170007_INSPECTIONS_20171231

t ivisiotrof Water Resources
Facility Number - Q Division of Soil and WaterCrvation
O Other Agency
type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: %Routine Q Complaint p Follow-up p Referral O Emergency p Other O Denied Access
Date of Visit: -A Arrival Time: Departure Time: /�� County: �Q$ W ll Region:)s
Farm Name: Tp hn 5h v M.p K.2.r 71d! irV FG7h c - Ow`�nerr Email:
Owner Name: _74phn_;5 KU!A0j.4- Phone: N 3g ! 'f `>r' d3 -;L -
Mailing Address: ! YLO _ l .oU in Tom(_ �Tt7 � F-fX-�.—C]� f i/'EC�1.��1_j
Physical Address:
Facility Contact: IQ S M,a,V-p__ Title:
Onsite Representative:
Certified Operator.
Back-up Operator:
Location of Farm:
Phone: SL`7�I 1 ✓f
Integrator:
Certification Number:
Certification Number:
t
Latitude: 360 a_5� S + Longitude: 24
N e. H" g6_ N j R,1q h 4- on to Countj HO rIe 2 , C M4A-, ff vu y i ss 6
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.
FTLLayer
Non -Layer
Design Current
Dry Poultry Capacity Poo.
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?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes6kr_",P
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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
[] Yes rNo
❑ NA ❑ NE
❑ Yes❑ NA ❑ NE
❑ Yes❑ NA ❑ NE
Page I of'3 21412015 Continued

'Vacility ]''umber: - 0 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
❑ NA
ONo
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes❑
NA
❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
[:]Yes
No ❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
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 reat, notify D"IR
7. Do any of the structures need maintenance or improvement'?
❑ Yes
No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
No NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No ❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
ZXNo 0 NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? Ifyes , check the appropriate box below.
❑ Yes
ONo ❑ 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): Clr /M ! . _� r r7'/h I'A-t YI S
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
NA
Noi
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
oNA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
El
oNA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application'?
❑ Yes
o NA
�N`o
❑ NE
18. Is there a lack of properly operating waste application equipment`?
❑ YesNA
❑ 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
o ❑ NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ONo ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes No 0 NA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ❑ No >rA ❑ NE
Page 2 of 3 21412015 Continued

Facili Number: 13- Date of Inspection: - %
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No j hNA ❑ NE
the appropriate box(es) below. 1�
❑ 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 PNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes nNo
NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ 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
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
W'No
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ 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.
Use drawings of facility to better explain situations (use additional pages as necessary).
.7 . (3 yr o U` h`� e �2� A,� v`eJc� ?
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2
r
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a6 . N"A & h ©o rs I '�o 1 g .
Gn1,bra4� vn, 6vi to - t _16
w,i ST o- 5 a h. p'E S /pit I le C: o -,e J 4o
Reviewer/Inspector Name:
Phone:
Reviewer/Inspector Signature
Page 3 of 3
G-( S
Date:- - 7 — _
21412015

Z�Division of Water Resources
Facility Number © - F 0# 0 Division of Soil and Water COrvation
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: Departure Time: County: GhSWCLL Region: WSRO
Farm Name: _)oW !jkVtLr\� (%(N FppA_._ lWL Owner Email:
Owner Name: >0 1w Phone: 33 C 5 l4 • fit 7 dc)
Mailing Address: 19-4( GyuJt Y MWAC_ RDO eLAOiniq K, r
Physical Address: A
Facility Contact: Title: owugR Phone: QA
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
"Usi 1st E " 4&o56 NC— Ho b6_4 ou Iz164F
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
pry tryy
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Design Current
DischarLyes 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 DWR)
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)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
Uo
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes KNo ❑ NA ❑ NE
❑ Yes ❑ No � NA ❑ NE
❑ Yes ❑ No t!� NA ❑ NE
❑ Yes
❑ No
g NA
❑ NE
❑ Yes
KN�o
D§NA
❑ NE
❑ Yes
?qNo
❑ NA
❑ NE
Page 1 of 3 21412015 Continued

Facili Number: - CY7 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑Yes
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: fVQW 44 (r,Wk*AN
Spillway?:
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?
9No ❑ NA ❑ NE
❑ No NA ❑ NE
Structure 6
❑ Yes KNo ❑ NA ❑ NE
❑ Yes X No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑Yes No ❑ NA ❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes �No K 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): Coma StLhC36 , VAOif stn8dj= G&NK0
13. Soil Type(s):
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
PqNo
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement'?
El Yes
LC No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
JKJ No
❑ NA
❑ NE
acres determination?
17.
Does the facility lack adequate acreage for land application'?
❑ Yes
K No
❑ NA
❑ N4
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 R Permit readily available?
❑ Yes
P< No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check01yes
❑ No
❑ NA
❑ NE
the appropriate box.
❑ Desig is
❑Other:
21. Does record keeping need.improvement? If yes, check the appropriate box below.
❑ Yes
4No
❑ NA
❑ NE
n jgaVxxjLv Freeboard n9@4 *nttiy
s
�].WLeaEhrrEede
�"Rairtfait
c to
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�No
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ 'Yes
❑ No
NA
❑ NE
Page 2 of 3
21412015 Continued

Facility Number: i - G Date of Inspection: ;
24. Did the facility fail to calibrate waste appkicauon equipment as required by the permit?
❑ Yes
5�No
A
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
❑ No
[K 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
J<No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No
NA
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes KNo
❑ Yes nNo
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes ut No ❑ NA ❑ NE
❑ Yes Dd No ❑ NA ❑ NE
❑ Yes I
❑ Yes No
❑ Yes t6,No
❑ NA ❑ NE
❑NA ❑NE
❑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).
�6� ogr�•w��z }to�K1 C � sue[ ���
9-0) *V6 Mttft) D eqea I L WOAD e,:,,P, �W-j -IIIA e
Reviewer/Inspector Name:
Reviewer/inspector Signatur
Page 3 of 3
Phone: 33 0M AO�013
Date: 61 15 A
21412015

777
Division of Water Resources.
Facility Number 0 Division of Soil and Water Conservation f 0 A A4
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: a Arrival Time: Departure Time: /�,2 G County: �g�_j Region:
Farm Name: -Tt> k r% j k U ryVA k..P r .j)a i r y Fkr Wl , Mr%c-Owner Email:
Owner Name: -To h n [l U M c7.- k4-e-+r Phone: �3 (p "I " r j r l C. 6� ( f
Mailing Address: 2q ID i�o U ►fl �.i H G M 2- �� i }� 1 ax, C. VN , Kj Cr a 7 X I -X---
Physical Address:
4/
Facility Contact: ,-.] DAl n Title: 10 y.,j ne.0
Onsite Representative: SO �1 Integrator:
Certified Operator: J O n 5 i UrAoL1i4,,r Certification Number:
1�j3;
Back-up Operator:
Location of Farm:
Latitude:
0ae: �3 fA 'C ' T 6_3 oZ--
1-
Certification Number:
Longitude:
F} rain (.SS C LM55 N C. H W �-(-3 Farm o n r"3 -�
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
Design Current
Dry Poultry Ca aci Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Pouets
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 DWR)
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)
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 M I I ir-
goo�
Dairy Calf
O
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes gNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
0 Yes ❑ No
❑ Yes [g No
XYes ❑ No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Page l of 3 21412014 Continued

Facili Number: - () . Date of Inspection: B 117 ..Q j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard?
�Structure 1 Structure 2 Structure 3 Structure 4
�dcntifier: sz'cc
Spillway?:
Designed Freeboard (in):
❑ Yes
LZ"No ❑ NA ❑ NE
❑No ❑NA ❑NE
Structure 5 Structure 6
Observed Freeboard (in):�
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
YNo
❑ 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
ONo
❑ 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
t 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)
T'
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
N/No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
C No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals
(Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of
Area
12. Crop Type(s):
Iroved
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
JXNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
C!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
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Vo
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes Vo
N❑ 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 ❑ Lease Agreements ❑Other.
21. Does record keeping need improvement? lfyes,-zh❑ Yes No ❑ NA ❑ NE
❑ Waste Applicati n � kly Freeboar ` Waste Analysis Soil Analysis ❑ ❑ Weather Code
Rainfall tocking Crop Yield �120 Minute Inspections Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes E'�(No ❑ NA ❑ NE
23_ If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No 1X NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - 0 jDate of inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No NA ❑ NE
the appropriate box(es) below. 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?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes JVNo
❑ Yes ❑ No
❑NA ❑NE
NA ❑ NE
❑ Yes Og"No ❑ NA ❑ NE
❑ Yes 6�No ❑ NA ❑ NE
❑ Yes ba No
❑ Yes bj No
❑ NA ❑ NE
❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes L)ro ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? [:]Yes J),.,'/�To ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes C No ❑ NA ❑ NE
Comments (refer to question ft Explain any YES answers and/or any additional recommendations or any other comments.
Use drWIngs of facility to better explain situations (use additional pages as necessary).
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CfDbP4 4tv+
_
a
T/,30f LouP
tk t"t�,
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
ra C_K__
Phone: 7 � 6 — �
Date: O a4I S
2/4/2014

'!
Division of Water Quality
Facility Number j'7 - O Division of Sothand Water (J , §ervation x
.O Other Agency
Type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: j f l Arrival Time: Departure Time: I__( County: (sNre j i
Farm Name: .1 {tin 51-we- ►ka b4Y Fr+'•v, y/l[ Owner Email:
Owner Name: d dllyi 5`AkwkAke1r Phone: 1 (� `�d3Z_
Mailing Address: ZZ G Loin ) L
Physical Address: 5�&,e-
r
Facility Contact: A 4M"'a "' Title: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Region: ESN!
Back-up Operator: Certification Number:
Location of Farm: Latitude: '2—f Longitude: 7� 9 7 -
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
Design Current
Dry Poultry CaDacity Poo.
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
ZOO
113
Dairy Calf
Daia 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
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 I 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

I\
IPacili Number: - Date of Ins ection:
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
Structu 4 I Structure 2�lStructure 3 Structure 4 Structure 5 Structure 6
Identifier: i nAr I daf J
J�
Spillway?: ey l �s
Designed Freeboard (in):
Observed Freeboard (in):
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 No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes d(No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence Wind Drift ❑ Application
Outside of Approved
Area
hof
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes A No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes :VNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes ANo
❑ 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 9 No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes XNo
❑ NA
❑NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes XNo
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute inspections ❑ Monthly and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes -k No
����❑
❑ NA
❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes No
X NA
❑ NE
Page 2 of 3
21412011 Continued

'acili Number: 17 - d Date of inspection: Y/I *L__j
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. l�
❑ 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) certifi
cation?
❑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?
''T
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑Yes � No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑Yes �No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface file drains exist at the facility? If yes, check the appropriate box below.
❑Yes [�No
❑ NA
❑ NE
❑ Application Field ElLagoon/Storage Pond ❑
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.
Use drawings of facility to better explain situations (use additional pages as necessary).
201 11""V j 6C V�f_j
,e�`%►1�5,,• �.c�.c,� �tsl�-
fl�n3ft {Yaw• �1__ 4-ca11, -eye- oA,
Pd.
W ,i ✓ — �l1;A /kr-* l 41 11 %CL 'e 1' l kind �7� iJlr �^�s � trlUl' Ni�� ✓ls�
0139 1 S sir go -� J'.j /S tj
Reviewer/Inspector Name: PC, 4-016 K L Phone: C.33� 77 �Z $
Reviewer/Inspector Signature: Date: 1,2_1o14
Page 3 of 3 21412011

Division of Water Quality
Facility Number j - p 0 Division of Soil and Water Conservation 10Awl
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: t3(Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 3 z l 13 Arrival Time: Departure Time: ounty: C4swi u.- Region: InWS2o
Farm Name: IA Sltvnna %V- V%A _ viC . Owner Email:
Owner Name: 'n�;� S�1u �✓ _ _ Phone: C 331a, 5 H i 11
Mailing Address: 12-14(P r1&VA-ti-on�� �Ij4 c� !�. 2 Zj1'�'SZ.j
Physical Address: C.hMg 8S A$o,45
l+
Facility Contact: J • Skawir"k" Title: Phone: )33ci~i -L4o-5
Onsite Representative: j a k V,
Certified Operator: �, S�1uVV. G K�X
Back-up Operator: a { G
Location of Farm:
fe�6 E , G i-1 %4 Y &' .1 f=r rw o„ F21A L'lt
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Soars
Other
Other
Integrator:
Certification Number N-'J" �r�r5 b, E�3l1[S
Certification Number:
Latitude:
Design Current
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)
Longitude:
Design Current
Cattle Capacity Pop.
Dairy Cow
2:30
li
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Yes �(No
❑ Yes Wo
❑ Yes ❑ No
❑ NA ❑ NE
❑NA ❑NE
❑NA ❑NE
c. What is the estimated volume that reached waters of the State (gallons)?
r d. Does the discharge bypass the waste management system? (If yes, notify DWQ) []Yes J}No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes �4 No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters Yes [—]No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

1
Facility
, Number: 1 -4- - D • Date of Inspection: 3 2.t
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes rvf In4 No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No .4 NA ❑ NE
1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
pStructure
Identifier: Se.wm
Spillway?: l
Designed Freeboard (in):
Observed Freeboard (in): th;'i1_
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes ER 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 [Z No ❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes No ❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes ;kNo ❑ 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 W 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 I�l'No ❑ NA
❑ NE
❑ Excessive Ponding ❑ .7Hydraulic 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 0No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes C ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes [4No ❑ NA ❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
-Yes 21 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
Yes r.7'1 No
❑ NA
❑ NE
Recjuired 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 oes record keeping need i rovement?-K-y=, ❑Yes No ❑ NA ❑ NE
W ste Applicat on eekly Frceb;120
d Waste Analysis Soil Analysis r� [v�Weather Code
Rainfall �ocking ropYid Minute Inspections onthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes OfNo ❑ 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

Eacili Number: - bIj. Date of Ins ection:
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 EfNo ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues AAA
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
❑ Yes 4 No
[:]Yes in No
❑NA ❑NE
❑NA ❑NE
❑ Yes 0 No ❑ NA ❑ NE
❑Yes MNo []NA []NE
❑ Yes b No ❑ NA ❑ NE
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 0 Other: u y4 j pcj, !21
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes
XNo
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes
Z No
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
2§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).
zOii Sn�ZaiLro+�}
g , k;,r F n L 0I Z
3vrks Fkiv-- hug IS rn lam,-n-►
o osr 2e
107/ 0-0 1 [""t.J.� Pam
was �-e .
N1 N
6-taV t(b
Lo W
L_ 5 b= eyj j r 3 S o ! l C1p 0 Q,
U 11
4.
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
dos,\
4 3 1.0 y+.ws= V-
�141 �b�e A. ai l
l 1,,�e- k f" i �c
p4PA
Phone: / oc
Date:
21412011

4D Division of Water QualityMrvation
acility Number - O op Division of Soil and Water 1v /�M
O Other Agency
e of Visit: Compliance Inspection 0 Operation Review Q Structure Evaluation O Technical Assistance
ason for Visit: Routine Complaint Follow-up 0 Referral Emergency 0 Other O Denied Access
to of Visit: Arrival Time: Departure Time:® County: l Region: LoS20
1 irm Name: 0 Mck V In r Owner Email:' + �/
ner Name: U ej,,- Phone: IT rC 'CC-�
failing Address: „� 4 fjUii N"ol)jea-ac r_ 1 G a 7 0-)- 1
1C� rn
hysical Address: e—
acility Contact: To h n Title: Phone: C- 5 q — %
)nsite Representative: Integrator:
"-ertified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Certification Number:
Latitude:�;L '� Longitude:
1.58 E. I Cro5S � S 6 at Farm on riQh 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 I I El
Dry Poultry
Layers
Non -Layers
Pullets
Turkeys
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:
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
a 0 O
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 0No ❑ NA ❑ NE
❑ Yes ❑ No [:]NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ Yes
[(No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3
21412011 Continued

� l
Facili Number: 1 7 - 0=1• jDate of Inspection:
G j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes
MNo
❑ 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: 5 e GLY1 Aa_ ty 1 J
Spillway?:
Designed Freeboard (in):
Observed Freeboard
(in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
C(No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
&No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
r5j,1qo
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
ZNo
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
[:]Yes
tj�`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 ❑ Leavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > t0% 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 L'No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes ❑ 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 ❑ No
❑ Yes no
❑ Yes EK0
❑ Other:
21. Jdoes record keeping need i - Yes No N� ❑ NE
Lj( Waste Application eekky Freeboard aste Analysis Soil Analysis aste Transfers �E/weather Code
Rainfali �tocking Crop Yield 20 Minute Inspectionsaonthly and 1" Rainfall Inspections _ ey
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 ` iA ❑ NE
Page 2 of 3 21412011 Continued
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE

51-
Facility Number: j - Q Date of Inspection, [
0
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes �" ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No rSKA ❑ 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 structurc(s) and date of first survey indicating non-compliance:
25. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
24. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes
[� `V o
❑ NA
❑ NE
❑ Yes
To
❑ NA
❑ NE
❑ Yes O No
❑ Yes b;YNO
❑ Yes �No
❑ Yes
❑ Yes No
❑ Yes r0
Yeso
❑ NA ❑ NE
DNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ 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 pa es as necessary).
I� Q1paj d i 19 Lk-)uP
U _
AO L2- 5nk 5 l e S ,? PaOL I
�l is aof a- t0asf ,5d-� e_ o � le- = l i ! bs . N 1000
Reviewer/Inspector Name:
ReviewerlInspector Signature: L ./JJJJ
raC_"V'
Phone:
Date:
21412011

,*
Division of Water Quality
Facility Number ©- Division of Soil and Water tervation /
0 Other Agency ! U
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: f dLrn� Arrival Time: ® Departure Time: County: dasLOO Region: �V
Farm Name: �� h 56 ngCI�X" bot ry FQIrd�Owner Email:
Owner Name: hV" _,<�tr\U (yL V Q&— Phone: 61 — q O 3 c-,
Mailing Address: 110 6 e) t l w� u 146�( 1�(�[ • , (alf�l��� I a 7 ,�—
Physical Address: Sow'
Facility Contact: ']-0 Title: Phone: �JC,571
—
Onsite Representative: Integrator:
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: No .tS 2 Longitude: ] q y c)`
jS b' 1 �roSS g� FaLv-vr2 no-
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
ury routtry
Layers
Non -Layers
Pullets
Turkeys
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:
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
Cl�oe Capacity Pop.
?�:Dairy
Cow
QO
Dairy Calf
Dairy Heifer
Dry Cow
.Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No
❑ Yes WNO
o
❑ Yes
❑NA ❑NE
❑NA ❑NE
❑NA ❑NE
Page I of 3 21412011 Continued

Facilli Number: - • Date of Ins ection: p2
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Ia Structure 1 Structure 2 Structure 3 Structure 4
identifier: On
Spillway?:
Designed Freeboard (in):I IT
_
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 property addressed and/or managed through a
waste management or closure plan?
Structure 5
X'No ❑ NA ❑ NE
❑ No [] NA ❑ NE
Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes t�]Ko ❑ 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 structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste ApI lication
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes U40 ❑ 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
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
Xyes
❑ 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.j
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
fSr<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 JRJ No ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. oes record keeping nee�irovement? If yes, check t appropriate box belo Yes ❑ No �Zeather
❑ NE
Waste Application ekly Freeboard Waste Analysis Soil Analysis ,EKaaste Transfers Code
Q R infal] tocking Crop Yield [�K20 Minute Inspections ❑Konthly and i" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes Er o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No JS�,IGA ❑ NE
Page 2 of 3 21412011 Continued

F46lity Number: - Date of Inspection:
' 24. Did the facility fail to calibrate waste appil-Ration 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 JSTNA ❑ 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
[XN"'o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
[] Yes
❑ No Dk A ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes
P�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 hio ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately. �f
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes jt2No ❑ NA ❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Zubsurface tile drains exist at the facility? If yes, check the appropriate box below, Yes ❑ No ❑ NA ❑ NE
pplication 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 W10 ❑ 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.
Use drawings of facility to better explain situations (use additional naees as necessarv).
19. A 4A_ -r-\ Lou
No
u s r...�
'7 l�.a-e�
lo°°�-o-P
Reviewer/Inspector Name:
Reviewerhnspector Signature:
Page 3 of 3
Phone: -1 � — ,j a O I
Date: 1
4 I LLL
214/2011
a

Facility Number 7
Division of Water Quality -
0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit
Compliance Inspection
O Operation Review Q Structure Evaluation
0 Technical Assistance
Reason for Visit
Routine 0 Complaint
0 Follow up 0 Referral Q Emergency
0 Other El Denied Access
Date of Visit: �Z Arrival Time: Q Departure 'rime: "J County: �1 Region: W5 0
Farm Nam-e: �6- k h s kma'ka. -7� a to-,., rM Owner Email:
✓k
Owner Name: a yl S'A4M a �� Phone: © 0 7 TLC 32-
Mailing Address: 1 7-J6 C_aUhl f 1/ ttt�MG �6a _ �it� U6�1 G 27Z1 Z
Physical Address: --�� r5awyi a I' ! p
Facility Contact: ✓aka- 5 `�Ma_kcr - _Title: Phone No:© JrI 'l I I r
Onsite Representative: K ex _ S l w c� q / Integrator: Jd
Certified Operator: Jd h A J� k M a W Operator Certification Number:
Back-up Operator:
Location of Farm:
Hwy ass eA54- av
f--A,rM lS 01h ri
Swine
Sack -up Certification Number:
Latitude: ® Z® Longitude:
I�a`n-t'eyv I1 e, crass �w y 8�0�' �a� become( Co d%
hT.
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
i
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Lavers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Design Current
Cattle Capacity Population
Dai Cow
[]'Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures:
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
❑ Yes
)XNo
////// \\\\\\
El NA
El NE
Discharge originated at: El Structure El Application Field El Other
a. Was the conveyance man-made?
❑ Yes
❑ No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
El Yes
�No
El NA
❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
❑ Yes
XNo
❑ NA
❑ NE
other than from a discharge?
Page I of 3
12128104
Continued

Facility Number: 17 — d r • Date of Inspection Zl v •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
❑ NA ❑ NE
El NA ❑NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
of pl, Is
Identifier: LJS lvelr
Spillway?: Er 4 A" f G f
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes )<No
ElYes ❑No
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes XNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes )<No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes )<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 XNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ) No
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes >No
❑ 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 Soi
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area /_5�
12. Crop type(s) Corn s,, 0 64--l/ ev,,A) , ja►� `�r atW4 ,
13. Soil type(s)
❑ NA ❑ NE
❑ NA ❑ NE
-�11 om q),
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
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
El NA
El NE
18. Is there a lack of properly operating waste application equipment?
El Yes
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):
3. L a we r 5do -Av-r r-L
1 ,
-v ad", G-c o
t� -4,ri -Gt, AJJ 4-, �► P
7, hill., f�l�
i-4mK�4,
�
f/
Reviewer/Inspector Name gyr`G tt
j1J) Phone: 33G "jrf — s'��
Reviewer/Inspector Signature:
Date: Q 2 i O
Page 2 of 3 12128104 Continuer!

Facility Number: — d7 0of inspection Z •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes `, XJNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes `YJ No ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ✓✓✓ \\\
❑ Design ❑Maps El Other
21. Doesrecordkeeping need improvement? If yes, check the appropriate box below. ❑ Yes )<No ❑ NA El NE
Lf Waste Application Weekly Freeboard Waste Analysis Soil 'Analysis "'- ____r___"" ��``
Rainfall Stockin Crop Yield Monthly and V Rain Inspections Weather 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?
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 Reviewerllnspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
Comments and/or Drawings:
❑ Yes ❑ No XNA
❑ NE
❑ Yes No ❑ NA
❑ NE
❑ Yes ❑ No XNA
❑ NE
❑ Yes �No [DNA
❑ NE
❑ Yes ,*o ❑ NA
❑ NE
❑ Yes XNo
❑ NA ❑ NE
❑ Yes gNo
❑ NA ❑ NE
❑ Yes )<No
❑ NA ❑ NE
❑ Yes )<No
❑ NA ❑ NE
❑ Yes �No
❑ NA ❑ NE
❑ Yes VNo
❑ NA ❑ NE
lj;
j
77 �Pce� horvejW -r Ve)�
2/. Card �Ar✓raf
D1�10 0.3-7 1.J"
Page 3 of 3 12128104

Division of Water Qualityl
[Facility Number Division of Soil and `Water, 0C eryateon
O'Other Agencv g�
Type of Visit Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit ('JRoutine O Complaint O Fo[low up O Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: 1 Arrival Time: 10_t_q_ Departure Time: ,2.' QQ � jounty: �. i Region: Q5
Farm Name: 1D ID sn u M C, WeAl' 4 L I' �i � � Owner Email: �19M S6U QmCt"'_ '
Owner Name: 1 Phone: �_ T T4O 3 nTt Ct
Mailing Address: a- (o C_ r\ t'_ Z 1 COM
Physical Address: oftAQ. q � l 1 —I
Facility Contact: M b n t_)�t)1iG_kLf_J/Title: Phone
Onsite Representative: 3o hn ! C 1 U OA Q 1C_A.lf Integrator:
Certified Operator: SC�J) Sh.,)MdL LPG Operator Certification Number:
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 5D Longitude: EN IN 149�
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population Cattle
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
❑ La er
❑ Non -Laver
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharp_es & 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 I
Capacity Population.
Dairy Cow
El Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number: of Structures:
d. Does discharge bypass the waste management system? ([f yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes o ❑ NA ❑ NE
12128104 Continued

0
Facility Number: — 6 Date of Inspection •
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structur I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?: Wf I MOL_V Se( oy\
Designed Freeboard (in):
Observed Freeboard (in):
❑ Yes No
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
El NA El NE
Structure 6
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
N No
❑ NA
❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. 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 t reat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
No
❑ NA
❑ NE
Do any of the stuctures lack adequate markers as required by the permit?
[:IYes
�No8.
❑ 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? ��,, ff
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes l.�No ❑ NA El NE
El Excessive Ponding El Hydraulic Overload El Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.) //////```"`
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
0Yes
❑ No ❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
No ElNA
ElNE
18. Is there a lack of properly operating waste application equipment?
ElYes
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):
V_37Y�0� t QS-fe aun a l s s-
3.1 S. N//C, oo
`
Ck--) asfe ak-ina sis -
0.3 '�- 11e5. mb000
3 dZ
SAC
Reviewer/Inspector Na e
_ Phone:
Reviewer/inspector Signature:
Date:
" _ %j d' .12128104 - Continued

U
Facility Number: — d At of Inspection
Required Records & Documents �.
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes piJ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes 03-1l o ❑ NA ❑ NE
the appropriate box.
❑ WUP El Checklists ❑Design El Maps El Other
21. Dos record keeping neeWW
rovement? If yes, tXasteAnalysis
I the appropriate box below. El Yes LKNo ❑ NA ❑ NE
aste Applica 'on kly Freeboard L"J Soil Analysis c 'on
IJ Rainfall Stocking Crop Yield M44onthly and I" Rain Inspections OU eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No R/ NA ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes YNo ❑ 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
❑ 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
Ill 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
ElNE
General Permit? (ie/ discharge, freeboard problems, over application)
32,
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
to
❑ NA
El NE
33.
Does facility require a follow-up visit by same agency?
El
o
❑ NA
❑ NE
Itional Comments and/or Drawings:
� 1 I � .fir �� E• t � �>f
r �
AM
1 v 12128104

Facility Number
10 Division of Water Qualit�W
O Division of Soil and Water Conservation
O Other Agency
Type of Visit 2rCom nce Inspection O Operation Review O Structure Evaluation 0 Technical Assistance
Reason for Visit Routine O Complaint Q Follow up Q Referral 0 Emergency O Other ❑ Denied Access
Date of Visit: D j Arrival Time: ! D Q Departure Time: County:
Farm Name: ot_ �� Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facility Contact: 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
Phone:
Phone No:
Integrator:
Operator Certification Number:
Back-up Certification Number:
Region:
Latitude: a o = ' = Longitude: = o =
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
j ❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Dischames & 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?
Ol
Design Current
Cattle Capacity Population
❑ Daia Cow
Q
❑ Dairy Calf
❑ Dairy Heifei
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
Number of Structures:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge'?
❑ Yes
VXo ❑ NA
❑ NE
❑ Yes
"NoNA
❑ NE
❑ Yes o NA
❑ NE
❑ NE
❑ Yes
El YesEl
roED
NE
❑ Yes❑
NE
12128104 Continued

Facility Number: Date of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No NA ElNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ElYes No ❑ NA ❑ NE
the appropirate box. ❑ WDP ❑ Checklists ❑ Design ❑Maps ❑Other
21. Does record keeping need improvement? If yes.. check the appropriate box below. ❑ Yes ZrNo ❑ NA ElNE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain Inspections4No
ather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 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 ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
NA
ElNE
26. Did the facility fail to have an actively certified operator in charge?
ElYes
❑ NA
jNo
ElNE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ NA
❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (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:
w f( 11-e C ra G r ' '?- 4 1<
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
12128104

Facility Number: — Date of Inspection 0
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
ZNo ❑ NA
❑ NE
Structure i Structure 2 Structure 3 Structure 4
Structure
5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ��
❑ Yes
❑ 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
VNo ❑ 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 thre ; 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 J2'No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need El Yes 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 l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) n S- 1, I f .''o S wy eV IF
-
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
OrNo NA
Noo NA
L�JN ❑NA
N NA
No ❑ NA
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):
-��j1s L:fZe two, = 11wt
Ark �,yl i arcfc. , lnD� ��✓I lA
0 + A � CY Je-1 d ii` //In lv' Fr o!C& - A- JJ'z"J,
Reviewer/Inspector Name PILL:
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
Reviewer/Inspector Signature:
Date:
12128104 Continued

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency I --I
Facility Number ; 170007 Facility Status: Active Permit: AWC170007 LJ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine County: Caswell Region:Winston-Salem
Date of Visit: 01/17/2007 Entry Time:10:00 AM Exit Time: 12;00 PM Incident #:
Farm Name: Jghn Shumals ai Farm. lnc. Owner Email:
Owner: John M Shumaker Phone: [phone]
Mailing Address: 1246 County Home Rd _ Blanch NQ 272129521
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 36"25'28" Longitude: 79°19'42"
US Hwy 158 east past Yanceyville, cross Hwy 89, and road tuns into County Home Rd. Farm is on right.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other issues
Certified Operator: John M Shumaker Operator Certification Number: 21633
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative John Shumaker
Title Phone
Phone: [phone]
24 hour contact name John Shumaker Phone: [phone]
Primary Inspector: M lissa Rosebrock Phone:
Inspector Signature: Date:
Secondary Inspector(s):
Inspection Summary:
16. & 18. Need to revise waste plan based on newly revised irrigation (wettable) acres determined by Joey Knight.
18. Morris Shambley applies waste by tanker for Mr. Shumaker. John applies irrigated waste himself.
Page: 1

0 0
Permit: AWC170007 Owner - Facility: John M Shumaker
Inspection Date: 01/17/2007 Inspection Type: Compliance Inspection
Facility Number: 170007
Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
Q Cattle -Milk Cow 200 149
Total Design Capacity: 200
Total SSI_W: 280,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
Waste Pond PRIMARY 12.00
aste Pond SECONDARY 66.00
Page: 2

Permit: AWC170007 Owner - Facility: John M Shumaker Facility
Number :
170007
Inspection Date: 01/17/2007 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?
❑
■
❑ ❑
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 (Le./ large trees, severe
❑
■
❑ ❑
erosion, seepage, etc.)?
6, Are there structures on -site that are not properly addressed and/or managed through a waste management ❑
■
❑ ❑
or 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 and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
■
❑ ❑
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?
❑
■
❑ ❑
If yes, check the appropriate box below
Excessive Ponding?
❑
Hydraulic Overload?
❑
Frozen Ground?
❑
Heavy metals (Cu, Zn, etc)?
❑
Page: 3

Permit: AWC170007 Owner - Facility: John M Shumaker
Facility Number: 170007
Inspection Date: 01/17/2007 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yes No NA NE
PAN?
In
Is PAN > 10%/10 lbs.?
❑
Total P205?
In
Failure to incorporate manure/sludge 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
Corn (Grain)
Crop Type 3
Small Grain (Wheat,
Barley, Oats)
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
Q ■ Q ❑
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?
❑ ■ ❑ ❑
Records and Documents
Yes No NA NE
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?
❑
Page: 4

Permit: AWC170007 Owner - Facility: John M Shumaker Facility Number : 170007
Inspection Date: 01/17/2007 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?
❑
■
❑ ❑
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?
O
■
❑ ❑
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?
❑
■
❑ ❑
Other Issues
Yes
No
NA NE
28, Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
■
❑
Q ❑
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

•
Permit: AWC170007 Owner - Facility: John M 5humaker
Facility Number: 170007
Inspection Date: 01/17/2007 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?
32. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
❑■❑❑
Page: 6

Division of Water Quality
=FacifityNumber � O Division of Soil and Water Conservation (]
O Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit `19 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: Ob County: D Region: U6"`D
Farm Name: O�IYi ShLV j���"Q-DQl r'_ VI OFt4owner Email:
Owner Name:, 0 Yl Yl �1i �Gi`��eJ'� Phone: q q_' f0,3.-L-
a + ou &a ry-).h [ � 7 d.Ia
Mailing Address:
Physical Address: t- ! n, r
Facility Contact: �.l� Y14'1 ��uM0.L4PJ�Title: Ph a o:3 3�°' �"1`�
Onsite Representative: Integrator:
Certified Operator: t I Operator Certification Number: °�
Back-up Operator: k
Location of Farm: 0 Cif
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: FSBc{ a Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
I❑ Non -Layer
Dry Poultry
❑ La ers
❑ 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?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
ZDairy Cow
b
Lj Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures: �IM
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
L No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
12128104 Continued

Facility Number: I 1 0 Date of Inspection I, O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: C_
Spillway?:
Designed Freeboard (in): f
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 threat, notify DWQ
7. Do any of the structures need maintenance or improvement? El Yes E ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes �No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
❑ Yes 0 No ❑ NA ❑ NE
11. Is there evidence of incorrect application? if yes, check the appropriate box below. ❑ Yes 0No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
WNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
0 No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
Xyes
❑ No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
VNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
ANo
❑ 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):
U('� .� pzp_/1 Q a
AL
1
Reviewerllnspector Name 1 � C � Phone:
Reviewer/Inspector Signatur . Date: d
Page 2 of 3 C. — 12128104 Continued

Facility Number: I I— Q Qate of Inspection i d
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
❑ WUP El Checklists ❑Design ❑Maps ❑Other
21. Des record keeping neeWim rovement? ❑ Yes QiJ No ❑ NA ❑ NE
FRaste Application eek y Freeboard Waste Analysis �l Analysis �aste Transfers
ainfall �tocking Crop Yield 120 Minute Inspections L"Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge?
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? (iel 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:
to w Pond = 0.5 3 l �-s � ►v J I obo
@ n &--t- d tA-, q ® '�4 . a 00`4
❑ Yes WNo ❑ NA ❑ NE
❑ Yes �,4 ❑ NA ❑ NE
❑ Yes
9No
❑ NA
❑ NE
❑ Yes
❑ No
0 NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
❑ No
XNA
❑ NE
❑ Yes
'§dNo
❑ NA
❑ NE
❑ Yes
❑ No
XNA
❑ NE
.Yes
❑ No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
❑ Yes
WNo
❑ NA
❑ NE
❑ Yes
,(No
❑ NA
❑ NE
❑ Yes
0No
❑ NA
❑ NE
❑ Yes
Wo
❑ NA
❑ NE
Page 3 of 3 12128104

16 0
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 1700 7 Facility Status: Active Permit: AWC170007 ❑ Denied Access
Inspection Type: �moliance Inspection__ Inactive or Closed Date:
Reason for Visit: Routine County: Caswell Region: Winston-Salem
Date of Visit: 0311712006 Entry Time: 10JO AM Exit Time: 12 MPM Incident #:
Faun Name: John Shumaker Dairy Farm. Inc— Owner Email:
Owner: John M Shumaker
Phone: [phone]
Mailing Address: 1246 County Home R Blanch NC 272129521
Physical Address:
Facility Status: 0 Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude: 36°25'28" Longitude: 7 "1 '42"
US Hwy 158 east past Yanceyville, cross Hwy 89, and road tuns into County Home Rd. Farm is on right.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: John M Shumaker
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative John Shumaker
24 hour contact name John Shumaker
Primary Inspector: M I' a R sebrock
Inspector Signature:
Secondary Inspector(s):
Operator Certification Number: 21633
Title
Inspection Summary:
3. Lower corner of calf lot looks great.
9. Operator has begun installing fencing and grading.
1 B. Hydrants checked and are ok.
21. Some fields calling for lime.
21. Records look great.
28. Fields containing stockpiled/co mposted waste have been removed from the WUP.
11/16/05 Waste analyses:
LSD=5.5 lbs. N11000 gal.
Irr.=1.3 lbs. N11000 gal.
Phone
Phone: [phone]
Phone: [phone]
Phone:
Date:
Page: 1

Permit: AWC170007 Owner - Facility: John M Shumaker Facility Number: 170007
Inspection Date: 03/17/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
O Cattle -Milk Cow 200 155
Total Design Capacity: 200
Total SSLW: 280,000
Waste Structures
Type IdentiFler Closed Date Start Date Designed Freeboard Observed Freeboard
Waste Pond PRIMARY 42.00
Waste Pond SECONDARY 60.00
}
.y
Page: 2

•
•
Permit: AWC170007 Owner -Facility: Jahn M Shumaker Facility Number. 170007
Inspection Date: 0311712006 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?
❑
■
❑ ❑
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)
❑
■
Cl ❑
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 (Le./ large trees, severe
❑
■
❑ ❑
erosion, seepage, etc.)?
6. Are there structures on -site that are not property addressed and/or managed through a waste management ❑
■
❑ ❑
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.
❑
■
❑ ❑
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? ❑ ■ Cl ❑
If yes, check the appropriate box below.
Excessive Ponding? ❑
Hydraulic Overload? ❑
Frozen Ground? ❑
Heavy metals (Cu, Zn, etc)? ❑
Page: 3

•
•
Permit: AWC170007 Owner- Facility: John M Shumaker
Facility Number: 170007
Inspection Date: 03117/2006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yes No NA NE
PAN?
❑
Is PAN n 10%/10 lbs.?
❑
Total P205?
❑
Failure to incorporate manure/sludge 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 Small Grain (Wheat,
Barley, Oats)
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
❑
■
❑
❑
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?
❑
■
❑
❑
Records and Documents
Yes
No
NA
NE
19, Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■
❑
Cl
20. Does the facility fail to have all components of the CAWMP readily available?
❑
■
❑
❑
If yes, check the appropriate box below.
WU P?
❑
Page: 4

Permit: AWC170007 Owner- Facility: John M Shumaker
Facility Number: 170007
Inspection Date: 03/17/2006 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?
❑
■
❑ ❑
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?
Cl
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?
❑
■
❑ Cl
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
■ ❑
Other Issues Yes No NA N
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? ❑ Cl ❑
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

Permit: AWC170007 Owner- Facility: John M Shumaker
Facility Number:
170007
Inspection Date: 03/17/2006 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?
■
❑
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ ■
❑
❑
33. Does facility require a follow-up visit by same agency?
❑ ■
n
n
Page: 6

NCDA Agronomic Division 4300 Reedy Creek Road Raleigh, NC 27607-6465 [phone]
Report No: P01174 P
Grower:
Shumaker Dairy Inc.
Copies To: Watson, Robin
Attn: John Shumaker
1246 County Home Rd,
Blanch, NC 27212
k`�
ant na ys�s ehort
Farm:
3/15/2006
Caswell County
Sample Information
Laboratory Results
Sample 1D:
N% P% K% Ca% Mg% S% Fe-ppm Mn-ppm Zn-ppm
Cu-ppm B-ppm Mo-ppm
C1% Na% Ni-ppm Cd-ppm Pb-ppm
2
4.92 0.46 3.54 0.41 0.18 0.29 96.7 77.1 40.3
9.2 6.6
0.02
Crop:
Interpretation Indexes
Ratios
Petiole m
Wheat
N P K Ca Mg S Fe Mn Zn Cu B MO
N.-S
NX Fe:Mn
Nitrate N '
Plant Appearance:
72 71 60 56 51 57 59 61 60 61
53
17.0
1.39 1.25
Normal
DRIS Interpretation: Most limitin -- --Least limitin
Recommendations:
Nutritional status of your wheat
samples looks very good; nutrient concentrations are all within the desired ranges at this time.
Nitrogen application is not needed based
on the N concentration in these two samples.
Greatjobl Please contact Robin
Watson for further assistance,
Brenda R. Cleveland, Agronomist
Jam le Information
Laboratory Kesult5
Sample ID:
9
N% P% K% .
5.06 0.36 3.51
Ca% Mg% S%
0.42 0.21 0.28
Fe-ppm Mn-ppm Za-ppm Cu-ppm B-ppm Mo-ppm C1% No% Ni-ppm Cd-ppm Pb-ppm
90.5 98.1 28.9 9.4 6.9 0.02
Crop:
Interpretation Indexes
Ratios
Petiole m
Wheat
Plant Appearance:
N P K
76 63 60
Ca Mg S
57 52 56
Fe Mn Zn Cu B MO
59 64 55 61 53
N:S NX Fe:Mn
18.1 1.44 0.92
Nitrate N
Normal
DRIS Interpretation:
Most limitino--
--Least limitino
0
•

Division of Water Quality
Facility Nutuber Division of Soil and Water Conservation 1 Q AM
O Other Agency I
Type of Visit (Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit - Routine O Complaint O Follow up 0 Referral O Emergency () Other ❑ Denied Access
Date of Visit: Arrival Time: /(J l V J Departure Time: County: L Region: &2fc v
Farm Name: T� -o �5bym L14e2c rY j P6ty-M Owner Email:
Owner Name: To VI r\ u m Phone 3 '3 (o ' 6 q [ 63 Z-
Mailing Address: a 7 OU n ju Home- {J , l f ttanc h. NC
Physical Address:
Facility Contact: To n S h U YYi6_14 e..r Title: Phone No:-) 310 + �q 7 333
i
Onsite Representative: t Integrator;
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Operator Certification Number:
Back-up Certification Number:
Latitude: o�jg Longitude: IM' EH'
[H-l"
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
0 Non -Layer ---_- - -
Other
❑ Other t
Dry Poultry
❑
Layers
❑
Non -Layers
❑
Pullets
❑
Turkeys
❑
urkey Puults
❑
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
p� O
El Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: F�El!
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 �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No
❑ NA ❑ NE
❑ Yes No
❑ NA ❑ NE
❑ Yes No
❑ NA ❑ NE
12128104
Continued

Facility Number: Oteofinspection rVolo�p
`
Required_ Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes XNo ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes Yo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Other
21. Does record keeping need i ' rovement? , El Yes o ❑ NA El NE
ry/waste Application ne
ed
ly Freeboard �aste Analysis oil Analysis [Waste Transfers /` n
Rainfall 014/0cking Yield M IZ20 Minute Inspections pQ Monthly and I" Rain Inspections eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes XNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No Cq6A ❑ NE
24. Did the facility fail to calibrate waste application equipment as required by the permit? O:* 010 ❑ Yes )� No ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes ❑ No Eq�NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes )<No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No XNA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes ANo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes gNo ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes J*No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ 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 A No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes bR�No ❑ NA ❑ NE
Comments and/or Drawings:
[.5t .S. 5 l lA . N/l000L 5 Q �rr� = 1 3 lbs.
I1 a9 o S O M,E-o F G 1
I j c s J� I�LtT6tj
Lem -Pon 4
LO LO 5 ['Co
qj A -, e_ � " i e�
� ,-7 a -8. �s - � 1�0
165
rage s of s ra1,461v4

Facility Number: 12 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes �No ❑ NA ❑ NE
a. if yes, is waste level into the structural freeboard? ❑ Yes ❑ No - ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: q < �eC_o n d
Spillway?: '
Designed Freeboard (in):
Observed Freeboard (in):
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.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes o ❑ 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 XNo ❑ NA ❑ NE
8_ Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes J�rNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) mac,
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? r
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 LZNo ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
e
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
A No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
§( No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
)%No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
�(No
❑ NA
❑ NE
Comments (refer to question ft 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):
Lo wet- e or rNe_r- o � co- l f' I of . —
i
� . stocr�-,peed w4s+e� � ti�z"tA_)v Po 1
Reviewer Inspector Name - 5, r � one: 1
S
Reviewer/Inspector Signatur Date:
o
Page 2 of 3 112128104 Continued

❑ Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 170007 Facility Status: Active Permit: AWC170007 ❑ Denied Access
Inspection Type: Compliance Inspection Inactive or Closed Date:
Reason for Visit: Routine _ County. Saswell Region: Winston-Salem
Date of Visit: 01/26/2005 Entry Time: 10:00 AM Exit Time: 12:50 Pam_
Farm Name: John Shumaker Dairy Farm, Inc. Owner Email:
Owner: John M Shumaker
Phone: [phone]
Mailing Address. 1246 Coufltyliome Rd Blanch NC 272129521
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude: Q6,42Longitude: -79.33
US Hwy 158 east past Yanceyville, cross Hwy 89, and road tuns into County Home Rd. Farm is on right.
Question Areas:
Discharges & Stream Impacts
Records and Documents
Certified Operator: John M Shumaker
Secondary OIC(s):
0 Waste Collection & Treatment 0 Waste Application
0 Other issues
Operator Certification Number: 21633
On -Site Representative(s): Name Title Phone
On -site representative John Shumaker Phone: [phone]
24 hour contact name John Shumaker Phone: [phone]
Primary Inspector: Mary M Rosebrock
Secondary Inspector(s)-
Phone: [phone]
Ext.383
Phone:
Phone:
Inspection Summary:
3. & 9. Evidence of run-off of waste and sediment from lower corner of calf lot. Must stop channeling, fence off corner, cut trees, etc.
Operator has 30 days to address.
3. & 9. Several hundred Feet of stream is impacted by sediment and animal waste due to streambank erosion, lack of vegetation, and
and cattle traffic in the heifer pasture. MUST be addressed. Also need crossing at the lowest point of pasture, near dam of freshwater
pond. Check next visit for possible NOV. Must start repairs within 60 days.
9. May want to fill in the gully on the stock trail to keep waste from channeling into freshwater ditch. Not a water quality problem yet.
1B. Check hydrants next year.
28, Field #10 needs to have the stockpiled waste applied or remove field from the WUP.
21. Soils ok. 11/24/04 waste analysis: Lower WSP=0.93 lbs. N/1000 gal.
Page: 1

•
•
Permit: AWC170007 Owner - Facility: John M Shumaker
Inspection Date: 01/26/2005 Inspection Type: Compliance Inspection
Regulated Operations
Design Capacity
Facility Number: 170007
Reason for Visit: Routine
Current Population
Cattle
0 Cattle -Milk Cow 200 146
Total Design Capacity: 200
Total SSLW: 280,000
Page: 2

Permit: AWC170007 Owner - Facility: John M Shumaker
Inspection Date: 01/26/2005 Inspection Type: Compliance Inspection
Waste Structures
Nurn Desc
Facility Number: 170007
Reason for Visit: Routine
Close Dt Start Dt Designed Freeboard Observed Freeboard
PRIMARY I Waste Pond 12.00
ISECONDTAWaste Pond 60.00
Page: 3

• •
Permit: AWC170007 Owner- Facility: John M Shumaker Facility Number: 170007
Inspection Date: 01/26/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Disrharges & Stream Imparts Yes No NA NF
1. Is any discharge observed from any part of the operation? ❑ ■ ❑ Cl
Discharge originated at:
Structure ❑
Application Field ❑
Other Cl
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 DWO)
❑
■
❑
❑
2. Is there evidence of a past discharge from any part of the operation?
Cl
■
❑
❑
3. Were there any adverse impacts or potential adverse impacts to Waters of the State other than from a discharge?
■
Yes
❑
No
❑
NA
❑
NE
Waste Collection. Storagp & Treatment
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 (Le./ large trees, severe erosion,
Cl
❑
❑
seepage, etc.)?
6. Are there structures on -site that are not property addressed and/or managed through a waste management or
❑
❑
❑
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
❑
■
❑
❑
and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
■
❑
❑
❑
improvement?
Yes
No
NA
NE
W Gta Applocatmon
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or improvement?
❑
■
❑
❑
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)?
Cl
PAN?
❑
Is PAN > 10%110 lbs.?
❑
Total P2O5?
❑
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
❑
Application outside of application area?
❑
Crop Type 1
Corn (Grain)
Crop Type 2
Corn (Silage)
Crop Type 3
Small Grain (Wheat,
Barley, Oats)
Crop Type 4
Crop Type 5
Page: 4

Permit: AWC170007 Owner - Facility: John M Shumaker Facility Number: 170007
inspection Date: Ot12612005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Wastes onliratinn Yes No NA NF
Crap 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 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?
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?
■
❑
❑
❑
❑
E
❑
❑
❑
❑
■
❑
❑
■
❑
O
❑
❑
■
❑
❑
❑
❑
❑
❑
■
❑
Page: 5

•
Permit: AWC170007 Owner - Facility: John M Shumaker Facility Number: 170007
Inspection Date: 01/26/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Other ISSL1es Yes No NA NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? ■ Cl ❑ ❑
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 concem? if yes, contact a regional Air Quality ❑ 0 ❑ ❑
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. Does facility require a follow-up visit by same agency? ❑ M ❑ ❑
Page: 6

ji'actltty Nurpbet
:Division of Water Q.uaIity...
Q Division o1' Soil and"Water.
0 Other Agency
nation. � ►) ,� f
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit
� <Rouuttine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other El Denied Access per,
Date of Visit: I Ij2 a �i71 Arrival Time: �Q Departure Time: ��� County: �_ Region:
Farm Name: �7— m Owner Email:
Owner Name: 4 I n r) 5 k_l r}Q a &o_r- Phone: J(c. & a�_ r a 3
,Mailing Address: , -A% en n4 Tl®m i? M ' + Ibl"C1' I . r Uy 2 -7 011 _ a
"
Physical Address: SQm e.,
Facilitv Contact: :Ton ,C) hum aYe 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
Phone No: W _336, kq 7 . 733
Integrator:
Operator Certification Number: . g1 (P 3Z�)
Back-up Certification Number:
0 0
Latitude: EY R� ® Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
:Division of Water Q.uaIity...
Q Division o1' Soil and"Water.
0 Other Agency
nation. � ►) ,� f
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit
� <Rouuttine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other El Denied Access per,
Date of Visit: I Ij2 a �i71 Arrival Time: �Q Departure Time: ��� County: �_ Region:
Farm Name: �7— m Owner Email:
Owner Name: 4 I n r) 5 k_l r}Q a &o_r- Phone: J(c. & a�_ r a 3
,Mailing Address: , -A% en n4 Tl®m i? M ' + Ibl"C1' I . r Uy 2 -7 011 _ a
"
Physical Address: SQm e.,
Facilitv Contact: :Ton ,C) hum aYe 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
Phone No: W _336, kq 7 . 733
Integrator:
Operator Certification Number: . g1 (P 3Z�)
Back-up Certification Number:
0 0
Latitude: EY R� ® Longitude:
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
��
Design Current
Cattle Capacity Population
Dairy Cow
vZGlt�
Dairy Calf
❑
Dairy Heifer
❑
D Cow
❑
Non -Dairy
❑
Beef Stockei
❑
Beef Feeder
❑
Beef Brood Cow
Number of Structures:
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes WNo ❑ 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'?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: PL1�Y1 U
ilk Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes Q4 No ❑ NA ❑ NE
❑ Yes ❑ No %NA ❑ NE
Structure 5 Structure 6
❑ Yes No
❑ Yes PNo
❑ 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 K No ElNA [INE
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) p
9. Does any part of the waste management system other than the waste structures require Yes V No ❑ NA ❑ NE
maintenance or improvement? A94- - 4
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No ElNA ElNE
mai ntenancehmprovement?
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 Drifl ❑ Application Outside of Area
12. Crop type(s) 0-1/90-1/9Frl 1 _ ,: I WIM Q ralo n
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
X No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination: ❑ Yes
.�KNo
ANo
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
�<No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
Wo
❑ NA
❑ NE
Comments (refer to question ft 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):
L"3U)+ JL'11V ah 5- [CK- *UJI * Keep wg5fe Ppl/Y11
OL P r0 �0 I CAY\ Y CA-. 1p 4 V
v� -nee, c r h-d Of 'i5 -e �S�t r ►� ~f- Fr-ovn 1owar cb rfn
t� uk U S#_ SiND_ ` +�Q ' E�
R vi a Inspector Name
Phone: ��
Revi w 1 nspector Signatu e'
Date:
i l -I - " _j 12128104 Continued

Facility Number: �.r
Da of Inspection
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
XNo
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAV4/4 readil available? If yes, check
El
WNo
[I NA
❑ NE
the appropiiate box. ❑ WUP ❑ Checklists w Tn s El Desig Maps ❑Other
21.
Does record keeping need improvement? Jf yes, check the appropriate box below. Yes
El No
El NA
El NE
❑ Waste Application ❑ Weekly Freeboard ❑ Wastee Analysts ❑ Soil Analysts ❑Waste
Transfers
❑Annual
Certi#ication
aAA4 X
Rinfall.❑ StoVng ElCr�ield 120 Minute Inspections Monthly and I"
Rain Inspections Weather Code
22.
Did the facility fail to install and maintain a main gauge?
❑ Yes
(No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
ANo
❑ NA
❑ NE
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
XNo
❑ NA
❑ NE
25.
Did the facility fail to conduct a sludge survey as required by the permit?
El Yes
❑ No
D<NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
1pfNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certif cation?
❑ Yes
*o
❑ 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 andlor document
❑ Yes
P(No
❑ NA
-❑ NE
and report the mortality rates that were higher than nonnal?
30.
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
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
XNo
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
[ No
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
El Yes
No
❑ NA
❑ NE
' 'onal Comments and/or Drawings:
PCSo I I s �?"� ) iN a*,04 145 - � t � a �-�� cow-
0, q 3
a
J_ !
212810
C

nical Assistance Site Visit Re
Dion of Soil and Water Conservation
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number 17 - Date: $13104 Time: 1 11:00 Time On Farm: 75 WSRO
Farm Name John Shumaker Dairy Farm, Inc. County Caswell
Phone: [phone]
Mailing Address 1246 County Home Road Blanch NC 27212
Onsite
Representative John Shumaker 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 DSWCISWCD 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
El
Feeder to Finish
El Layer
❑ Non -Layer
❑
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
® Dairy
❑ Non -Dairy
® Dairy
❑ Non -Dairy
200
❑ 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 Ono
requiring DWQ notification?
b• Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes Ono
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier Primary I I Secondary
Level (Inches) 18 11 58
CROP TYPES Corn, Silage Ismall grain silage Fescue -graze Fescue -hay
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

0
Facility Number 17 - 7 Date:
8/3/04
PARAMETER
QQ No assistance provided/requested
❑ 8. Waste spill leaving site
❑ 9. Waste spill contained on site
TECHNICAL ASSISTANCE Needed
Provided
El 10. Level in structural freeboard
25. Waste Plan Revision or Amendment
El
❑ 11. Level in storm storage
26. Waste Plan Conditional Amendment
❑
❑
27. Review or Evaluate Waste Plan w/producer
El❑
El 12. Waste structure integrity compromised
❑ 13. Waste structure needs maintenance
28. Forms Need (list in comment section)
❑
❑
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
❑ 15. 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. Latelmissing waste analysis
❑ 19. Latelmissing lagoon level records
33. Organizelcomputerization of records
❑
❑
34. Sludge Evaluation
❑
❑
❑ 20. Latelmissing 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 sprayfield 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 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 • The waste plan was revised on 4-02-03 to add
47. Evaluate WAD certificationlrechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
fields and crops.
2.
49. Drainage worklevaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5.
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

0
IFacility Number 17 - Date: 1 8/3/ I
COMMENTS:
Waste analysis: 4-15-04 (upper) LSD 5.7 Ibs.N/1000 gals. B, 3-17-04 (lower) LSD 1.2 Ibs.N/1000 gals. I
Last soil samples, dated 10-28-03, look good. 11
The facility and records look good overall. Good farm.
TECHNICAL SPECIALIST lRocky Durham
SIGNATURE
Date Entered: 8/4/04 Entered By: JRREkj Durham
3 03/10/03

Division of Soil —
and Water Conservation
0 Other Agency
Type of Visit 0 Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit 0 Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 17 7 1)a►e or Vki►: 3/10/2004 Time: Ei94+}
N'ut O ►erational 0 Below Threshold
M Permitted M Certified 0 Conditionally Certified 0 Registered pate Last Operated or Abuve 'threshold:
Farm Name: Johm.�btumat�ex.RaaxS:.Fa> tn,.ln�.......................................... Count-,.: C-4slr_ell----------------------------------- )'.Y; .Q--•--•
Owner Name: ,l4bri-----------Sattuttaker------------ Phone No:33�_�43__4Q31----------------
Mailing Address: ..1.�..4.�.�ou.ntx..H.Qme..Road................................................................ B.la.figki'K.............................................................. VZ12 ..............
Facility Contact: Jobn5bujuaker..................................'Title: ............................................... Phone No: 33.6ffl.4,7.333..................
Onsite Representative: d9hv_Shlla3akel------------------------------------ Integrator: -------------------------------------------•
Certified Operator: ,lObm.Al................................. shtLmaRer ....................................... Operator Certification Number: 2.1.633.............................
Location of Farm:
JS Hwy 158 east past Yanceyville, cross Hwy 89, and road tuns into County Home Rd. Farm is on right.
❑ Swine ❑ Poultry 0 Cattle ❑ Horse Latitude 1 36 • 25 2$ Longitude 79 • 19 I 42
Design Current
Swine Canarity Pnnnlatinn
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Number of Lagoons 0 2
Design Current Design Current
Poultry Cavacitv Population Cattle Capacity Population
❑ Layer 0 Dairy 200 155
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 200
Total SSLW 280,000
Discharges & Stream lmpacts
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. Ifdischarge is observed, did it reach Water of the State'? (Ifyes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ....... Prgmar.y_....... ...... S=ondary..... -----•--•--•--•--•-----•-- --------------------------- ---------------------------
Freeboard (inches): 16 35
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
Structure 6
12112103 Continued

Facilih' Number: 17-7 Dale of Inspection 3/10/2004 •
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or ❑ Yes ® No
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need 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 Applicalion
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 Small Grain (Wheat, Barley, 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
Odor Issues
17. 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 #): 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 ® Final Notes
16. Morris Shambley (of Ef7and, NC) does some application fpr Mr. Shumaker.
+
16. Operator to replace broken reel gauge. Gauge on the irrigation gun is ok.
23. Records look great. Don't forget to obtain waste sample for March 2004 applications, though. Will need to obtain 2004 soil
samples by Dec. 31, 2004. Check next visit.
T
Reviewerllnspector Name Me1'ssa Rosebrock
Reviewer/inspector Signature: ,w1hALIrcl)Date: 131101 Q
12112103 L Continued

Facility Number: 17-7 of Inspection 311012004
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 ail 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 I" 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.
12112103

ivicinn of Avafpr.niteity ,
�ivision of Soil and;Wateir, Conservation
Q Other Agency
Type of Visit A Compliance Inspection Q Operation Review Q Lagoon Evaluation
Reason for Visit %) Routine Q Complaint Q Follow up 0 Emergency Notification Q Other ❑ Denied Access
Facility Number ()ate of Visit:419 Time:
O Not Operational O Below Threshold
Permitted © Certified [3 Conditionally Certified (] Registered Date Last Operate or Above T]hr hold : ........................
D
Owner Name ...... Phone No: °.�..'....
Mailing Address:....L -
............ flaryw-'a. ...
Blanch ...... !��C_' ........................... a..-7..,21 -�-
.......................
Facility Contact: ►!�.......��- ..�tle:................ Phone No• ,310 •..�p�f...L................
Onsite Representative:JDi.....1.C.1 Q.`"................................ Integrator:... ...... ............... ............................................................
Certified Operator:.. '.5- n....---M......... ��.t �..� (.� �- ��........ Operator Certification Number: ......... a` ! �e.3.3......
Location of Farm:
❑ Swine ❑ Poultry �Cattle ❑ Horse Latitude �• ®� ��� Longitude �• «
Designn__ - . Current Design Current'_.' Design Current: .
Swine ::Ca -city. Population Poultry Capacity: Population-,- .Cattle, :Capacity: -Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
of. Lagoons' T
~• Hniiiino Pnndc / gnGel Tram
N
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'?
Non-
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
j� Structure 1 tructure 2 Structure , Structure 4 Structure 5
Identifier: 1...r.� ........ aea - ..V....................... ............. .......
Freeboard (inches):
❑ Yes IXINo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
IXINo
❑ Yes
YNO
❑ Yes
Alfo
Structure
6
12112103 Continued

Facility Number: Amok Date of Inspection
0
W
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
V0
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
(No
10. Are there any buffers that need maintenance/improvement?
❑ Yes
(
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
13. Do the receiving crops differ lith those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
o
14. a) Does the facility lack adequate acreage for land application?
ElYes
ONo
b) Does the facility need a wettable acre determination?
❑ Yes
No
c) This facility is pended for a wettable acre determination?
❑ Yes
No
15. Does the receiving crop need improvement?
El Yes
o
16. Is there a lack of adequate waste application equipment?
❑ Yes
XNo
Odor Issues
I7. 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 No
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, El 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.
Cominents_(refer to question#)i Explain any YES°ansi ers annd/or:any recommendations onany other comments..
:Use drawings of facility .to better explain situations` (use:additional-pages as.necessary): �� Field Copy v❑ Final Notes
r /off. z �
d
Reviewer/Inspector Name
Reviewer/Inspector Signature:
12112103
Date:
Continued

y i Facility Number: 1 L_ '7 i of Inspection 31
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
X No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
*o
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
N
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
��❑
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 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
II! No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. j
dditional Comments :an or'. ravings:.
l&
12112103

� vtston of Water.Quality v
d'Division of Soil and Water.Conservation
0:Other Agency
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
Rafe of Visit: 11/13l2t1o3 Time: itltlo
Facility ,Numhcr l7 7
0 Not O erational 0 Below''I-hreshold
{� Permitted ® Certified [3 Conditionally Certified [3 Registered Date Last Operated or Ahove'l'hreshold: ....---.--...
Farm Name: J9hn..Shuma ex.Aaa�ry..F.arm,.lnc,......................................... County: C_aawcU ----------------------------------- yYW�.O...._.
Owner Name: dvhu6ttttt�user-----------___----------- Phone No: 33k_k2�c_4Q32------------------------------
Mailing Address: .1.Z.4.G..�ou.otx..li.Qlme..Road................................................................ Mam.101iG............................................................... U2.1Z ..............
Facility Contact:JQhn.SburlUu3kkr...................................I'itle:............................................... Phone No: 33G,69.4,7.333.(Baritl)......
Onsite Representative: ,l9hn_Shuu181;�rIntegrator: ---------------------------------------_-_--
Certified Operator.Joh.n..i................................. ShIlmaher ....................................... Operator Certification Number: 2.1.{3.3.............................
Location of I -arm:
JS Hwy 158 east past Yanceyyille, cross Hwy 89, and road tuns into County Home Rd. Farm is on right. A
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 ' 25 28 Longitude 79 • 19 , 42
Design Current
Swine Canacitv Ponulation
❑ 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 200 1149
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity 200
Total SSLW 280,000
Number of Lagoons 1 0 10 Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 0 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation'?
Discharge originated au ❑ Lagoon ❑ Spray Field []Other
a. If'discharg,e 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 D11'Q)
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 S Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? to Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ------- Plunary........ ...... Sacuudary.--•---•--•--•-----•--•--•------•--•--•--•--• • • •---- ---•--•--•--•--•--•--•--•--
Freeboard (inches): 12 48
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
05103101 �'sI P Continued

Facility Number: 17-7 , Dale of Inspection 11/13/2003
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement'?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
I. [s there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Corn (Silage & Grain) Small Grain (Wheat, Barley,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application'? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
®No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available'?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design'?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
IN 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
IN No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question ##): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑ Field Copy ®Final Notes
8. Run-off from corner of pen and silage trench looks ok this year.
_
16. Shambley Farms does pumping for facility on occasion. Operator does his own irrigation.
19. Records look great!
6/16/03 Waste analyses: LSD=0.24 lbs. N/1000 gal. and FCD=3.4 lbs. N/ton
10/24/03 Waste analyses: Lower, LSD=0.56 lbs_ N/1000 and Upper Composted Waste, FCD=3.4 lbs. N/ton.
2003 soil test results look ok.
Reviewer/Inspector Name MOW Rosebrpck
AVIReviewerllnspector Signature: Date:
05103101 Continued

1 Facility Number: 17-7 1 1).& Inspection 1111312003
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'?
2$, 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?
Additional Comments and or Drawings:
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
[:]Yes ❑ No
❑ Yes ❑ No
0510.3101

""` 4 �- fr
n 1]n �szon of Soil and �'VaterCtnservation
', � _
O o therrlgency..
•' � F
IType of Visit P Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Fallow up ()Emergency Notification O Other ❑ Denied Access
Date of Visit; i ime: i
Facility Number
Nlitbt O erational 0 Below Threshold
[Permitted 0 Certified © Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: County: ��f/
Owner Name: 0 1� Phone No 9)13,3 [/ P . 104. 't 6 3
Mailing Address: 4lt�x J 7a
Facility Contact: -TO bVI t) 14a—V-2-flitle: Phone No: '
Onsite Representative: t )MO 1 LPJ, _ Integrator:
5h
Certified Operator: Tf��� 11 0A 6 Operator Certification Number:
Location of Farm:
❑ Swine ❑ Poultry yCattle ❑ Horse Latitude E�' �' ®" Longitude ®0 . 1 1 66
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Capacity Population
❑ Wean to Feeder
❑ Layer
Dairy200
El Feeder to Finish
❑ Non -Layer
I
I
ILI Non -Dairy
El Farrow to Wean
El Farrow to Feeder
Other
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
Total SSLW
2$p oo a
❑ Boars
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes 4NO
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)
c. If discharge is observed, what is the estimated flow in gal/min?
d, Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
Structure I Structure Structure 3 Structure 4 Structure 5
Identifier: COI'1
Freeboard (inches): - `
05103101
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ Yes
No
Structure 6
Continued

Facility Number: , --7 Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑Yes )(Noseepage, etc.)
6. .Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes No
(I€ any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify D«'Q)
7. Do anv of the structures need maintenance/improvement? ❑ Yes X1110
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
elevation markines? ❑ Yes WNo
'*Vaste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes > No
11. Is there evidence of over application? Excessive Ponding ❑ PAN ❑ hydraulic Overload ❑ Yes No
12. Crop type
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA'A'MP)?
❑Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑Yes
No
b) Does the facilin, need a wettable acre determination?
❑ Yes
No
c) This facilin• is pended for a wettable acre determination?
❑ Yes
No
15.
Does the receiving crop need improvement?
❑ Yes
No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
D<No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
IVUP, design,
❑ Yes
No
(W checklists. maps. etc.) ✓
19.
Does record keeping need improvement? (iel irrigation, free -board, waste analvsis & 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 facilin- fail to have a actively certified operator in charge?
❑ Yes
N,0
22.
Fail to notifi- regional DWQ of emergency situations as required by General Permit?
(ie" discharge. freeboard problems, over application)
❑ Yes
gNo
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
t!�No
25. Were any additional problems noted which cause noncompliance of the Certified AVVMP? ❑ Yes ANO
10 No violations or deficiencies were noted during this visit, You will receive no further correspondence about this visit.
Coniments (refer to gne§hon answers�andlor. any reroarmendatrons or:any o er c6mmeuti4
%se drawings of facalit} to better ezplarn situations (use additional pages as necessan) Field Coy Final Notes
r�
�:.--.�...•--'*r---�,�...- --_Lm -%«i:»
Reviewer/Inspector Name
Reviewer/Inspector Signature:
Date:
r
05103101
Continued

.1 4 0 0
• Facility Number: — Date of Inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
X 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?
Additional Co meats and/or Drawings:
6fff• r r "v 4./ i.Ch-lam- � �C/[J I
l &
Cpj.-)
N/l000
v ppzr - ,3, s . N
& /rp /0-
3
N/ To N.
0,003 A�
G
11
❑ Yes No
❑ Yes No
F

nical Assistance Site Visit Report
❑Wean to Feeder
El Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
• DivliWh of Soil and Water Conservation 'W
O Natural Resources Conservation Service
O Soil and Water Conservation District
Other...
Facility Number 17 - �7 Date: Ii3103 Time: 1 9:15 1 Time On Farm: 100 WSRO
Farm Name John Shumaker Dairy Farm, Inc. County Caswell
Mailing Address 1246 County Home Road Blanch NC
Onsite
Representative John Shumaker 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
Phone: [phone]
Purpose Of Visit
pp 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
0 Other...
Design Current Design Current
Capacity Population Capacity Population
❑ Layer
ElNon-Layer
® Dairy 200 144
❑ Non -Dairy
❑ Other
27212
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
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier Primary Secondary
Level (Inches) 65 30 1
CROP TYPES hmall grain silage I 1corn, Silage Fescue -graze Fescue -hay
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03
• DivliWh of Soil and Water Conservation 'W
O Natural Resources Conservation Service
O Soil and Water Conservation District
Other...
Facility Number 17 - �7 Date: Ii3103 Time: 1 9:15 1 Time On Farm: 100 WSRO
Farm Name John Shumaker Dairy Farm, Inc. County Caswell
Mailing Address 1246 County Home Road Blanch NC
Onsite
Representative John Shumaker 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
Phone: [phone]
Purpose Of Visit
pp 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
0 Other...
Design Current Design Current
Capacity Population Capacity Population
❑ Layer
ElNon-Layer
® Dairy 200 144
❑ Non -Dairy
❑ Other
27212
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
Structurel Structure 2 Structure 3 Structure 4 Structure 5
Identifier Primary Secondary
Level (Inches) 65 30 1
CROP TYPES hmall grain silage I 1corn, Silage Fescue -graze Fescue -hay
SPRAYFIELD
SOIL TYPES
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

•
0
ber 17 - 7 Date:
5113103
ER
0 No assistance provided/requested
ste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
ste spill contained on site
rE_E
in structural freeboard
25. Waste Plan Revision or Amendment
❑
❑vel
vel in storm storage
26. waste Plan Conditional Amendment
❑
❑27.
Review or Evaluate Waste Plan wlproduceraste
structure integrity compromisedaste
28. Forms Need {list in comment section)
❑
structure needs maintenance
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
30. 21-11.0200
❑
❑
❑ 15. Over application < 10% or < 10 lbs.
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. Organize/computerization of records
❑
❑
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
[121. 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 sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker checklcalibration
❑
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
43. Irrigation design/installation
El
El
❑ 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- The waste plan was revised to add additional
47. Evaluate WAD certificationlrechecks
❑
❑
48. Crop evaluationlrecommendations
❑
❑
fields to apply solids on.
2
49. Drainage work/evaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
3
52. Buffer improvements
❑
❑
53. Field measurements(GPS, surveying, etc.)
❑
❑
4.
54. Mortality BMPs
❑
❑
55. Waste operator education (NPDES)
❑
❑
5.
56. Operation & maintenance education
❑
❑
57. Record keeping education
❑
❑
6
58. Crop/forage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/ 10/03

Facility Number 17 - l -J Date: 1 5/13/03
COMMENTS:
Waste analysi - upper) 4.0 Ibs.N/1000 gals. B, 5.6 S.I., LSD (lower) 1.4 Ibs.N/1000 gals. I
2-17-03 LSD ower) 0.76 Ibs.N/1000 gals.
Facility and r�Iookedood.
Supplied Mr. Shumaker with some slurry II forms.
TECHNICAL SPECIALIST lRocky Durham Mitch Thompson
SIGNATURE
Date Entered: 5/16/03 Entered By: lRocky Durham
3 03/10/03

tonkof Water Quality 9,
ion of Soil and Water Conservation
Q Other Agency
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 17 07 Date of Visit: tli7/2t�2 'Time: 0930
Q Not Operational Q Below Threshold
® Permitted ® Certified 13 Conditionally Certified .0 Registered Date Last Operated or Above Threshold- .........................
Farm Name: ... ...............................
Owner Name.JjohR........................................ Shomkelr................
Mailing Address: 1Z4.4..Qouiat3:.khta=.t Qad........................................
Facility Contact: ............................................Title: --.
Onsite Representative:JQbjj.$hulnkei:..................
County: CA5WCj1.............................................. W,SRO........
Phone No: 33.fi-694-49...........................................................
VI.4MUS.0............................................................. ZN.it.2..............
.. Integrator:
Phone No: 33669.4723.3.ktatm.............
Certified Operator: dslktAl.1.l'1.................................. SImmaicex....................................... Operator Certification Number-,Z16.33 .............................
Location of Farm: _
US Hwy 158 east past Yanceyville, cross Hwy 89, and road tuns into County Home Rd. Farm is on right.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 25 6 28 46 Longitude 79 •' 19 1 42
Design Current
Swine Canacitv POnulation
❑ 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 IN Dairy 200 128
❑ Non -Layer JE1 Non -Dairy
❑ Other
Total Design Capacity 200
Total SSLW 280,000
Number of Lagoons 0 ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 2 10 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 dischar=e 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-al/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? IN 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: ......-....Solt ........... ....... ..Liquid ................... ...............................................-.....................................................................................
Freeboard (inches): 24 66
05103101 9�� Continued

Facility Number: 17-07 Date of Inspection 8/7/2002
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,
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy ® Final Notes
3. Still getting some run-off from an empty, lower cattle lot nearest the creek. Run-off of sediment and waste has not reached creek yet.
Suggest letting this area re -vegetate before putting cattle back on the lot.
3. Appears that silage leachate from the silo nearest a drainage ditch may be getting into the ditch. Suggest cutting a diversion to run
aarallel with the creek after the silo is filled to contain the "everyday" leachate.
3. Run-off of manure from the lot was noted on the stocktrail area nearest the upper waste pond. Suggest extra wood or concrete curbing
:o be added.
19. 3/15/02 Waste analysis: Broadcast=8.5lbs. NI1000 gal. Irrigation=2.2 lbs. N/1000 gal.
Reviewer/Inspector Name 'Melissa Rosebrock j
Reviewer/Inspector Signature: �]/] 1 Date:
05103101 Continued

. Facility Number: 17-07 I)a01nspecIion 8i7/2d02 •
Qdor 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
It10 �'Omme t$A8I1 _Ot: r�awIn _. _.."r'T
05103101
05103101

,3a
Division of Water Quality
Division of Soil and Water,Cunsetvation
0 Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Lagoon Evaluation
Reason for Visit Routine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other ❑ Denied Access
Facifih• Number
"ate of' Visit: D= Time.
Not Operational 0 Below Threshold
0 0 Permitted Certified [3Conditionalli Certified ❑ Registeredll pate Last Operated or Above Threshold:
Farm Name: S6) K1GZ�� �l r Tmc. County: - L a
j,, I _ Owner Name: -ld I 1 n � 1 l U �.-� )Phone No:: -3 36. 6 ! Q iJ • r `j , Z
Mailing Address: a Ono
Facility Contact:,, v , Title:
Onsite Representative: � h n Sk U aw -�.r �-
Certified Operator: � �b _ n 0 ho C.t4a.4 _
Phone No:� /� ' � 3�
Integrator: oft)a e��. V nG+• �
Operator Certification Number: ;,, 16 3
Location of Farm:
u Hwy is-8 Gqs yanceyv► ri � -
ElSwine ❑ Poultry Cattle ElHorse Latitude Longitude ' `III
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Capacity Po ulation
❑
_ _
Wean to Feeder
10 Laver
Dairy
oZ 00
❑
Feeder to Finish
10 Non -Laver
❑ Non -Dairy
❑
Farrow to Wean
❑
Farrow to Feeder
❑ Other
❑
Farrow to Finish
Total Design Capacity
02 dd
❑
Gilts
Total SSLW
❑
Boars
Number of Lagoons ®' ❑ Subsurface Drains Present ❑ La oon Area 10
Bolding Ponds! Solid Traps ❑ No Liquid Waste Management System
Spray Field Area -
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
El 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 ves, 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 ves, 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
X Now
N aste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? Spillway
ElYes
No
Struc e 1 Spuerure : Structure 3 Structure 4 Structure 5
Structure b
Identifier: Sales Ul�
Freeboard (inches):
05103101
Continued
\ la

Facility Number: f % — �] Date of inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any sructures 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 Q PAN ❑ Hydraulic Overload
12. Crop type '
13. Do the receiving crops differ with those designated in the CA
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?
Animal Waste Management Plan (CAWMP)?
16. Is there a lack of adequate waste application equipment?
Re uired 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? (ic/ 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 AR'MP?
❑ Yes KNo
❑ Yes
I''lo
❑ Yes
A No
,Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ Yes
No J
c
❑ Yes gNo
❑ Yes X No
❑ Yes No
ElYes No
❑ Yes XN .ElYes No
❑ Yes �No
❑ Yes �1vo
❑ Yes "Wo
❑ Yes j{1S�J No
❑ Yes )�No
❑ Yesio
❑ Yes JX No
❑ Yes o
❑ Yes X No
[] 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 Conv Final Notes
J_
11
Reviewer/InspectorHame _e _ � _ ..__ _ ......_w _.� _ __V _.Y.,.�•..._ _ ..._„ w_ _ ._ _.� _..._, e� .
Reviewer/Inspector Signature: Date: Q
05103101 Continued

Facility \umber: Date of Ins1weticin
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? 4
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?
Additional Comments andler Drawings:
_A't�
CIJ
. A411-1�
�-
4�
iq 3riSf baOtffaALtA_4t, g. s �/V�iaoo
,O 2J2 I (�; _ ? • a 'W Al//00o goQ•
0
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes . rNo
❑ Yes -'WNo
19-yrr—ET'no
05103101

ion of Water Quality
Q ion of Soil and Water Conservation
Q Other Agency
Type of Visit Q Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit OO Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Dale (IF �'isi,: 2Jt3/2001 'I'inu.: 0945
17 07
Q Not Operational O Below Threshold
® Permitted ® Certified [3 Conditionally Certified 0 Registered pate Last Operated or rlbr»e Threshold: .........................
FarmName: ......................................................... County: GaS:elf.............................................. }Y,SW. ....
OwnerName: Jaltnt........................................ sbumalk.1m ................................................. Phone No:b-f9.-403Z..........................................................
Facility Contact: J.s b a5himUr ............................. ....Title:............................................................... Phone No: 3.3b&9.4..7.,3,3..............
Mailing Address: .12.4.4.Co��nxx.kIa�ne..Roac1................................................................ blaingb IC.............................................................. MU....
Onsite Representative: .Ioh.n.5bkt. laakgjr............................................................. ............ Integrator:.......................................................................................
Certified Operator:.Iola........................................ 5humakin...................................... Operator Certification Numher:z,,63.3............... I.............
Location of Farm:
I mile North of Yanceyville. Eastside of County Home Rd. 1/2 mile east of Fire Tower Rd. +
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 36 " 25 2811 Longitude 79 G 19 ' 42
Design Current
Swine Capacity Pnnulation
❑ 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
1 ❑,Layer ® Dairy 200 120
CO Non -Gayer IM Non -Dairy
❑ Other
Total Design Capacity 200
Total SSLW 280,000
Number of Lagoons 0 10 Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 2 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
DischarL�e originated at: [-]Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. 11 discharge is observed. did it reach Water of the Slaie? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed. what is the estimated flow in galhnin?
d. Does discharge bypass a la��oon system? (If yes. notify DWQ) El Yes [I 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
UI/UI/UI � ��� � Continued

Facility, Number: 17-07 Date of Inspection F 2/8/2001
Taste 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: ...........5..t?.j1d.5....................... 6dSiUlA.......... ............ ..
Freeboard (inches): ..............13. ..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 Wheat 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
17. Are rock outcrops present?
❑ Yes
❑ No
18. Is there a water supply well within 250 feet of the spraytield 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? (iel 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
IN 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

Facility Number: 17-07 17n*11spectinn 2/8/2001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
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_)
33. Do the animals feed storage bins fail to have appropriate cover'?
34. Do the Flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Printed nn; 2/9/2001
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
01/01/01

E
of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
n for Visit Routine O Complaint O Follow up O Emergency Notification O Other p Denied Access
Facility Number Date of visit: og Time: �)
�( O Not Operational O Below Threshold
® Permitted 0 Certified © Conditionally Certified p Registered Date Last Operated
Qorr Above Threshold: ............. Q
/Farm Name: ...-3i��.n.. �.i. i i.Ir.t�....Fetrm n�C . Count':..... v....�.. r..�r.L.................. l -d
Owner Name: .... Q.Il.%Z....ij.ti1C4 -1..... ... .. .. Phone iVo:..t0 �1..................................................
....
Facility Contact:.. .hr .....f)Il 1S C}<x- X`......,Title: ..�. 9 ,...7
Mailing Address:.... �.. P...4................................. T.Lf........14W E... �.DA� t.......�..�.-At. - ..Nc .............. .�. .I. ......
Onsite Representative: ... .-.1.Q.hl!1..._._._ . /k�..1�"�!.......................... integrator:. luU.1.l�..... .+;-m-a. � ...:....[1 .....
Certified Operator: ........ TDh,.f1........ kk-,,..... -5.h ................... Operator Certification Number:......0-.�.�p.,,3. ......
Location of Farm:
1.3 Miles NE w Y 1 4-tt S o 512157� COUNTry fidU6
1Q t3 a C i 11Q ICU 2. 1 f �e O
trQ Latitude' �' �'� Longitude•
El Swine ❑ Poultry Cattle Horse
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 Dairy (�
❑ Non -Layer Non -Dairy
❑ Other
Total Design Capacity a-
.TOta1=SSLW
Number of Lagoons ❑ Subsur face Drains Present ❑ Lagoon Area ❑ Spray Field Area
Haldtng Ponds"/, Solid Traps oZ- ; ❑ 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 ycs, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'
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`?
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes []No
❑ Yes KNo
❑ Yes XN0
01/01101 Continued

I?acility, Number: 17 — � � ;)ate of Inspection
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:
.. ............j
Freeboard (inches): ..........�.. lP.................:�..:. ...........--•------..-.-..-...--- -. - .-
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type V}IN-e cck ( W At) ern
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?
17. Are rock outcrops present?
18. Is there a water supply well within 250 feet of the sprayf eld boundary?
❑ On -site ❑ Off -site
❑ Unknown
Required Records & Documents
19. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
20. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
21. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
22. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
23. Did the facility fail to have a actively certified operator in charge?
24. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
25. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
26. Does facility require a follow-up visit by same agency?
27. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Odor Issues
28. 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?
❑ Yes �j No
Structure 4 �
❑ Yes ko
❑ Yes �No
❑ Yes ANo
Yes ❑] No
❑ Yes XNo
❑ Yes A No
❑ Yes [VNo
71
❑ Yes KNo
❑ Yes jj�No
❑ Yes kNo
❑ Yes .kNo
❑ Yes KNo
❑ Yes ANo
❑ Yes 0 No
❑ Yes XNo
❑ Yes A No
❑ Yes CW1Qo
❑ Yes li-No
❑ Yes A No
❑ Yes o
❑ YesTNo
o
❑ Yes
Yes ❑ No
29. Are there any dead animals not disposed of properly within 24 hours?
01/01/01
❑ Yes A No
Continued

Facility Number: j'7 — 0 1? Inspection
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
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.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Printed on: 1/4/2001
❑ Yes JVNo
❑ Yes N No
❑ Yes XNo
❑ Yes XNO
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #):A Explain'any YES answers and/oi any recomrreendations or any other. commentst;:
7. ., ram. r
Use drawings of facility to better explain situAions. (use additionat pages as -necessary) i � Field Copy Final Notes t
SO_,V.4p)eS LA S e>(
I'70 ka UP*1i'2-eO l0 �-d0 0
5- 1 ey eu-
1� fej .
1 fi r o -4-- Z na Pe s o
1&_0 c c SeS o—re- not
3000 N dcx'.P� l l C (,i_;l4J C 1" 5
ago bat fe-- Pt Pe
LO KuN po tiped a ova V) `T(� ► 5
Reviewer/Inspector Name
Reviewer/Inspector Signature:
6 0'C y� If.
is a O4fe- rl Ievef
5 ViL' `4
Date: 1- / S / b
01/01/01

vision of Water Quality
vision of Soil and Water Conservation ,1}
Other Agency Natural Resources
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
Date of Visit: 12/7/2000 Till -Re: e: Printed on: 1/30/2001
17 7
0 Not Operational 0 Below Threshold
® Permitted 0 Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ••...••••••.....
Farm Name: , ....................................................... County: G�lSkteal...... ....................................... �h�SQ...... ..
OwnerName: dobn........................................ Slxtat ukrr.................................................. Phone No: 9.1Q- �4-4Q 2...........................................................
FacilityContact:..............................................................................Title:................................................................ Phone No:...................................................
Mailing Address: x244.QQmaty.H9.mc.Road................................................................ Mauch.N.0 .............................................................. Z.7.212 .............
Onsite Representative: John.5.1mmker.
Certified Operator:JQbrx...........
Location of Farm:
................................... Integrator:
S]t411A akv, :....................................... Operator Certification Number: 2,1(33................. ..
I mile North of Yanceyville. Eastside of County Home Rd. 112 mile east of Fire Tower Rd. +
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 36 • 25 30 Longitude 79 • 19 ' 45
Design Current
Swine Capacity Pouulation
❑ 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 I 200 120
❑ Non -Layer I I JE1 Non -Dairy
❑ Other
Total Design Capacity 200
Total SSLW 280,0o0
Number of Lagoons ❑ Subsurface Drains Present ❑ t.agaon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 2 10 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. (lid it reach Water of the State'? (If yes, notify DWQ) El Yes ❑ No
c. If discharge is observed. what is the estimated flow in Ial/rnin?
d. Does discharge bypass a lagoon system? (Il' 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 5 Structure 6
Identifier:.....................................................................................................................................................................
eeboard (inches): 20 - --- -
�5/00-- - - - ---- _ Continued on -back—

'i
1
Facility Number: 17-7 Date of Inspection 12/7/2000 Printed on: 1/30/2001
411rity
5. Are there any immediate threats to the 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 maintenancelimprovement?
❑ Yes
® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crop type Corn (Silage & Grain) Rye Fescue (Graze) Fescue (Hay)
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
t5. 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?
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
0; Nd vidlatidris;oir deficiencies-were.noted during this, visit. ;You;will iecewe no further ; ;
corres ondence: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):
Reviewer/Inspector Name Warren Mincey
Reviewer/Inspector Signature: Date: 5/00

Facility Number: 17-7 1) f Inspection 12/7/2000 Printed on: 1/30/2001
( dor Issues 0 0
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, buildings 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,

0 Division o and Water Conservation - Operation Revs
0 Division oa. and Water Conservation - Compliance InWon
Division of Water Quality - Compliance Inspection
0 Other Agency - Operation Review
10 Routine 0 Complaint 0 Follow-up of DWQ inspection 0 Follow-up of DSWC review 0 Other
Facility Number 17 07 Date or Inspection F 3/16/2000
Time of inspection 1030 24 hr. (hh:mm)
® Permitted 0 Certified E3 Conditionally Certified 0 Registered 113 Not Opera Date Last Operated:
Farm Name: ................................................... County: CAS-Agll.............................................. W.SRQ........
.....
OwnerName: dohit......................................... Shtumaker................................................. Phone No: 33.649.4.-40N......_....................................................
Facility Contact: Jolin ShIAMali r............................................ Title:S)!Y.[led.0.ptratoir........................... Phone No: fAr m.,33.C..69.4..733.3............
Mailing Address: J244.C.Qmuty.QA.mttw.l QAd............................................................... BlaptCfINC.............................................................. 2=2 .............
Onsite Representative: ,1Q�Al.Shultil)tt*......................................................................... Integrator:
Certified Operator: ,hQ)am.J,1'1.................................. ShUmAku ....................................... Operator Certification Number; ZXG33.............................
Location of Farm:
--- 39E
Latitude 3b ° ZS { 30 46 Longitude 79 ° 19 45 44
Design Current
Swine Canacitv Ponulation
❑ 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 200 139
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 200
Total SSLW 280,000
Number of Lagoons I I ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds I Solid Traps 2 ❑ No Liquid Waste Management System
Discharees R Stream Impacts
I. is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. II'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 i Structure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier. Secondary -solids Primary -liquid
Freeboard (inches): ................3.6...............................3.6...................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
Continued on back
Printed on 3/21/2000
3/23/99
-# .a 73 7 !�'A

Faciliiy Number: 17-07 1 o1' Inspection
6. Are there structures on -site which are n0properly addressed and/or managed through ae 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
F3n6/200a
[]Yes
® No
❑ Yes
IN No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
12. Crop type Wheat Corn (Silage & Grain) Fescue (Graze) Fescue (Hay)
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?
Rer aired Records & Document
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?
®: Np•yibl_ations:or defcieneies•were;noted during•this: visif::You:will �eceiveno-fti_rth�er�:-:•
correspolidence: 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
conditional approval due to waste application and handling equipment. To be installed by 3/31/98. Has been installed and
aste samples taken 10/01/99 (irrigation) and 1 1/17/99 (broadcast). 5/13/99 application not within 60days.
61 test 05/14/99.
to large groundhog hole between two ponds needs to be repaired.
pall amount of sileage runoff noted. Buffered by several yards of grassed area.
Reviewer/Inspector Name EMelissa Rosebrock
Reviewer/Inspector Signature: Date:
Printed on 3/21/2000

Facility Number: 17-07 of Inspection 3/1fi/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
IN 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:
r
7
Printed on 3/21/2000

zY F:
D Division o and'Water.Conservation - Operation'Re• �-
:, Q°�IY1510nr0 ii andvWater Conservation_ = Compliance Ins Ctlon
, . a Division of Waier' Quality - Compliance Inspection
El Other Agency -Operation Review
Routine O Complaint Q Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection 103L&MO
Time of Inspection 24 hr. (hh:mm)
Permitted 0 Certified [3 Conditionally0 Certified Registered LE3LNpt O erational I Date Last Operated:
�`
Farm Name: .-TA.n........ 5. �'�..FF ....i l.r..1�......E LM...... Co nty:...........&.'Su : il..........................................
4 Owner Name: ... b....... . .............. Ph. q� 3P7....................................... N3' .........................(...
..)63
Facility Contact: ...:....... Tale Phone ...
........j...,.................................................... -................................................................ .........FF..... �
Mailing Address:...°..y..l.........CtSVn.�...... f .qn- ........[ .�... V1.0Ln.e.h.... NC— oZ22J.a...................
OnsiteRepresentative:........................................................................................................... Integrator:......................................................................................
Certified Operator: ...... q. h.fi.......Uh!jQ� ..................................... Operator Certification Number:......4.1...le..��.....
...... .......
Location of Farm: I ,
Latitude E•®' 0°6 Longitude L' �« 01— f t rL To wv. r-d .
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 l?o` ulation
❑ Layer Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design. Capacity.' P-0 a
Total SSLW; : _ Veo, 0 O CI
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 10 No Liquid Waste Management System
Discharges & Streann Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes No
Discharge originated at: ElLagoon ❑ Spray Field ElOther
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 ycs, notify DWQ) ❑yes ❑ No
c. If discharge is observed, what is the estimated flow in gallmin?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ) El Yes y❑l No
2. Is there evidence of past discharge from any part of the operation? ElYes No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes A No
Waste Collection & Treatment
4. Is storage capacity (freeboard pl storm torage) less than adequate? El Spillway ❑ Yes �iJ No
r Structure I So I��Sructure 2 Structure 3 Structure 4 Structure 5 Structure b
Identifier:}G�� `il Pt-tma" Crer++ oh)
Freeboard(inches): �f..................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes No
seepage, etc.) x
3/23/99 Continued on back

Facility Number: — • ol' Inspection
fr Are there structures on -site which are not properly addressed and/or managed through af!e 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?
S. 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? ❑ Excessivey,Ponding ❑ PAN l
12. Crop type �Drl V),% AV%J1►][.L�; Y�.Q.�'71 OC CQM
Cad
❑ Yes KNo
❑ Yes �(No
❑ Yes )� No
❑ Yes XNO
❑ Yes &No
❑ Yes F No
13.
Do the receiving crops ffer with those destgnate in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes No
b) Does the facility need a wettable acre determination?
❑ Yes No
c) This facility is pended for a wettable acre determination?
❑ Yes No
15.
Does the receiving crop need improvement?
❑ Yes No
16.
Is there a lack of adequate waste application equipment?
❑ Yes No
Required
Records & Documents
17,
Fail to have Certificate of Coverage & General Pert -nit readily available?
❑ Yes No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
'(No
(iel WiJP, checklists, design, maps, etc.)
❑ Yes
19.
Does record keeping need improvement? (ic/ 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 o
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?
'§�No
(ie/ discharge, freeboard problems, over application)
❑ Yes
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes )j(No
24.
Does facility require a follow-up visit by same agency?
❑ Yes No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes No
*i61*atit5iis'ot. deficiencies -W' re potted- dirrtrtg fhistvisit; - ;Y:otiwill-feeeive rid rui-ther - : :
: ;corre's• orideuce. about: this :visit: :::::::: :: :: ::: ::: ::: ::::: :: :: :: :
Comments (refer to,questibn #) Explain any YES.answers and/or,any recommendations or any other:comments.l
Use drawings, of -facility to betterexplain situations: (use'additional pages as,necessary)
4" CoAXOR,OnO.I Prova.1 aue- +0 6 p)iccdjor) q- hand Irh�c
ui P me-n+, To be i ns�&I kA 61 3-- 31-el
365 bad 5i-ora,3 e
F-SC oe - yoam a.ha l
Su m me r a- l.v t n •rr an�1_1
— � eaf
LL_VA15-ie. 6ow+le 5 iojo t q-9 - rri q a�oh �- I Il17�gcj roc �iCaS -
Reviewer/Inspector Name 4 o ,
Revi ewer/] nspector Signatur % I A A,r " .�i J# Date:

• Faci ity Number: of inspection 103
f F
0
-0doi- 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? QM ,T— awl)
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,
ElYes
)(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
x
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 �� a�0
❑ Yes
❑ No
AdditionalComments and/orDrawings:
.&I
56'11 Test- OS-/iq/97 e-�
fl oi-) - Was><-e oa mple cvi h;
�0o
d h 4&c�—
�1.et?d_s

e
Facility Number 17 7 Date of Inspection 5/28/99
Time of Inspection 1300 24 hr. (hh:mm)
13 Permitted ® Certified 0 Conditionally Certified 0 Registered JE3 Not O eratianal Date Last Operated:
Farm Name: ....................................................... County: CaN-AvA ............................................. WSRQ........
Owner Name: Jointt......................................... Slxujuak�x..........................................-...... Phone No: 334:694:403.2 ...........................................................
Facility Contact: Jolm,Shumakcr............................................ Title: QW.UCT .................................................. Phone No: 33.6_694nU.33 .......................
Mailing Address: A244.C.Qtanttx.t 9Me.Ru;ad............................................................... l3la�t�kx.. .............................................................. 2.7.2.1.2..............
Onsite Representative: JQU.Shuttllali,cr......................................................................... Integrator:......................................................................................
Certified Operator:JQbg.M.................................. Sttxuxtokfx....................................... Operator Certification Number:21(33.............................
Location of Farm:
.pnitl�. past.Q:f..l;az�..�:QK:�x..tid..........................................
....................................................................................................
Latitude 36 ' 25 30 f4 Longitude 79 • l9 4516
Design Current
Swine Canacity Ponniation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
I
IEEE
-
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer IN Dairy 200 165
❑ Non -Layer JE1 Non -Dairy
❑ Other
Total Design Capacity 200
Total SSLW 280,000
Number of Lagoons I JE1 Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Holding Ponds / Solid Traps 1 ` J ❑ No Liquid Waste Management System
Discharges & Stream Im ac
I. 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: pond pond
Freeboard(inches) ...............,?. ............... ...............24...................... .............. ............... ................ ......... ........... .................................... ............. I......................
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

t
Facility Number: 17-7 of Inspection 5/28/99
6. Are there structures on -site which are noTproperly addressed and/or managed through a w�te 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 Annlication
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Yes ® No
12. Crop type Small Grain (Wheat, Barley, Corn (Silage & Grain) Fescue (Hay) Fescue (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application`? ❑ Yes ® No
b) Does the facility need a wettable acre determination'? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Records_& Documents
17,
Fail to have Certificate of Coverage & General Permit 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
®; NOWAti6tis;or :deficiencies were;noted during this; visit;.• :Y6u:Will ireeeive n6 further
: cor:respondence: about this :visit. :: ::
l�UC-qsoemdmr�awii�ii�6ff�'c�ii�e�t'o.,Iietter,,exDlai'�
(refer to"question #):.Expla�n�anyYES ansv♦ers and/or ariy'recommendations or any other comments."
situations '(use.additional a ees as neces'sa ): "_'i'
acility appears to be well maintained and operated. This farmer had a good attitude and was very cordial to deal with during the
nspection.
iome minor silage seepage observed previously that does not appear to interface with surface waters. (This should be addressed if
he CAWMP is ever modified.)
Reviewer/Inspector Name Ron Linville Hamid Rafiee Tom Yocum
Reviewer/Inspector Signature: Date:

n Division o I and Water Conservation - Operation Re
O'Division olUl.and,Water Conservation - Compliance I tion
�. Division of Water Quality -Compliance Inspection
C Other Agency - Operation Review
I* Routine 0 Uoniplatnt 0 hollow-np of Inspection 0 1.011ow-up of reyieW 0 (Aher
Facility Number '> >I•`+' +nsnc,•tr=u'
® 24 lir. (hh:mm)
p Permitted ■ Certified 13 Conditionally Certified p Registered in Not Operate►nat Dme L'IN1 Opernlcd:
Farm Name: ................... - ... .... Count.y: Caswell WSRO
OwnerName: John ........................................ S.humaker.................................................. Phone No: JUA-01AUZ ..........................................................
Fnc•ilily Contact: John. ShLunaker ............................................. Fide: owrier .................................................. I'hone No: 9.4.7.7 ........................
i•lnilinf,+ Address:.1.2A4..Catutly..NomeRaa,d.......................... . B.la.nctt.NG.............................................................. 27212 ..............
[hlsite Itcpresenu[tiVe:,it0.h.11.Shuwakrx........................................................................ .......................................................................................
Certified Operator:dahn.,M.................................. Sh.umaket'........................................ Oherator Certification Niiniber:21633 .............................
Location of farm:
1..mi1 .N.aKttz.af..Xatts.� vi11c....1,;3tstsxd.e.s�T tr.urt.l4.anat.Ks1....11,2.�nal....t<ast..af.....iXe:1:A.r...ex.1;.d..........................................................................
�y =�
Latitude ®�© ® Lon,'itude ®0
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
[3 Wean to Feeder
❑ F ee er to rots
❑ Farrow to can
p Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
p Boars
❑ Layer
❑ Non -Layer
p ter
Total Design Capacity 200
Total SSLW 280,000
Number of Lagoons
1. ❑
u 3sur ace
Drains
Present ❑ aguon rea p Spray re c rea
Holding Ponds / Solid Traps
p
No Liquid Waste
Management
System
Disch:rr±-ors &, sireurt► 11111 ►cis
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
DischarL,e 01i+winatrd a1: ❑ Lagoon p Spray Field p Other
a. ll'dischar+ue is observed. was the conveyance nlan-1ltadc'! ❑ Yes ❑ No
1). Il-dischal-Le is observed. did it teach \Pater ofilw State' 1li'ves. polity ❑ Yes ❑ No
C. li'dischoree is observed. what is the eslimated I'low in eal/ntin?
cl, Does discharge bypass a I.=,00il system'? (II'ves. 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
1Yas1e CoIleCtiotl & Tr•rI[tnent
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes 0 No
Structure I Slruclurc 2 Structure Structure 4 tilruclurc sInIClurc G
I dent i tier. ....... pQ.ad............. ............. Pund............
............... 4
Freeboard (inches): ............... �fi................ .»................. ... ................................ .................................... .................................... ....................................
5. Are there any immediate threats to the integrity of any of the structures observed? (iel trees, severe erosion, [3 Yes ®No
seepage, etc.)
3/23/99 Cowi►rired on hark

Facility Number: 17._7
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 M No
NV,isw Applic,Etiron
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑Yes ®Na
12. Crop type Small Grain (Wheat, Barley, Corn (Silage & Grain) Fescue (Hay) Fescue (Graze)
MH
13. Do the receiving crops iffer with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes M 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
M No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
p Yes
®No
Regilirrd Records & 1MV111nCI11S
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 ReviewerAnspector 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
K: Nn iolh tions:or' defici'enc e's:were:noted.during:this visit.:I(du. ivill:receive no' further.; ::
come'' ideiic6. aV.out this:visit,. .:.. • : • : • :.: •::.:.:.:.:.:.:....:...:..:.:.:.....::::::: .
Comments (refer to question #): Explain any YES answers and/or any recommendations or any othercomments.
Use drawings of facility to`6e1ter explain -situations. (use additionalpages as necessary): ,
Facility appears to be well maintained and operated. This farmer had a good attitude and was very cordial to deal with during the I&
inspection.
Some minor silage seepage observed previously that does not appear to interface with surface waters. (This should be addressed if
;he CAWMP is ever modified.)
Reviewer/ins ector Name
p Ron Linville Hainid Rafiee Tom Yocum
ReviewerAnspector Signature: Date:

` Number*
aci
ity
t.Mor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
p Yes
p 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,
p 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?
p 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
E3 No
31.
Do the animals feed storage bins fail to have appropriate cover?
p Yes
,No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? []Yes p No
J

--,- 0 Division o and Water Conservation - Oper`ation=Re
0 Di ' ion AM andMater'Conservabori =.Com Nance tion
ivision of Water Quality - Compliance Inspection
13 Other Agency Operation Review,
J{DF'Routine Q Complaint 0 Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection "
Time of Inspection 3 24 hr. (hh:mm)
© Permitted 016cIrtified Q Conditionally Certified © Registered 10 Not O erational Date Last Operated:
Farm Name: .........
--1 U County:....... Js?C.......................................
..... x�......t.K.rrr... ......
Owner Name:.......�i.c]... 1..Ys. ................... .' I.. ..x* �.. ..Q- ....................... Phone No: c .Ala .-...�..� .`.�tl�. � ..............................
Facility Contact: ...j..Q. ..!►.......... ......s..... Title SJ..C4.Y�.er✓. Phone 33 '..irt.1,........ :3 2
N,lailinb Address: ... 1..2... t.%.Y...... Lrj..�c / ....1 '7t r/�.. :...,tr ........................................................................................... .......... ..........................
Onsite Representative: .. ......... "':.KXn...a..".✓................................. Integrator:......................................................................................
Certified Operator: .... =- .9..A„n............. .... Operator Certification Number:... .�....Q.d.. ..........
Location of Farm:
J
-
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
----------------------- 7
Latitude ®� 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 10 Dairy o Q
❑ Non -Layer 10 Non -Dairy
❑ Other
- Total Design Capacity a d-t)
Total SSLW �w
Number of Lagoons JE1 Subsurface Drains Present ❑ Magoon Area ❑ Spray Field Area
Holding:Ponds / Solid Traps ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated au ❑ 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/ruin`?
d. Does discharge bypass a lagoon system? (If ycs, 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
❑ Yes 2<o
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes R110
❑ Yes
❑ Yes �fo
Structure I Structure 2 Structure 3 Structure 4 Structure a Structure 6
Identifier: 2
Freeboard(inches): .......lt......................... ... ................ ........ .-.......................... ........................... ........................................... .....
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
.......................
❑ Yes E Io
3/23/99
Continued on back

Facility Number: 1 �_7 — 170 0 of Inspection
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste implication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)-
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, 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. W re any additional problems noted which cause noncompliance of the Certified AWMP?
Vo violations 4. d4mciencies -Were noted• diWirig phis:visit; • Yoit :Will •reeeive tio: further
corresnoric�ei�ce a�aut: this visit.::..:.:.:.::.::...:::.:::.:::..:.::
❑ Yes
❑ Yes zQ.Alo
❑ Yes [s Ko
❑ Yes Ly'No
❑ Yes M-Ko
❑ Yes To
❑ Yes E�-1 o
❑ Yes Leo
❑ Yes [4•No
❑ Yes 2-1100
❑ Yes ,❑....,, No
El Yes U-tvo
❑ Yes SIKo
❑ Yes ENV o
❑ Yes E�Ko_
❑ Yes 0-Ko-
❑ Yes 9-110—
❑ Yes ©-t'4o
❑ Yes &4o
❑ Yes 9-No
❑ Yes D4<0
Cotntnents (refer.Fto qutstion #): ,Explain.anyVYES answers and//or;any recoinmendattons ormmany other comments. g'
Us Arawings of facility to"befter explain situations.'(use additional pages as necessary) >
}
C5 f'Y1 ,r S`""-U- Sat' o-�
J
(ems / -5 U .r 4-c-e- G.3 �-A2� 5 ,
3123/99

�0 Routine p Complaint p 1,ollow-up of tjwtl inspection O Pollow-up of v�Pwc review p Vther
Facility Number Date of Inspection
Time of Inspection ® 24 Itr. (hh:mm)
13 Registered ® Certified p Applied for Permit p Permitted 0 of perationa Date Last Operated:
Farm Name:,to.hu..Shtutnnaker..Lairy..Farm,.Iuc_....................................................... County: Caswell WSRO
Owner Name: John ........................................ S.hilmak.er...................................... ........... Phone No: 336T.69,4-.4.032 ..........................................................
FaeilitV Contact: .1ohn.Shttm.akt:r......
...Title:............................................................... Phone No........................ .............................
Mailing Address:.L244..Caunay..Romr_.Paad ................................................................ Blaxtrh.NC .............................................................. 27212 ..............
Onsite Representative: dah.a.Shumakea:........................................................................ Integrator: ...................................................................... I................
Certified Operator:Jahn..N.i................................. shumaker ....................................... Operator Certification Number:2.1.63..3............................
Location of Farm:
loa e.. tar .a .. atat eyx............. asis� e.� -, ttutntY.... ome.. .m e.east.o ..ire...arver.
Latitude Longitude ®+ ®®«
Swine Capacity Population
p Wean to Feeder
p Feeder to Finish
p Farrow to can
p Farrow to Feeder
p Farrow to Finish
p Gilts
❑ Boars
Poultry Capacity Population Cattle Capacity Population
p ayer
p Non -Layer
p Other
Total Design Capacity 200
Total SSLW280,0=
:�
11
-Number of Lagoons / Holding Ponds
®Subsurface
p
No Liquid Waste
Drains
Management
Present IF
agoonArea p Spray Held Area
System
1. Are there any buffers that need maintenance/improvement?
p Yes
® No
2. Is any discharge observed from any part of the operation?
[]Yes
® No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made?
p Yes
p No
b. if discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
p Yes
p 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)
p 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?
p Yes
® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
p Yes
N No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
[]Yes
® No
7. Did the facility fail to have a certified operator in responsible charge?
p Yes
N No
7/25/97
7193

act ity N um er: I7_07 Datlenspection
8. Are there lagoons or storage ponds on site which need to be properly closed?
p Yes
® No
Structures (Lagoons,Holdin Ponds, onds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Structure
6
Identifier: Holding Pond I Holding Pond 2
Freeboard(ft): ..a................. ...............2...........................................................................................................................
...................................
10. Is seepage observed from any of the structures?
p Yes
® No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
p Yes
M 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 WNIP, or runoff entering waters of the State, notify DWQ)
15. Crop type ....... Com..(Silage.&.CTxain)....... 5rna1l.Craia.(..Wheaz..Bar1ey......................... E.escuz...................... ..............................................
t6. Do the receiving crops differ with those designated in the' Animal Waste Management Plan (A WMP)? 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?
R . .:o:vio tions.or acrencies:were.note wring t rs visit:�v . ou. t .receive no_further.' .
[]Yes ® No
p Yes ® No
p Yes ®No
p Yes N No
p Yes ® No
p Yes N No
p Yes M No
p Yes ® No
p Yes ® No
Coinments~F(refe to,questi(Iin"#):- l xONin anyYFS answers.andlor-.any"recommendations-or any other continents.
'Use drawings-of.facility to, better..explain situations. (use additional pages.as necessary):.- .
Recommend lookingat NW corner of concrete ad to see if an additional activities could be advantageous. Guttering
p y � eying may be .a
considered later if volumes become difficult.to utilize. Currently appears under control w/o guttering.
fter Inspection Note: When leaving the farm and after the inspection had been completed, a small silage pit discharge and another
ground discoloration area was observed which did not appear to reach surface waters. Local agricultural reps will review for further
actions as needed..
6I17198
Reviewer/inspector Name Ron Linville•"^
Reviewer/Inspector Signature: Date:

f- ❑ D WC An 1 Feedlot Operation Review
P c
.WQ Animal Feedlot Operation Site Inspection
N
0 Routine 0 Cant faint 0 Follow-u of DAVQ inspection 0 Follow-up of DS%VC review . 0 Other
Date of inspection �Q f
Facility Number J O '�?
Time of Inspection 1 24 hr. (hh:mm)
-6eostered tfid [] Applied for Permit [3 Permitted 0 Not O crational Date Last Operated:...
Farm Name: ...ti� 4..r1..th.....v+rS pt'iL4✓ r...!t............................ County :...........4C.`1.L.&..1.f....................................
Owner Name: ..... �^.......... "!-!�..`...\4..�.........../.............................. Phone No:.3-3-.6 �� `/4 3 L
T!. off..i`.........................................
Facility Contact: .............................................................. . Title: d/ ............. Phone No:.....................t.�.........................
i4lailittgAddress: .�.�2.r>�. ........... ......l�T!`r..Q �,c � 1. L .. .a.l.Z ... ..... ......
Il......................................
Onsite Representative:.._. P..! ..'....... s.jX..wrr....+�'�.-.......................... Integrator: ......................................................................................
Certified Operato........................'..`....................... ...---....
r:............................... Operator Certification Number-_1Z(...6...3 3..
1 fie -I in" if PtIrm-
/ .. .........5l. ..A..........Q................. ...� !" SZ ......................1yi7-}............... ............... `7Z.C. ...r✓./......P ...............
z.......,f�Z� er._..._ ..,5., ...._......6/......./......r.i�. -.-1,� /-------.%�.....l.......................................................••---..............................._ .
Latitude • k 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 ��]❑ Dairy JgO 16)
❑ Non -Layer ❑ Non -Dairy
❑ Other
` Total Design Capacity oZ0 -0
Total SSLW
Number of Lagoons / Holding Ponds 10 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
[[],No Liquid Waste Management Syslem
General
1. Are there any buffers that need maintenance/irtiprovertieiit'?
2. Is any discharge observed from any part of the operation'?
Discharge onginated it: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the: conveyance man-made?
b. lipdischarge is observed, did it reach Surface Waier? (If' yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in al/min?
d. Dees discharge bypass a lagoon system? (Ifycs, nntify DWQ)
3. Is there evidence of past discharge from any part of the operation'?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
ma ntenancMini) rove ment?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
G' o
❑ Yes
B-I<Io
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
EkM-o
❑ Yes
E3'ZO—
❑ Yes
ED-No
❑ Yes Q-1'Co
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes
Continued on back

Facility Number:/7 — 0
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons,11olding Ponds Flush Pits etc.
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier: ...............................................................
67
Freeboard(ft):......~3........................................................................................................................................
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed'?
12. Do any of the structures need maintenance/improvement?
(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 WIMP, or runoff entering waters of the State, notify DWQ)
15. Crop type.....�scrs%.,.�..r...C.l+.�..rr..s
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AW,MP)'?
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?
No.violations or deficiencies. were no'te'& during this ;visit. Ao'Ll4ill receive no further
correspondence shout this -visit.,
❑ Yes RNKO
❑ Yes ©<
Structure 6
❑ Yes z `o
❑ Yes ET a
❑ Yes ( 1 o
❑ Yes [moo
❑ Yes e- o
❑ Yes
[a<1 0
❑ Yes
`o
❑ Yes
Ek<o
❑ Yes
N�o
❑ Yes
[�"No
❑ Yes
11vo
❑ Yes-
FKO
❑ Yes 310
❑ Yes EK
❑ Yes
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.=
Use drawing's;'of facility to better explain. situations. (use additional pages as necessary}
S—'=+L t '1 0.� .y 0.�� � , � ► �4.,.� � p'rC �— i J . `Y ,, 2.t' W 0 wl t5f ii..s�.j
7/25/97
Reviewer/Inspector Name �' " , ✓ w
Reviewer/Inspector Signature: Date:

❑ Dtv�sion-of nd Water Conservation. ❑ Othec ncy �'�`M � � f�
� $,� (,'Division of Water Quality �, �z �,
tontine -Z ConV laint =`O Follow-up of DAVQ inspection 0 Follow-up of DSWC review O Other
--- -.. — -- ---.. Date of Inspection
- -.Facility NurriUr. d
Time of Inspection 11.23 Q 24 hr. (hh:mm)
iMegistered © Certified © Applied for Permit 0 Permitted [3 Not Operational Date Last Operated:
Farin Name: ....... %tiGs?.�}.fJ@l�...... �R....... 1.3c.�4�'!^.._. County : .......... .................................................... .......................
we—!/
Owner Name: ..... ....:J.Qh. .✓.................. .�.v./! G? ���. ,2........................ Phone N`o:. 4/0.....��..In.�r<..^.T..l.....-..............
FacilityContact: .............................................................................. Title:................................................................ Phone No:...................................................
1av
Mailing Address: .............................. ..........................
c1 u fv.J.. �,{onn .e......Rd ........ �l�!ve: Li a 7 2�..� ...: y....
OnsiteRepresentative: ................ ........................................... ....:....... ......... ................ ... Integrator :......................................................................................
Certified Operator;.......... rJ.0 .�..�J/...................... �...... v(� G� .. �.�..�..... Operator Certification I�'umber:r„r�..�....�...,,,�,,,�...
Location of Farm:
Latitude •®` cc Longitude ° 1`' ' "
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Non -Layer
�' -
❑ Non -Dairy
_
ss.: N e7�fr. �e. Y•.:
o ��
azy.rE�
Other
❑ Subsurface Drains Present
❑ Lagoon Aeea 10 Spray Field Area
_J`
❑ No Liquid Waste Management System x
-..
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yea, notifyDWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
-dl Does discharge bypass a lagoon system'? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than ]agoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes [SKO
❑ Yes Q>Sr
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
❑ ?
❑ Yes
❑ Yes
ts1_Dll
❑ Yes
❑ Yes
Continued on back

r �,b . .
Facility Number: — i
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures a oonsMoldinPonds.FlushPits etc.
9.-'Is storage capacity (freeboard plus storm storage) less than adequate?
Structure I Structure 2 Structure 3 Structure 4
Identifier: .,1 lGii.•N. ► ft! .....ld11,t.1.............................................................. ....
Freeboard (ft): (. I .
.........�.............................y.:.....-
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?
❑ Yes
No
❑ Yes
To
Structure 5 Structure 6
........................................ ..........................
❑ Yes
f o�
❑ Yes
[,
EJ Xco
I2. 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�W7MP, or runoff entering waters of the State, notify DWQ)
15. Crop type .... �/..-........�1 r��-.-C__,eegrLj,!... �......�.!Q.��..............................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need. improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0
❑ Yes ELWin-
es ❑ No
❑ Yes LU.o
❑ Yes ekN<
❑ Yes Ct -X
❑ Yes ❑-Ko
❑ Yes
QWO,
❑ Yes
❑ Yes
,"
l_ 4TO-
❑ Yes
a?
❑ Yes ❑ No
❑ Yes ❑ No
25. We y additional problems noted which cause noncompliance of the Permit? ❑ Yes ❑ No
No.violations.or de%iencies.were.ntited duritig this:visit: You:will receive, rzo:ftirffier;:
- Ofr606fideh6e aboutt this:visi-.: .: .. - .
Reviewer inspector Name
.�,. .. 5��.' ,'z�. ':. •'{, V � .,ss3.a a. � C ilmi m � 3 -'x" ��,
Reviewer/inspector Signature �;�� 1 Date: %p
1

❑ Division of Soil and Water Conservation ❑ Otiier Agency
E21Division of Water Quality
10it, on�_0 Complaint 0 Foliox-up of DN Q inspection 0 Follow-up of DSWC review 0 Other
Date of Inspection p�
Facility Number Q ��
Time of Inspection E� 24 hr. (hh.mm)
U'Registered ❑ Certified (ll Applied for Permit 0 Permitted 0 Not O terational Date Last Operated .
ft.0 Pam. . Farm Name: ��a E.R. l�t.!�-!..... County: �Qd W��........................................
Owner Name: ....,.....J.-O.A..!✓................. ............ Phone No:CQ/O ..x�.y..`.7<1.. ......................
FacilityContact: ..................................ritle:................................................................ Phone No:..................................................
/..y.......
Mailing Address........./ . Rd ........... ..............................
OnsiteRepresentative: ........................................................................................................... Integrator: .................................................................
Certified Operator,.........s_1c].�t..�l.................... ......vr!1Gi.. . .. ...... Operator Certification Number .........................................
Location of Farm.
Latitude ®' =1 U46
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder_
❑ Farrow to Finish
❑ Gilts
❑ Boars
Longitude
Poultry
Design Current
Capacity Population Cattle ,
❑ Layer
❑ Dairy
❑ on -Layer
[I Non -Dairy
❑ Other
Total Design Capacity_
Total SSLW
Number of.Lagoons /Holding Ponds C
4.
IE
General
1. Are there any buffers that need maintenance/improvement?
Subsurface Drains Present
No Liquid Waste Manager
C
C
C urrent .,:.
r;sPnnielatinn•<
2. Is any discharge observed from any part of the operation?
Discharge originated at: El Lagoon El Spray Field [I Other
a. If discharge is observed, was the conveyance. malt -made?
b. if discharge is observed, dill it reach 5urtacc W tter'? (lf' yes, tiotit-\� DWQ)
c_ If discharge is observed, what is the estimated flow in gal/min?
-d. Does discharge bypass a lagoon system? (If yes. notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
Lagoon Area I❑ Spray Field Area
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes M-K-o
❑ Yes Qw-
❑ Yes ❑ No
❑ Yes ❑ No
El Yes
El..,
Yes
.❑NNoo
�vo i
❑ Yes
❑xo�
❑ Yes
i
❑ Yes
❑ Yes
9-?
E3 ado
Continued on back

Facility Number: —
0
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes ��10
Structures (Lagoons,t-Iolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes Li'No
l/`!StfIru//cture I Structure 2 p Structure 3 Structure 4 Structure. 5 Structure 6
Identifier: ./..Y,ZdJ.dj:i .... ..���.....fflJlief.l�}s.c ........................
Freeboard (f1):.........(t...
................... ....... .........I...........................
10. Is seepage obsmed from any of the structures? ❑ Yes ,B 0
5 11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes -eco
12. Do any of the structures need maintenance/improvement? ❑ Yes M_W1 -
(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? es ❑ No
Waste Application
14. Is there physical evidence of over application? ❑ Yes Epfo
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15. Crop type P..�i..'v... .. J...... ...C.............................................................................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes [t}-hit�
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes M-i
18.
Does the receiving crop need improvement?
❑ Yes
❑-Ko-
19.
Is there a lack of available waste application equipment?
❑ Yes
Q.�dtr
20.
Does facility require a follow-up visit by same agency?
❑ Yes
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
Q-�O
22.
Does record keeping need improvement?
❑ Yes
M.Pd_
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
❑ No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
❑ No
25.
We ny additional problems noted which cause noncompliance of the Permit?
❑ Yes
❑ No
No.vialations o' r deficiencies. were noted during this',visit.- You.wiII re'ce'i�e• no-furthei
• . ,
correspondence: a4oitt this: visit:, .. , :: ' .::
Reviewer/Inspector Name
7/25/97
ReviewerAnspeclor Signature:
Date: 9i

,TEA-14-1995
15;34 FROM DEM WATER OUAI_ITY SECTION TO
Site Requires IMM'Cuate Attention:
Facility No. _ l 2 - 7
DMSION OF ENVIRONMENTAL MANAGEMENT
ANIMAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: U 7 , 1995
Time•
Farm Namc,(Owner. ��---
Mailing Address: PY70 ,. N t- 7 2! Z
County: (L0'aS'zv ,e,l
Integrator. Phone:
On Site Representative: _ � r- f ir_ Phone: /D ? 6 9 y - S'a 3 4-
Type of Operation
Design Capacity:
Swine Poultry — Cattle -L-,—/ oe-0-7
Number of Animals on Site:
DEM Certification Number: ACE DEM Certification Number: ACNEW_
Latitude: Z te ' 2 ) " Longitude: --a' /c/ .'. 3c- " Elevation: _ _ Feet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximately 1 Foot + 7 inches) Yes or No Actual Freeboard: -fit. inches
Was any seepage observed from the lagoon(s)? Yes No�yV�'as any erosion observed? Yes or o�`
Is adequate land available for spray? es No Is the cover crop adequate? es or No
Crop(s) beiug utilized: - .'�,1�a 0�-�
v
Does the facility meet SCS minimum setback criteria? 200 Foot from Dwellings? Yes or No
100 Feet from Wells? Yes or No
Is the animal waste stockpiled within 100 Feet of USGS Blue. Line Stream? Yes or No
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes or No
Is animal waste discharged into waters of the state by man-made ditch, flushing system. or other
similar man-made. devices? Yes at No If Yes, Please Explain.
Does the facility maintain adequate waste management records (volumes of manure, land applied,
spray irrigated on specific acreage with cover crop)?? Yes or No
worw Corammts: --.1
for N2ihCgnature�
cc; Facility Assessment Unit Use Attachments if Needed.
TOTAL P.02

yPERATIONI BRANCH - I)IQ C- ,
u
Fx:�19-71� 604�• J�_,1 ?0 95 18:28 P.07t11
• Si,ttr � jaiarc A�
+ c—&M,T92r-��
S:: VISUATION PSZORT3
DAM' J 6(-Y
4Wner,rJ ��Jrt fa.rC,� ItmMas.nsR!:E'�� i
Agent Yisit�jg Sites _UJAPRgSn3 _'Porte' 91 D - 58l
a��crstoc: ,-�-a �?ti1 Sy�,� �'c�,� Phou'a; _ � � �� �o q�• - 4 a 3 �
ca Site Retresentativa:
114,1),{cal k- ddms• .
,�f1i�img l�.t��tGs3: ,• ! �•t•7b �pc�n�T`f �` �M� �,D
'7 i Z—
Tync a t O rwmdoa: Sw rlo P--uIL' :• (7-a ?c I�
=,;a capacif)r l5g .Nur-.ccr, c f Ax,IMnis m_--
i,1�iV:. .v .-lii«:L:'. i W=- Lagc= LSs,r7 — �,� �n� � ..9".06--4 3 ! zc::L AC rff+� �"': ..riir �.•�~� =V' �'i
Y ,1.�..Vaa. ,.1vr.I r♦.Yi \. ii •
�%�C`f�.LuL:iCty' � :fit � . �C'"_3} _ «$ CJT �!: .�'.at.�: r.w::f.+1Li. ".,,,,,,,� • � � lyt5.:�`�
C2' f4:.`sl:e3 w.,;l more r} "" �„ : i�+'^!}, �:�;^ h6d?$.:tC
� Vns -Inv 6L+�.� OVSL�1"i4 "„" .' •a;r y :WvOrfc:)-.N�u Yw
is .�:.'c:�,�� :2�c� :�j�i�.�I� 'c:t .��s� 3{�Ci;C..1S:-e;r.': �-�; �+v is ; 3e �.•,_:;� .��. ��w3nW. ��» :� tic
F-.; 1,91 715-3..`9