: 43-13 *f Inspection 511112404
Required Records & Documents
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 ® No
❑ 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
® No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
27,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
® 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
® No
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 V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
® No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
dditional .Comments and/or,Drawings: -
12112103

vision of Water Quality
ision of Soil and'Water,Conservation .
Q Other Agency
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit ]) Routine O Complaint O Follow up Q Emergency Notification O Other
0 Denied Access
Facility Number Date of Visit: ime:
0 Not Operational O Below Threshold
Permitted Certified 0 Conditionall e ' ied 0 Registered Date Last Operated or Abore Threshold : .........................
f a Tj
Farm Name: ....A.�.. A..T ..V i.%�....... rt�%F ........... �i , ...... County:... �}/,.�..�... ..................
Owner Name:..._....I.........:.�.�.1'i� i "Pa4-Ale+•.... �...... .....V.....4. .................... .
Mailing Address: .... h..l�f.I .....P:......�.l...../. -Ly)-..........-1=.1.Y..� �.�-------------------------------------------��6..:..:�7..°�....... U a..IL.......'`
Facility Contact: ......L?..... �Q:`� W„].. Title: Phone No: °�. ;... 0157,
1 r
_ ............................... )................................................ .... ..-...-
Onsite Representative: $ b. �W V)„3- Integrator• "" ------
Certified Operator: ....... &,b1 ............P .1�a�� �.---------------........ Operator Certification Number: . �... .......
Location of Farm:
[]Swine []Poultry [Cattle []Horse Latitude ' 4 66 Longitude • ®4 ®«
Design . Current
Swine •,Ca act � Po ulation Poultt
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons
`"-`� ^ �nlriind.Pnnr�c / Rniirl'Tranc
I❑ Non -Layer I
t Current Design Current .
Po ulation, Cattle Ca act'Population-
Dairy
1
Non -
Other
- Total Design Capacity Jed.
}.:Total .SSLWa Ink
Discharges & Stream Impacts
1, Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. if discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon 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 Structure 2 Structure , Structure 4 Structure 5
Identilicr: ' i ............................. ................ ............... ................................... ......
Freeboard (inches):
❑ Yes No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes I
❑ Yes No
❑ Yes No
Structure 6
............................
12112103 Continued

Facility Number: —1,31 0 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, Yes o
seepage, etc.) �4
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑Yes
closure plan? Y�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 o
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes o
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes o
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes o
❑ Excessive Ponding ❑,�AN ❑ jlydrauiic (�verload� ❑-�rozen GrounA ❑ Copper and/A Zinc \
• . . - �,�•�Lj!!I1—�/.;�/1%L��L%ice/� ✓T.%� ',1LI_ns�i /ram
13. Do the receiving crops differ with those dgsignatetYin the Certified Animal WWe'Management Pidn (CAWMP)? ❑ Yes )l No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes 'AVo
b) Does the facility need a wettable acre determination? ❑ Yes RNo
c) This facility is pended for a wettable acre determination? ❑ Yes o
15. Does the receiving crop need improvement? ❑ Yes *'o
16. Is there a lack of adequate waste application equipment? [I Yes
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? ❑ Yes o
19, Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes No
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional ❑ Yes>z<o
Air Quality representative immediately.
Commenis ji,4ei to question #) Explain any YES"answeirs aindior.any."recomrriendations of any aiher, comments
:L3se'drawings.of facility -to betterexplain situations. (use, additioirai pages as necessary) 1 r Feld Copy ❑Final Notes
j-
�3) aCC4 (kd U-q" d
Reviewer/Inspector Name : ^ W 4-1,!�—__7,C-,/a .
Reviewer/Inspector Signature:
12/121n3
Date: I i1 A

Facility Number: — l f Inspection
i
Reciuired Records & Documents
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. El No
El Waste Application El Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yesio
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes Aqqo
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application) ❑ Yes ><0
27. Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative? ❑ Yes fN(o
28. Does facility require a follow-up visit by same agency? ❑ Yes
24. Were any additional problems noted which cause noncompliance of the Certified AWMP? El Yes
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
A No
3I.
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 I" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
12112103

•
v

hnical Assistance Site Visit Repo
• DiWon of Soil and Water Conservatio
Q Natural Resources Conservation Service
0 Soil and Water Conservation District
Q Other...
Facility Number 03 - 3 Date: 10/13/03 Time: 1 13:05 1 Time On Farm: 90 WSRO
Farm Name Bobby & Alvin Evans Dairy Farm County Alleghay _ Phone
Mailing Address 3423 Pleasant Home Road
336-372-8611
Sparta NC 28675
Onsite
Representative Bobby Evans Integrator
Type Of Visit
® Operation Review
❑ Compliance Inspection (pilot only)
❑ Technical Assistance
❑ Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
❑ Swine ❑ Poultry ® Cattle ❑ Horse -71
Purpose Of Visit
O Routine
O Response to DWQ/DENR referral
O Response to DSWC/SWCD referral
O Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current Design Current
Capacity Population Capacity Population
❑ Layer
❑
El
Wean to Feeder
El Feeder to Finish
Non -Layer
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
® Dairy
ElNon-Dairy
® Dairy
ElNon-Dairy
107
�-7
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes ® no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of.the waste structure (large trees, ❑ yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ® no
requiring DWQ notification?
5. Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ® no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structure1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier WSP
Level (Inches) 32
CROP TYPES 13mall grain silage Corn, Silage
SPRAYFIELD
SOIL TYPES CeC HaC HaE WaE
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

r
a
Facility Number 03 - 13 Date:
10/13/03
PARAMETER
Q No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
25. Waste Plan Revision or Amendment
❑
❑
❑ 10. Level in structural freeboard
26. Waste Plan Conditional Amendment
❑
❑
❑ 11. Level in storm storage
27. Review or Evaluate Waste Plan w/producer
❑
❑
❑ 12. Waste structure integrity compromised
El 13. Waste structure needs maintenance
28. Forms Need (list in comment section)
El
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
❑
❑
❑ 15. Over application < 10% or < 10 lbs.
30. 21-1.0200 re -certification
❑ 16. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
❑ 18. Late/missing waste analysis
33. Organizelcomputerization of records
❑
❑
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
❑ 21. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
[122. Crop inconsistent with waste plan
36. Sludge removal/closure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
❑ 24. Deficient sprayf[eld conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker check/calibration
❑
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
El
❑
El Referred to NCDA Date:
43. Irrigation design/installation
❑
❑
❑ Other...
system
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45. Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
❑
❑
46. Wettable Acre Determination
1
47. Evaluate WAD certificationlrechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2.
49. Drainage worklevaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
El
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
El
5'
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Croplforage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

Facility Number 03 - 13 Date: 1 10/13/03
COMMENTS:
Waste analysis: 7-03-03 LSD 1.4 Ibs.N/1000 gals. B, 3-05-03 LSD 3.2 Ibs.N/1000 gals. B
Facility and records looked good. The 2003 soil samples went to a Virginia lab. They have the PH, Zinc
and Copper levels and the results looked good. ,
Provided Mr. Evans with some freeboard and slurry application forms.
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 10/15/03
Entered By: lRocky Durham
03/10/03

rrsiion of Water Quality �irision of Soil and Wa"ter Conservati.on
Q'Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 03 l3 Date III' Visit- D7102l20t)3 Time: 1o(i0
0 Not Operational 0 Below Threshold
® Permitted ® Certified E3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: BobbyA.A,lYittE ans.Aairy.FarmForm ....................................... County: Aaleghanx............................... WSRQ......
Owner Name: Bohby-P 1AlYiinF.yams-----------------------_-_--- Phone No: 3 Ct- I2:$�ll_Char .-----------------.---
Mailing Address: 342 .�leasantt..kiaurae..l oad.............................................................. 5p.aAta..x..................................._.......................... Z&.0.75 ..............
Facility Contact: 00bbY.laxans......................................Title:............................................... Phone No: 336,37M.715.1[bome)......
Onsite Representative: --- ----- ----- ----- - - _ ----- ---- Integrator:._.- - --- --- - --- --- _.--- - --- - - -
Certified Operator: BQbhy..l'................................ 1�Y.�ttS..................:..._.......................... Operator Certification Number: ZJ,39-9 .............................
Location of Farm:
7 miles north of Sparta Rd. 18 left on Pleasant Home Road. Dairy is 2 miles on left.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude ®• 33 ®�� LongitudeF $l • 02 S3
Design Current
Swine Canacity Pnmilatinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ® Dairy 150 l05
w ❑ Non -Layer I I ❑ Non -Dairy
❑ Other'
Total Design Capacity 150
Total SSLW 210,000
A.
I Number of Lagoons 0 JLJ Subsurface Drains Present JILI Lagoon Area i❑ Spray Field Arca I
Holding Ponds I Solid Trap"s l ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. 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. II'dischurge is observed. did it reach Water of the State'? (II - yes. notify DWQ)
c. Hdischarge is observed. what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system'? of 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• W%Cte Pnnd
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes 0 No
Structure 6
Freeboard (inches): 66
05103101 Continued

Facility Number: 03-- t3 . Date of Inspection 07/02/2003 •
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion. ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement`? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11 _ Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Small Grain (Wheat. Barley, Fescue (Hay) Corn (Silage & Grain)
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
IT
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
IN No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refeir to^question #).. Explatn'ariyYES:'an"swers! d/or.any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Field Copy ® Final Notes
19. Records look great!
_
19. 2002 soil test results ok. Need to take 2003s.
Waste analyses:
3/6/03 3.2 lbs. NI1000 gal. ALD
10/9/02 4.5 1bs. NI1000 gal. LSD
,Questions left blank are not applicable to this facility at this time.
Reviewer/Inspector Name Meliss Rosebrock
Reviewer/Inspector Signature:
Date: -7' Q,
05103101 1 Continued

Facility Number: 03-13 �of' Inspection 07/02/2003
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)
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?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
05103101
J

lom
Division of Water Quality -
Dlvision of Soil and Water. Conservation
O Other Agency
Type of Visit P Compliance Inspection 0 Operation Review Q Lagoon Evaluation
Reason for Visit Routine Q Complaint Q Follow up 0 Emergency Notification 0 Other ❑ Denied Access
hate of Visit:
Facility Number
Permitted O Certified 0 C)onditionally Certified TO Registeged
Farm Name: � i � A 11r i_n lyYL1u +� _ �L Tit i r
Owner Name: !}j7
Mailing Address:
Facility Contact:
Onsite Representative:
Certified Operator: _
Location of Farm:
15
"Title:
1-7/Z/0-51 'Time'
Not Operational 0 Below Threshold
Date Last Operated r Above Threshold:
[� County:
Phone No:
Phone No: _/z a 0 I I
Bar n
Integrator:
Operator Certification Number: t9 19 11
❑ Swine ❑ Poultry 16Cattle ❑ Horse Latitude ' ®' ` Longitude ' ®'
Design Current
Design Current
Design Current
Swine Ca achy. Population
Poultn•
Capacity Population Cattle
Ca acity Po ulation
❑ Wean to Feeder
1
1[:--] Laver
❑ Feeder to Finish
I
❑ Non -Laver
_—ADairy
Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
Total SSLW
a— [} C QQ
❑ Boars
Number of Lagoons ® 10 Subsurface Drains Present ❑ Lagoon Area 10 S rav Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Stream Imnacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Sprav Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. if discharge is observed, did it reach Water of the State? (If yes. notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If ves. notifv DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes D(No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes J�J No
Waste Collection & Treatment C `
4. is storage capacity (freeboard plus storm storage) less than adequate? Spillway ❑ Yes x No
Struc e 1 Structure 2 Structure 3 ' ` Structure 4 Structure 5 Structure 6
Identifier:
Freeboard (inches):
05103101 Continued
1 '�

Facility Number: — Date of Ins Inspect
Z
. p
5. Are there any immediate threats to the integrity of any of the structures observed? (ieI trees, severe erosion, ❑yesNo
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes XNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes >(No
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes pQ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ` `
elevation markings? ❑ Yes KNO
Waste Application,�(
N
10. Are there any buffers that need maintenancelimprovement? El Yes j�,j o
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes 3wo
o / o i It
13.
Do the receiving crops differ with thge designatedlin the Certified animal Este Management Plan (CAV ?
❑ Yes XNo
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
X No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
wio
18.
Does the facility fail to have all components of the Ce fied Animal Waste Management Plan readily available?
WUP, design,
❑ Yes
�o
(ie/ checklists, maps, etc.) nn�� / / Z
19.
Does record keeping need improvement? (ie�a�en. freeboard, waste analysis & sample reports)
❑ Yes
�Rgo
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?
(ieI discharge, freeboard problems, over application)
❑ Yes
No
23,
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
'o
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
o
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES answers and/or any recommendations or. any other comments.
lise drawings of facility to better explain situations (use additional pages as necessary): Field Conv µ ❑ Final Notes
Iq.
spectorName
EReAewer//3:Inspector
Signature: Date:2-10-3
05103101 1 . L 4 ' . Continued

4
Facilih- lumber: 10-3 — ILIJDate of Inspection a
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?
29. 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?
--S �,
❑ Yes ANo
❑ Yes 1KNo
v
Additional Comments and/or Drawings:
lr as4e- A na l � s 15 3 610 3 3- -2 46. N/ 00o IWO
ALb
�SD 10 /40 2, Z/L5�/1°d�
,44j& oW6.3,,4
,� (,,2 06.)- 4/�J
05103101

M
ision of Water Quality t
ision of Soil and Water Conservation
f -Other Agency
Type of Visit O Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 03 13 Date of Visit: 4/4/21102 'Time: 1300
rO Not O erational Q Below Threshold
® Permitted ® Certified 1:1 Conditionally Certified © Registered Date Last Operated or Above Threshold: ........•••.....
Farm Name: D4.bky.&.AlyiAl.E' Y.AItS.J)airy...Form..................................................... County: AlIggliany ......................................... WSRO........
Owner Name: 130.b1Zy..)?�.l..AlYini................Eyaats........................................................... Phone No: 33.6. 3.7.2...B7..1.5...........................................................
Mailing Address: �42�.�1ca��nt.�vnalti.ltA.a�............................................................. SR;� la...N.G....I.......................... .. 2B.615 ..............
.................................. ............................
Facility Contact: 130.bby.Exam..................................................Title:................................................................ Phone No:arn...........
Onsite Representative: .abby. �a .................•••• .... Integrator:
Certified Operator: &b.by..PR . .............................. Exa10.a..:............................................. Operator Certification Number: 2.1.3.4Q.............................
Location of Farm:
7 miles north of Sparta Rd. 18 left on Pleasant Home Road. Dairy is 2 miles on left. y
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 ' 33 46 �� Longitude 81 • 02 S394
Design Current
Swine Cauacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ® Dairy 150 121
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 150
Total SSLW 210,000
Number of Lagoons 0 [[-]Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps 1 JE1 No Liquid Waste Management System
Discl� targes & Stream Im acts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® 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: .._...Waste.Pond.....
Freeboard (inches): 54
05/03/01 q4 If- --%, &-r/ Continued

Facility Number: 03-13 Date of Inspection 4/4/2002
*,,ere
5. Are there any immediate threats to the ill0ity of any of the structures observed? (ie/ tree erosion,
El 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
N 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
N No
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes
N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
N No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
N No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
N No
12. Crop type Com (Silage & Grain) Rye Cover
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
N No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
N No
b) Does the facility need a wettable acre determination?
❑ Yes
N No
c) This facility is pended for a wettable acre determination?
❑ Yes
N No
15. Does the receiving crop need improvement?
N Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
N No
Required
Records &; Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
0 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
N No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
N No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
N No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
N No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
N No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
N No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
N No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
N No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑Field Copy N Final Notes
15. Per Mr. Evans, the field beside the waste storage pond is triticale. On the date of today's inspection it was mostly henbit (broadleaf
winter annual weed). Need to contact NRCS/SWCD or Southern states regarding suggestion for contol of weeds.
19. Soil test results are back and look ok. Are dated 3/l/02.
19. Remember to deduct PAN from corn in the Spring when the rye (or small grain, grass, etc.) receives waste in the Fall and is not
harvested in the spring.
25. Operator wants to put waste on grass strips in Tract-1221 Field-ICL. The "grass" needs to be added to the CAWMP. Only rye and
corn is currently listed.
Waste analysis dated 1 1/20/01=8.0 lbs. N/1000 al.
Reviewer/Inspector Name A1Ie1is a Rosebrock
Review er/Inspector Signature: Date: d Z
05103101 Continued

Facility Number: 03_13 ll t f Inspection 4/4/2002 •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional omments and/orDrawings:
w
05103101

asa- 96 I P
vision:of Water Quahty..
ii aa
OfSod WaterCOnserY$la0q
o O Other Ageucp
Type of Visit A Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Voutine O Complaint. O Follow up O Emergency Notification O Other 1 ❑ Denied Access
Facility Number Date of Visit: Q Time:
Q Not O erational Q Below Threshold
Permitted Certified 13 Conditionally Certified 0 Registered Date Last OperateJd)or Above Threshold:
Farm Name:.. .b .A...v..i�. van .._I �.r ....f.�M.... County: A. .�Q:h........................................
Bar
Owner Name:.. s, l�.�i.�?................��► L....�.n............. h...l............................ Phone Na:... ,�......... -_.. n
acility Contact:...............�Jlri......1�eiiih�....I�G1!r`Sh..�er--.l................................l.J
ailing Address: f. 1. .......... . V a.L.L ..................... ......... ate. �... ... S
g
Onsite Representative:.,.. .. ...��.Ja.h,�.....,,, integrator:
.... ............................I...... ............. .... ................. ........
Certified Operator......., bh.b............EY. aft ? ........................................ Operator Certification Number: .......�.�..�.......... � Y .
Location of Farm: 1
❑ Swine ❑ Poultry 0Cattle ❑ Horse Latitude ®• ©° « Longitude • ®� ®
Design. Current -
awinc
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feedei
❑ Farrow to Finish
Gilts
❑ Boars
Design Current Design ' Current `
Poultry Capacity. Po elation Cattle Ca aci ,' Po ulation
❑ Layer Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity S�
Total.SSLW I 1/101 60
Number of Lagoons ❑ Subsurface Drains Present 110 Lagoon Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
❑ Spray Field Area
Discharaes & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
❑ yes ❑ No
c. If discharge is observed. what is the estimated flow in gai/min?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ)
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation?
❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
❑ Yes No
ure Structure 2 Structure 3 Structure 4 Structure 5
Structure b
��Struc,
Identifier: ..................................
................ ....................
Freeboard (inches):
5/00
Continued on back

Facility Number: 0A— Date of Inspection
5. Are there any immediate threats to the 410grity 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 � 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 o
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 )Rfgo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes �No
11. Is there evidence of ove pplication? ❑ ]l"o
Excessive Ponding PAN ❑ Hydraulic Overload ❑ Yes
12. Crop type -(]& Aj.42
13. Do the receiving crops differ with those desilAated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
A 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
o
15. Does the receiving crop need improvement?
Yes
❑ No
16. Is there a lack of adequate waste application equipment?
❑ Yes>(No
Required
17.
Records & Documents
Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes KNo
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 ONO
19.
Does record keeping need improvement? (ie/ irrigation, frebo/, wataanal sis & soil sVam le reports)
❑ Yes o
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes I] No
21.
Did the facility fail to have a actively certified operator in charge?
El Yes / 00
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
XNo
(ie/ discharge, freeboard problems, over application)
❑ Yes
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes )WNo
24.
Does facility require a follow-up visit by same agency?
❑ Yes i*O
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes XNO
�'�10 yiQlaiiQris:or- deficiencies -v're 00teQ. O(Wing tbis:visit; • Y;oo wiii r& iye i furthef
icorresponciertee. about this visit..
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comunents. -
Use drawings of facility to better explain situations. (use_ additional pages as necessary) r'
A. 1 ..-- t f i A B -
i
0
Reviewer/Inspector Name
Reviewer/inspector Signature:
Date:
VIVID

Facility Number: UJ — 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 W4&—Q-N�
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 XNo
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.) ❑ Yes )� No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ANo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? E4*es El
.&I
II �ao�o/ g o i L5 N/l 600 crn.P.
Q
190 � 3/1 /oaL
P P1.40 //
✓hB� �e�
5100

�J (vision of Water Quality
vision of Soil and 'Water Conservation �f
Q Other Agency
Type of Visit O Compliance Inspection Q Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit: 8/21/2001 Time: 14:00
Facility Number 03 13
O Not Operational O Below Threshold
® Permitted ® Certified © Conditionally Certified © Registered Date Last Operated or Above Threshold: .... .....................
Farm Name: Uo.l7kt3:.&Ah:ba.E):aus.DAir'.farm ..................................................... County: Alliz9ftwxy ......................................... WSRQ ........
Owner Name:>3V.blt3'.E.L.Q►lAu................ Ey;kps ........................................................... Phone No: 91.Q-�.7.2-$.k� t............................ ...............................
MailingAddress: ..4. leas at. onn�.RQ.atl............................................................. Sp rta...N.C............................................................. 2.86.7.5 ..............
FacilityContact:.............................................................................. Title:................................................................ Phone No:...................................................
Onsite Representative: .akby`.y,'......................................... Integrator.
Certified Operator:B.abbJ..................................... FY.a>Jls................................................ Operator Certification Number:2.13.9.............................
Location of Farm:
F mules north of Sparta Rd. 18 left on Pleasant Home Road. Dairy is 2 mines on left. +
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 33 46 46 Longitude 1 81 10 02 1 53 4�
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Capacity Population
❑ Wean to Feeder
❑ Layer
IN Dairy
150
]08
❑ Feeder to Finish
❑Non -Layer
JE1 Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
Other
❑ Farrow to Finish
Total Design Capacity
150
❑ Gilts
Total SSLW
210,000
❑ Boars
Number of Lagoons I I ❑ Subsurface Drains Present 110 Lagoon Area I0 Spray Field Area
Holding Ponds / Solid Traps 1 ❑ No Liquid Waste Management System
Discharacs & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
2. 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 ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Stricture G
Identifier : ..................................
Freeboard (inches): 72
051-03/01 Continued

Facility Number: 03-13 71 Date of Inspection $121/20Q1
5. Are there any immediate threats to the in ty of any of the structures observed? (ie/ tree Overe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10, Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Corn (Silage & Grain) Timothy, Orchard, & Rye
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19, Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss 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?
El Yes
® No
❑ Yes
® No
❑ Yes
N No
❑ Yes
N No
❑ Yes
ONO
❑ Yes
N No
❑ Yes
N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes ONO
■ ►5
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes ONO
❑ Yes ® No
❑ Yes N No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):El Meld Copy N Final Notes
Facility and records are in good shape.
r. Evans has painted a line on the concrete wall of the waste pond, for the spillway, as requested by the DWQ inspector.
Reviewer/Inspector Name Rocky Durham
Reviewer/Inspector Signature: Date:
05103101 Continued

Facility Number: 03-13 1) of Inspection $12112401
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)
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?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
Additional Comments an orDrawings:
Waste analysis: 7/23/01 LSD 2.8 lbs.N/1000 gals. B +
J
05.03/01

F/
�vision of Water Quality
ivision of Soil and Water Conservation •
0 Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 03 13 I):ate of Visit: 4/1t3/2001 Time: t2:oo
O Not O erational 0 Below Threshold
® Permitted 0 Certified 0 Conditionally Certified E3 Registered Date Last Operated or Above Threshold: ...............
Farm Name: ........................... County: Allegha ,K................... .WSRt.?........
......................... ..................
t
Owner Name: B.abby..P 1..A►lY.iat................ l;,.Y.auS.......................................................... Phone No: DAUSe. fi.: 7.:8�k�at>�..Z�,I; X1..........
Mailing Address: 4 .1't�a amk.tlatone.ltct�d.............................................................. spam—NC ............................................................. MAU ..............
Facility Contact: ROWY.EYaw ..................................................Title:..
Phone No: ........................
OnsiteRepresentative: .......................................................................................................... Integrator:.......................................................................................
Certified Operator: Dobkty.................................... �',tY.�tttS........................................._....... Operator Certification Number- Z139..4.............................
Location of Farm:
miles north of Sparta Rd. 18 left on Pleasant Home Road. Dairy is 2 miles on left.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 33 6 4G 16 Longitude 81 • 02 53 L'
Design Current
Swine Canacitv Panulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Soars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I ® Dairy 150 1l05
❑ Non -Layer I JEI Non -Dairy
❑ Other
Total Des.ign Capacity 150
Total SSLW 210,000
NumberolF3Lagoons 0 ❑Subsurface Drains Present ❑ t,aguon Area ❑ Spray Field
Arid
Hording Pon IASoIid Traps 1 - ❑ No Liquid Waste Management System a, .
DischarNes & `beam Impacts
1. is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If dischar�ye is observed, ,.vas the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (lt yes. notify DWQ) ❑ Yes ❑ No
c. Ifdischar,_,e is observed, what is the esiinrated flow in uml/min?
d. Does discharge bypass a lagoon system? (if yes. notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
01/01/01 Tto /(/, Continued

Facility Number: 03—I3 • I)ate iil' Inspection 4/18/2001
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ® Spillway ❑ Yes ® No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..... :W A.Q�t ...... ...............................
Freeboard(inches): 3;3.. .................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑Yes ®No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley, Rye
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
17,
Are rock outcrops present?
❑ Yes
❑ No
18.
Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown
❑ Yes
❑ No
❑ On -site ❑ Off -site
Required
Records & Documents
19.
Fail to have Certificate of Coverage & General Permit or other Permit readily available'?
❑ Yes
® No
20.
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
21.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
25.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
26.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
27.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
Odor Issues
28.
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?
29.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
01/01/01
Continued

Facilit Number: 03-13 0ni' Inspertinn 4/18/2001 0 Printed r,n: 5/1/2001
30. 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)
31. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
32. 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
33. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
34. Do the flush tanks lack a submerged fill pipe or a permanentltemporary cover? ❑ Yes ❑ No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy ® Final Notes
Need to paint line for "spillway."
samples: 2/14/01 = 4.1 lbs./1000 gal. 10/20/00 = 5.61bsA000 gal
Reviewer/Inspector Name
Reviewer/Inspector Signatu I J ,1 ar7 Date:
A
:t
01/01/01

12
a Division of Water Quality e,
Division of Soil and' WaterConseivation .
0 Other Agency
Type of Visit ACompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit *R'outine Q Complaint O Follow up O Emergency Notification O Other
❑ Denied Access
Facility Number Date of visit: kime: : OC
0 Not O erational 0 Below Threshold
Permitted 0 Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold
Farm Name: ... .b.b.i, .. .. .l.Uj. .... .If 1 5.. r.%.. .... f.` iil7 County:..t �leQ..l!lan.lf...........................................
y� 11 n _ •� ! I 7 l
Owner Name: L1Q. . ..... r..:... ° '.�.�..�ill...... �..v�a. ns... ... Phone No::..1.. 5 .!...3..
.... 1 r .........
FacilityContact: ..........[.✓..�i../,1............15A(..a.1l...5...... Title:............. &n- e RrojJ 3,&0 , 3 7 a .
Mailing Address:...... . . . ..... . eaS�Q} ......l...lQm -.... '.� .........5P1.a-+r:.�:�.. I ..�L.........-.a•. ..---75
OnsiteRepresentative: ..b.` v...... IF.V..�5................................................. Integrator:......................................................................................
Certified Operator:. .�&b.y.....P'... 1 a h.�5 .................................................... Operator Certification Number: oZ f 39� .................... .............
Location of Farm:
-7 m 1 lo5 her41-h 5 po-r-+� e - I p i 1� n 4o 5a-n-1-- rn�
❑ Swine ❑ Poultry 0 Cattle ❑ Horse Latitude 13 6 01 `13` 1_" Longitude I I 1J' 1 6,2, 1 53,,
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
'Design Current
Poultry Capacity Population Cattle
❑ Layer Dairy
❑ Non -Layer Non-Dair
❑ Other
Total Design Capacity
Total SSLW
Desigti :Current
c) !01 060
Discharges & Stream Impacts kNo
1. Is any discharge observed from any part of the operation? ❑Yes
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge it observed. did it reach Water of the State'? (If yes, notify DWQ) ❑ Yes ❑ No
c. li'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 lq'No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes J2(1110
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway ❑ Yes ,1�5No
Structure 1Q SLrUCLurc 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:��.T. .....1..(�hd...
.............................................................................................................
Freeboard (inches): 3
5100 Continued on back

Facility Number: 13 Date of Inspection Printed on: 1/9/2001
5. Are there any immediate threats to the„'llftegrity of any of the structures observed!.(ie/ trees, severe erosion, ❑ Yes f�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 XNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes P(No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes b(No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes 0 No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes b(No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes )KrNo
12. Crop type Phrn ­� :'la AP-q r4 N L (H,%,A_94r",P_5wrP
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management PlanjCAWMP)? ❑ Yes ANo
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ;;tNo
b) Does the facility need a wettable acre determination? ❑ Yes (9No
c) This facility is pended for a wettable acre determination? ❑ Yes VNo
15. Does the receiving crop need irprovement? ❑ Yes *No
16. Is there a lack of adequate waste application equipment? ❑ Yes _N�CN0
Reuuired Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
❑ Yes Al�o
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 1
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 'KNo
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes Islo
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'100
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes [ No
,1 0 V1Qi;iti0Fis ,OT• dficjendt1 S -*&iD h6fe • d(Wing fhis'AsIt' • Y;o{.t 'Will •ree�iye o fu>i'#
cOFI'f'S OIl[YeIICC. a�t7ut t�i1S V151t. '
Comments (refer to question #): Explain any YES answers and/or any recommendations or`any other comment&;;
Use drawings of facility to better explain situations. (use additional pages as necessary): A
A.
Reviewer/Inspector Name ('
Reviewer/Inspector Signature Date:
S/00

Facility Number: e of Inspection O� +{/j$/d J� . Printed on: 1/9/2001
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 C*o
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 *0
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 RSNo
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? No
IAJ (X 5+f- af,N lot q-j f l3's1r000
. .
5100

ton of Water Quality
t17!'ision of Soil and Water Conservation
0 Other Agency
Type of Visit O Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit O• Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Dale rat' Visit: l t/812000 Time: 15:30 Printed me 4/10/2001
Facility Number 03 13
FO Not Operational O Below Threshold
E Permitted ® Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ...............
Farm Name: ................................................ I.... County: A1199hURY ........................................ �E'-SRQ........
OwnerName: Bobky..E..L.A ylix................ EY.7,ItS........................................................... Phone No. 9,1-3.7.2.461t...........................................................
Facilitv Contact: ......................
Titie:................................................................ Phone No:.............................. .....................
Mailing Address: .4.Z .t?I.eas�ttat.Donnt;.ltuali............................................................. Spma... NC............................................................. MAU ..............
Onsite Representative: B.9b.by.KyAw.............................................................................. Integrator:_.....................................................................................
Certified Operator: Bobby ...................................... Ey.aas ................................................ Operator Certification Number:2X3.99...............................
Location of Farm:
7 miles north of Sparta Rd. 18 left on Pleasant Home Road. Dairy is 2 miles on left.
I,F
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 3G • 33 46 Longitude 81 • 02 53 11
Design Current
Swine CanaClty PODulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacitv Population Cattle Capacity Population
❑ Layer ® Dairy 150 97
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 150
Total SSL W 210,000
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 1 JE3 No Liquid Waste Management System
Discharges X Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharc ori�inatcd at: ❑ Lagoon ❑ Spray Field []Other
a. If disch',11'2e is observed. was the conveyance man-made? [:]Yes ❑ No
b. If discharge is observed, slid it reach Water of the State? (Ifyes, notify DWQ) ❑Yes ❑ No
c. If discharge is observed, what is the estimated flow in i2fl/min'?
d. Does dischtugc bypass a Ia oc7n system? (If yes. nntifv DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection R Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Ident itier:........................................................................ ....
............................... ........................................................................
Freeboard (inches): 96
5100 Continued on back

falCjlit;:Number: 03-13 Dale (11' 1 w pecl ion F11/8/2000 l'rintc 4/10/2001
5. Are there any immediate threats to the i0ity of any of the structures observed? (ie/ trevere erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Rye Corn (Silage & Grain)
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?
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? (iel irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0: N6-A6lati6ris:or deficiencies-were:noted:dueiitg' this: visit': NO -Will i7eeeive,no•fu:rther,:
correspondence about this.visit.
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
17. If you can't find your copy of the certificate of coverage, call the DWQ ( Melissa Rosebrock ) at Winston-Salem for a copy.
19. Need to start keeping weekly waste pond levels per General Permit requirements.
rerall facility and records look good.
aste analysis: 10/20/00 LSD 5.6 lbs. N/1000 gals. B
05/24/00 LSD 7.7 lbs. N11000 gals. B
03/06/00 SSD 6.8 lbs. NI1000 gals. B
L
..
Reviewer/Inspector Name `Rocky Durham-_-
Reviewer/Inspector Signature: _ _ _ _ _ Date: 5100

Facility Number: oil' Inspcctinn 1 11/8/2000 I'r intc[I on; 4/10,'200t;
Odor Issues qu
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ®No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ❑ No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters. etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments and/orDrawings:
5100
5100

r- tsion of Water Quality
t ision of Soil and Water Conservation 0
0 Other Agency 11
Type of Visit © Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Date ul' Visit- 6/6/2000 Time: 114� Printed on: 6/23/2000
03 13
0 Not O erational 0 Below Threshold
0 Permitted ® Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold : .......................
Farm Name: ..................................................... County: AM1,9hanY ........................................ WS1tQ........
Owner Name:o�?XtJ.1'�.L.Al�irx................ Y.Ott&........................................................... Phone No: >at ...............................................
Facility Contact: UobbY.E.Y.ax1s.................................................. Title:................................................................ Phone No: Rom.33.6.3.77.47..1.5.........
Mailing Address: 3.4..�Lea�atot.k>lonat.RAas1............................................................. SPA17ta._N-C ............................................................. MAU .............
OnsiteRepresentative: ........................................................................................................... Integrator:......................................................................................
Certified Operator: fobby..F................................ Ey.ark$ ................................................ Operator Certification Number:Z13.Q9
Location of Farm:
........................................................................................................................................................................................................................................................................
7...mil.�.txax�tlx.of.� .a.rta.�d..X.S.lift..a►x.�lea��tot.tl4mt�.Ro�st...X?air...is.�_z�nAles.apt..l��tt.........................................................................................�
:I
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude Longitude 81 • 02 53
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Cavacitv Population Cattle Capacity Population
❑ Layer ® Dairy 150 95
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 150
Total SSLW 214,044
Number of Lagoons 11 10 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps I 1 I0 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: []Lagoon ❑ Spray Field [:]Other
a. If discharge is observed, was the conveyance man-made'?
b. If discharge is observed, did it reach Water of the State'? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in 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 R 'Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3
Identifier:.......Waste.Road........................................................................
Freeboard (inches): 48
. k
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
® Spillway ❑ Yes ®No
Structure 4 Structure 5 Structure 6
.............................
AA,
Continued on back

i Facility Number: 03-13 Date of Ins ection 6/6/2000 Printed un; 6/23/2000
3 p
5. Are there any immediate threats to thel}[fegrity of any of the structures observed? (ie/ t9severe erosion. ❑ Yes ®No,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes ® No
8. Does any part of the waste management system other than waste structures require maintenance/improvement'? ❑ Yes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Corn (Silage & Grain)
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?
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?
®: No-violations:or deficiencies were noted;dui-iiig-this: Ai if. L.N.u:Will "reeeive-no•fu:rther,:
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)-
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signaturi. /A" 6 Date:

Facility Number: 03-13 1) I' inspcclion 6/6/2000 • Printed on: 6/23/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
❑ No
Additional Comments and/orDrawings:
A,

Division of �nd Water Conservation - Operation-Revi S
r] Division of nd Water, Conservation - Compliance Ins ion
bivision of Water Quality - Compliance Inspection
Other Agency - Operation Review
It Routine 0 Complaint 0 Follow-ue of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number Date of Inspection M924hr.(hh:mm)
Timeof Inspection
0 Permitted © Certified [3 Conditionally Certified © Registered JE3 Not O erational Date Last Operated: ..
Farm Name: &.Ql-fil..✓..1n...E VQ �j.....1 !..r. .... � f ............ County: ..... ,["T.1.kyhell lrf ............................. .
Q j c �.0 -7 !q
Owner Name:..IJQ�. ....Pr....° .. .!.. .%.ir .....G..vQ.!.L..l............................. Phone No:33 ' 3.7. R......t:?..7.1 .......90.05 e—
Facility Contact: .Bob-1j........ Evan.5....................... Title: ....-...................... ....... Phone No:336, 37o VIAj(...�,.C�n
75—
Mailing Address: >.....!....�..4 Sr n.l.......L..!..0�......1`'..c....j.................la-.......1..!................v.!f'...........
Onsite Representative:... ..Y�. ...... ...v .. Integrator:...............................................................r...........
Certified Operator:.8b.bb.4..... 1".•..... .]hn,5......... Operator Certification Number:....�G..�..e e
Location of Farm:
......�i.0 ,,....,. .......-,.t..r. .........�... . m-..._.,....:....._...�........ f..w----- r... _....,........— . . -- .w ..,. , ..,............ ,...r ..........
�CiI.r......`1.....ml. ...n.n....�e f'+......................................................................... ..................................... :
Latitude ?, ° 3 ° © Longitude
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts,
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer I I Dairy Q
❑ Non -Layer I I Non -Dairy
❑ Other
Total Design Capacity
Total SSLW
Number of Lagoons 10 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
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. Dares discharge bypass a lagoon system? (If ycs, notify DWQ)
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes No
Waste Collection & Treatment Aspillway
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes o
Structure I 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 No
seepage, etc.}
3/23/99 Continued on back

aciiit}dumber: — 3 �of'Inspection 6p d Q
6. Are there structures on -site which are nroperly addressed and/or managed through a waste management or
closure plan'?
❑Yes O(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 XNo
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
'i
elevation markings?
❑ Yes X No
1
Waste INPphcation
10. Are there any buffers that need maintenance/improvement?
❑ Yes XNo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes YNO
12. Croptype
13. Do the receiving crops differ with -se designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes tNo
14. a) Does the facility lack adequate acreage for land application?
ElYeso
b) Does the facility need a wettable acre determination?
❑ Yes DVo
c) This facility is pended for a wettable acre determination?
❑ Yes RNo
15. Does the receiving crop need improvement?
❑ Yes XNo
16. Is there a lack of adequate waste application equipment?
❑ Yes �No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
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 'CZNo
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes Wo
21. Did the facility fail to have a actively certified operator in charge?
❑ Yes N:No
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ic/ discharge, freeboard problems, over application)
❑ Yes XNo
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative`?
❑ Yes o
24. Does facility require a follow-up visit by same agency?
ElYes No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes N0
No violafigris b - deficiencies -r'Vere h6 ed- d4thig Ois.visit. .' - Y:OO Will -receive rio rurther -
corres• &idence' about: this :visit. • : • : • : • ' • : • : • ::::::::::::..:::::::::::::: :
Comments (refer to question #): Explain any YES answers'arid/or any recommendations or any other comments.
;
Use drawings of facility to better explain situations. (use additional pages as necessary).
A.
Reviewer/Inspector Name ems- r d Cam:
Reviewer/Inspector SignatureSignaturen %ln! j I Nn A t q4 # ),_1 & jt6� Date: &,j Q1p 6e)
3/23/99

g'acllity Number: — 3 1 A inspection 106106
Odor Issues
26. Does the discharge pipe from the confinement building to the storage e—��
age pond or lagoon fail to discharge atlor below -& o
OM
liquid level of lagoon or storage pond with no agitation? 1 - 0t=6
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes VNO
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes V-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 XNo
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? O M /T 0600 E * N— 9-NO
pppIlei ror PUM1+ ? � Pr2 TnS�eCdion �oi-es
Was I,ouP now ?,�,.
PJA'"�'

0 Division of c 'I and Water Conservation,- Operation Revi
E3 Division of nd Water Conservation -:Compliance In on
EMMsion of ;ter Quality - Compliance Inspection
116il ei.,Agency Op`eratron Review
Routine Q Com laint O Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number 03 13 Date of Inspection 12/2/99
Time of Inspection 10:[H! 24 hr. (hh:mm)
Permitted ® Certified E3 Conditionally Certified 0 Registered 0 Not O erational Date Last Operated:
Farm Name: 13ob.by..&.Alt:im.l;yatts.1)Wry..F.u.tug..................................................... County: AlItgWAY ........................................ NVS.RQ........
Owner Name: U.Abhy.P../..AIxhx................ Lym ........................................................... Phone No:'1tQ:..1.2-Ct1A.13a�tt.................. ........... .................
FacilityContact:..............................................................................Title:................................................................ Phone No: 33.b:3.72: 7..15.......................
Mailing Address: �k .�leasatttt. orraR.3tna............................................................. SvArka... N.C.............................................................. 2N.6.7.5 ..............
OnsiteRepresentative:................................................. ..........................................................Integrator:......................................................................................
Certified Operator: llabbx.P.,............................... Exams................................................ Operator Certification Number: 213.99.............................
Location of Farm:
Latitude 36 ' 33 1 42 Longitude 81 • 02 6 54
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Cavacitv Population
❑ Wean to Feeder
JE1 Layer
I
I
® Dairy
1 150
1 1 10
❑ Feeder to Finish
❑ Non -Layer
❑ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Other
❑ Farrow to Finish
Total Design Capacity
E150
❑ Gilts
Total SSLW
210,000
❑ Boars
Number of Lagoons I I ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps II ❑ No Liquid Waste Management System
Discharges g Stream Impacts
I. 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?
L 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 �7al/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
Identifier:
Freeboard(inches): 25... I .......... I...........................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed`? (ie/ trees. severe erosion.
seepage, etc.)
3/23/99
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
❑ Yes ® No
Continued on back
Printed on 12/7/99 ,

WNW-,- Number: 03-13 1*management
1' lnspectiun
6. Are there structures on -site which are noperly addressed and/or managed through a wor
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
12. Crop type Corn (Silage & Grain) Rye
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14, a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18, Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
H. No vit) lati6ris;or :deficiencies were ;noted dijthig4h6 visit.-'You;will r ecei'vc•n6-firthee.
rnrrPsnnrirlPnrP ahni�t this visit
12/2/99
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
[:]Yes ® No
[:]Yes ® No
1 I IIILCu Val 1411 IUV

E.Division of -= and Water Conservation - Operation Stevie
Q Division of nd Water Conservation - Compliance Ins on
Q°Division of ater Quality - Compliance Inspection
Q Other Agency - Operation Review
10 Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number 03 13 Date of Inspection 6/9/99
Time of Inspection 12:50 24 hr. (hh:mm)
Permitted ® Certified Q Conditionally Certified Q RegisteredJE3 Not O erational Date Last Operated: p . ..........................
Farm Name: l3Q.bby/.A.1xAtx.Exaxts.t?alry..l;.airmt.......................................................... County: AllmlianY ......................................... WSRQ........
OwnerName: Bobby ..................................... ExatttS...... ..................................................... Phone No: 91.017..2A.611.............................. .............................
Facility Contact: .. Title: ........ ....................................................... Phone No....................................................
MailingAddress: �i4. .1 R.1S.1.......................................................................................... S r%J..NNC............................................................. MAU ..............
Onsite Representative: U.Rbby.,Eians.................... .... Integrator:................
......................................................
Certified Operator:liRbby..F. ............................... E.Y.41th ................................................ Operator Certification Number: 213.99...............................
Location of Farm:
IV
Latitude 36 a 33 4 42 64 Longitude Sl • 02 4 54 [i
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Soars
Design Current Design Current
Poultry Cavacity Population Cattle Capacity Population
❑ Layer WE airy 101 110
❑ Non -Layer I 1 1[:] Non -Dairy
❑ Other
Total Design Capacity 101
Total SSLW 1 141,400
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area I0 Spray Field Area
Holding Ponds / Solid Traps 1 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes []No
b. If'discharge is observed, did it reach Water of the State? (If yes. notify DWQ) ❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure l Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(inches): g4.............................................................. .................................... ....................................
.............................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, ❑ Yes ® No
seepage, etc.)
3/23/99 Continued on back
Printed on 12/1/99

J.
Facility Number: Q3— l3 D f I nspection 6/9/99
6. Are there structures on which are nooperly addressed and/or managed through a w management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered ves, 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
H. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes ® No
12. Crop type Corn (Silage & Grain)
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)�1'his 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 readily available'?
❑ Yes
❑ No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
® Yes
❑ No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/]nspector fail to discuss review/inspection with on -site representative'?
❑ Yes
IN No
24_
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
0:.Nb-yioIAW)nsbrdefici&n ies-werebbted:dii iiig•this visit.•N u:will receive-h6-fif thief.
.
•correspondence: about this:visit:: ... .. :: : : .::: :::: :: :: : . .. . .
18 Didn't see a copy of the animal waste management plan certification.
wrier said the technical specialist was working on adding additional fields to plan.
Reviewer/Inspector Name Rocky Durham
Reviewer/]nspector Signature: Date:
Printed on 1211199

uj- p Division of Soil an ter Conservation - Operation Review
p Division of Soil an er Conservation -Compliance Inspectio
E Division of Water Quality- Compliance Inspection
p Other Agency - Operation Review
10 Routine p Lomplalnt p rollow-up of MvV Inspection O hollow -lip ctt [)_SkV : 1"evrew O t.lther '
Facility 1N`urtther. Date of Inspeetioll
mime or Inspeclion 24 hr. (hh:mm)
a Registered 0 Certified p Applied for Permit p Permitted p Not 0perutlr,Ila Date Last Operated:
Farm Name: Eafa6.y/ALyiu.Evans.❑airy..F.arm........................................................... County: Alleghany WSRO
Owner Manic: Eobtxy..................................... Evans .......................................................... Phone Igo: 9.lfl-322-Sri[.I...........................................................
F:I(ilily Cllrlt'let:...............................................................................Title:............................................................... I'limic No: ....................................................
Mailino Address: RU.Box.1.51.......................................................................................... sptarta..Nc ............................................................. 280.5 ..............
t.
OitsiteRepresentative: .......................................................................................................... Integrator:.......................................................................................
Certified Operator:13abby.1 ................................ Evans.................. ....... Operator Cerlification Number:2.1.39.Q.............................
............ ........................
Localion of Farm:
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::..............................: A
:€
L,alllllde ®�©' ®•• Longitude ®� ®: ®••
Swine Capacity Population
p Wean to Feeder
❑ Feeder to Finish
❑ Farrow to can
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Poultry Capacity Population Cattle Capacity Population
❑ ayer
❑ Non -Layer
❑ Other
Total Design Capacity 101
Total SSLW '=
Number of Lagoons / Holding Ponds
JE3 Subsurface
rains
Present Ip
agoonArea p pray ie ( rea
p No
Liquid Wasta
Management
System
General
. Are there any buffers that need maintenance/improvement?
❑ Yes
a No
2. Is any discharge observed from any part of the operation?
❑ Yes
a No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed. was the conveyance man-made?
❑Yes
❑ No
b. ll'discharec is observed, did it reach Surface Watcr? (lf ves, notily DWQ)
❑ Yes
p No
c. II discharu�c is observccl, what is the estimated Ilow In gal/min?
d. Does discharge bypass a lagoon system? (If ves, notify DWQ)
❑Yes
❑ No
1 Is there evidence of past discharge from any part of the operation?
❑ Yes
a No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
a No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
a No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
a No
7. Did the facility fail to have a certified operator in responsible charge?
❑ Yes
a No
7/25/97
w�

r/
4 sera .,, um er: 03_ 13 DIM, ''spectiorr
•
8. Are there lagoons or storage ponds on si�E`hich need to be properly closed?
0 Yes
No
Structures I La'_'oons.floldin,_, fonds. Flush fits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
[3 Yes
® No
Structure I Structure 2 StrucMn•e 3 Snructare it Strucnure 5
Su-ucture
6
Identifier: I
Freeboard (11): 4J!.
10. Is seepage observed from any of the structures?
E] Yes
® No
11, Is erosion, or any other threats to the integrity of any of the structures observed?
p Yes
® No
12. Do any of the structures need maintenance/improvement?
p Yes
® No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
p Yes
® No
Waste Application
14. Is there physical evidence of over application?
p Yes
® No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type .......C.umJSJage.&.Gratin.)........................................................................................................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? p Yes M No
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 Perrnitted 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?
�. ..o.vto ttons.or .rreren.cies-were .note . uringt its visit:. Von. will -receive no further.,
:•:�oireSpo�laetie�abQutthis•vi§i�::•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•:•.•:•:•:•:�:-:•.•'-:•••:•:•:•:•:
Comments (refer to question #): Explain any YES answersand/or any recommendations or any
Use drawings of facility to better explain situations. (use additional pages as -necessary):
p Yes M No
p Yes N No
p Yes ®No
p Yes M No
p Yes ®No
p Yes ® No
[]Yes ® No
p Yes ® No
p Yes ® No
er comments.
AL
1W
ReviewerAnspector Name 'Jenny Rankin ..
ReviewerAnspector Signature: Q PNt /Y -u Ore IK k 1 nor Date:

p Division of Soil Water Conservation p Other Age,`
Division of WaterQuali
■ h'
outine p Complaffit p Follow-up o inspection p o 0W-up of review p Other
Date of Inspection
Facility Number
Time of Inspection f�nf�] 24 hr. (Ith:mm)
o Registered 0 Certified p Applied for Permit p Permitted 13 NotOperational_ Date Last Operated:
Farm Name: JEkoh ty/Alvin.Evatns.,Daitry..F.arm........................................................... County: Alleghany WSRO
Owner Name: Rahbty..................................... Evans .......................................................... Phone No: 9.11372=8611 ..........................................................
Facility Contact: B.ohby.Exams..................................................Title:.......................... ....................... Phone No: 9.1ft-372.-.8.7.15 .......................
gd 3�7_3
MailingAddress: Rk.2-Ro.%J51.....................................fl......` ................................. Stxajrla..Nc ............................................................. Z8625 ..............
OnsiteRepresentative: Aluitn.Exaas................................................................................ Integrator:.......................................................................................
Certified Operator: B bby..................................... Evans ................................................. Operator Certification Number:2.13 yQ.............................
Location of Farm:
m es.nar ..a rota. t;pa, rouse. m es.�n.. aL as i AL
I?a..'::
-----------------
Latitude r©i ®41 Longitude ®•
Swine Capacity PopuIation
p Wean to Feeder
p Feeder to tnis
p Farrow to Fan
p Farrow to Feeder
p Farrow to Fmish
p Gilts
❑ Boars
Poultry Capacity Population Cattle Capacity Population
❑ Layer JIM Dairy
❑ Non -Layer JE3 Non -Dairy
p Other
Total Design Capacity 101
Total SSLW141,4=
Number of Lagoons / Holding Ponds ❑ u sur ace Drains Present ❑ Ligoon Area ❑ pray ie r rea
ana ement Sy - _ - - ❑ o Liquid Waste g -
General
1. Are there any buffers that need maintenance/improvement? p Yes ® No
2. Is any discharge observed from any part of the operation? p Yes N No
Discharge originated at: p Lagoon ❑ Spray Field ❑ Other
a. If'discharge is observed, was the conveyance man-made? []Yes p No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) p Yes []No
c. If discharge is observed, what is the estimated flow in gal/tnin?
d. Does discharge bypass a lagoon system? (if yes, notify DWQ) ❑Yes p No
3. Is there evidence of past discharge from any part of the operation? []Yes '® No
4. Were there any adverse impacts to the waters of the State other than from a discharge? []Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require p Yes ® No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? p Yes ® No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ® No
7/25/97

ac1,�_,; N um b er: 03_13
8. Are there lagoons or storage ponds on s0thich need to be properly closed?
Structures (Lagoons.Iiolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3
Identifier:
Freeboard (ft): ............ 4-ff-et............ .....
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
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)
p Yes ® No
p Yes ® No
Structure 6
[]Yes ® No
17 Yes ® No
Yes ® No
p Yes ® No
p Yes N No
15. Crop type .......C.orn.4Si1age.&.Gxairx).............................Fescue...................................... ..........
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? p Yes ® No
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?
. . o.v10 tlons.or a erenrtes•were.note . uringthis visit:. You. wt .recelve no.further.-.
o>re51(so�fic ef' aborxt ttilS visit:......... .
0 Yes Cl No
Yes ® No
p Yes ® No
p Yes ®No
p Yes ®No
p Yes ®No
[:]Yes N No
p Yes ® No
p Yes ® No
:Comments:(refer, to questiofi irpfain any, _ - "answers an y _or any°recommendations.or. any. of ier coiu'meiits.
g y
U� V ez lainFsituations use;atldtttonal a es as q ? se drawm seof facilit to better.
I1 ( P g Y
.
Farm' is in good.condidtion.
7/25/97
Reviewer/Inspector Name Jenny Rankin
Reviewer/Inspector Signature: Date:

9-16-1997 10:03AM FROM SPARTA FIELD OFFICE 1 910 372 4E4S P_2
1ffD.Q#WC Animal Feedlot Operation Review
❑ DWQ Animal Feedlot Operation Site Inspection
Q Routine Q Complaint O Follow-up of TAVQ ins xtitm O Follow-up of DS%VC re-vivv O Other
Dow o fusp.`c.tiotn �
Facility Number tj'
Time of Inspection 24 hr. (hh:mm)
Total Tune (in fraction of hours
Varm Status: E3 Registered [I Applied for Permit (e.\J.25 for I hr 15 min)) Spent on Reviev.
® Certified [) Permitted or Inspection (includes travel and provessing)
113 Not Operational Date Last Operated:
8 � � .I �.A., l cr....z........... .i.r...l Q.,r.I$1 runty. ! 1 ...
f I
Owner Name: . .........�..... A...�r..!t,.....09,41 5.......................................................... Phone `u:
i�. ...........................................
-! 7
Fatality Contact: $;A2 — ..i lk. ,..P1.S........................Title:����i_�.C.c�._..C�:�.f�.i.�rd'. Fhone No......:. ..Id�...... .1, 6........
MailingAddre": 4'a-_3 1 ft QC. ,r T;...,,.....�............................. ° .
.................. c..�1.:f............ �rn.� ,............................ .........._...5".
On%ite Representative:.,,,.....i.-SK.I.a------- E..b.q..1a..s................................................... Integrator :.......................... .................... I...........
Certified OPcrtor:,.b.b. . ........................�......,.......,.,......,..,..,.,. Operator ferit5ratiE� Nunler:.............. .. .
.�.... ....
Location of Farm:
Latitude �•® I V=a T, Lon'gitude $�_�0=;E�o:(
Type of Operation .: Design.: .`Current'' .. Resign Current Design " Cur'r to W'
Swine,:...... `,'. C:apacitV.. P.apulstian. N Poultry Capacity Population Cattle Capacity Population
❑ Wean to Fccdcr
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrov,, to Finish
p OThe�•
:.. ❑ Layer ®Dairy 7. 100
❑ Not] -Laver ❑ Non -Dairy ;
Total Desi'a Capacity'
Total SSA, W
:;' Nutnl�er of La¢ridiiS7 ltioldirx" oads.a. ❑ Subsurfact Drains PreseEtt t•agoon Area IffSprayFitIdArea ;.
General
1. ,Are tltrrc aov huffy.('~ fbat need mnintenanee/imi)r(-)vement?
2. Is any discharge observed from any part of the Operation:'
Discharge ori-inatcd at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if Ji:c:i).a rgz is observed, was the conveyance mar.-r adc')
b, If discharge is obsrrve i, did it ns Ach Surfzrce Wuter'? (if )'CS: no it'y DVCQ.)
c. ifdisch:trp is observed. Wilt is tt:e c,;tintatctl flow in ttlltnE.E7;'
(.I. i�(7Cti cjl;<Clritf�C bV'il(iti� a 1<i;;cr��rr titi'sTzEx;? (Ir yes, notify 3��i'()?
3. 1; there ev ,dence of past discharge from any part of the opnnEtiun?
4. Wert. there any adverse irttpacts to the waters.of the State other than from a discharge ;'
❑ Ycs C No
❑ Yes ®o
❑Yes ❑`'o
0Ye. ❑No
r(
Yes [A No
❑ Yew 6Z- No
5. Does an}' part of the waste tnannzement system (other than ponds) require: ❑ Yes � \O
^ry „� cltaintenanccJimprovcrcr�n['?

r ,
9-16-1997 10:04AM FROM SPARTA FIELD OFFICE 1 910 372 4.645
v
Facility Number: 6 3 —
6. is facility not in compliance with any applicable setback critrria in effect at the time ofdesi4n?
7. Did the facility fail to have a certifted operator in responsible char,-'-_?
8. Are thcrc lagoons or storage ponds on site which need to be properly closed?
Structure-_L agoons and/car Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure l Structure Structure 3 Structure 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 maintcnancelimprovement?
(If any of questions 9-1.2 was answered yes, and the situation poses
an iinimediate public health or environmental threat, notify DWQ)
13- Do any of the structures lack adequate minimum or ntaxitnum liquid level markers?
Waste Application
14. is there physical evidence of over application?
(if in excess of Wi4IP, or runoff entering waterG of the State, notify DWQ)
15. Crop Type �' C` r� a .5S a Ir v 14-
P. 3
❑ Yes
Q5 No
❑ Yes
Rf No
❑ Yes
W No
❑ YcS
PS No
Structure 5
Structure: 6
❑ Ycs (X N-o
Q Yes 04No
❑ Yes Ji No
❑ Yes 0 No
❑ YES 0 No
........................ ................ .1':......•...•.., ........T... ,.., . .....-------------- ---.-............ ............... ..,.... ............. ............ .......... ......... I.,------------
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWNIP)? ❑ Yes XNo
17. Does the facility havo 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?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Ani.nmal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWNW?
24. Does record keeping need improvement?
❑ Yes
N No
[ Yes
6d No
Yes
CQ No.
❑ Yes
pirNo
© Yes
X No
❑ Yes WNo
❑ Yes El No
❑ Yes ® No
Reviw£�+�^.•"if
ewer/Inspector Name a v"�� /1:. ..,. }fl i.x
Reviewer/lnapector Signature: '_'� v - / ! t�, - y Date- q - l--?- -