290014_INSPECTIONS_20171231

( Division of Water Resourc
Facility Number - O Division of Soil and Watere servation
L_+ O Other Agency
Fype of Visit: N Compliance Inspection 0 Operation Review O Structure Evaluation Q Technical Assistance
Reason for Visit: 56 Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: D : �,ccit County:"DQU1d50Yj Region: VJSP2Q
Farm Name: C f a use— CQ ( 2 rQ rm Owner Email:
Owner Name: r' e-5 t i e— Crouse_
Mailing Address: f X 3 f Ce.cdcir SDr t n4 S RJ -
Physical Address: V/
Facility Contact: 1 �S l 1 (�r0 USA Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Swine
Phone:
,e--L 1 r) Q 1-0 0
Phone: C e— //
1
Certification Number: 20g39
Certification Number:
5
_ a �
Latitude: _ 3 S �a r 6 t Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Dry Poultry Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
.,Turkey Points
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
Q
/so
Dairy Calf
o2 S
O
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes P No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes No
❑ Yes No
NA ❑ NE
NA ❑ NE
JNA ❑NE
T❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412015 Continued

f,.
acility Number: 02 1 - � Date of Inspection: gaik
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 i Structure 2 Structure 3 Structure 4 Structure 5
Identifier: push d��- Pc,, -or 6t-
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.)
No ❑ NA ❑ NE
❑No �NA ❑NE
Structure 6
❑ Yes $ No ❑ NA ❑ NE
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ N1
waste management or closure plan?
T'
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
ONE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
E ] No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
TT''
9. Does any part of the waste management system other than the waste structures require
❑ Yes
r*No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
EP No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes f� 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 Driift� ❑ Ap
plication Outside of Approved Area
�-�`4�f
12. Crop Type(s): �S�.i + l ��'2`..� ` �s'"h !RV , 56/
', • L►\ -0—t-' 5�' t-c0,
13. Soil Type(s): 68 i �eT, A P, B4r, . Qpll� f
v
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
{g No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
[S No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
[5g No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
4111No
❑ 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
E4.No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists [:]Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? Ifyes, check the appropriate box below.
❑ Yes
* No
❑ NA
❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and I" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�g 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
X19
21412015 Continued

JiFacili57Number: jDate of inspection:
24. Did the facility fail to calibrate waste applOcation equipment as required by the permit? ❑ Yes No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes ❑ No NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes rNo
o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑Yes ❑ 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:
❑ Yes Wo ❑ NA ❑ NE
❑ Yes EANo ❑ NA ❑ NE
❑ Yes Q9 No ❑ NA ❑ NE
❑ Yes �No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes . No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes T 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).
a2 l SD l 5� rEr reJ 1 n a t 7 -_r0 fk_ CoMf7"�
a � L rrj jo-flov� Ca i b r-a`iiaN J u e- �20 [7 S u �` i'�1 f1 i� a j6 (cil e-c0 .
To CD rr•lp ,�� F� { d �� f s ZD16
i�� +� P G1 � �-�-�`
Reviewer/Inspector Name: PI-0 � MCL�
Reviewer/Inspector Signature: �,",.I'/
Page 3 of 3
Phone: 1/0- f;r;—,?349
Date: _r /2Z �j
21412015

' Division' of Water ResourAW:
Facility Number -lam 0 Division of Soil and Water Conservation
0 Other Agency
Type of Visit: ACompliance
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: CO ounty:' jJ50A Region: (�
Farm Name: Cry [) S I� �Q�.�m Owner Email:
Owner Name: r, �s l(_ crn l , i e_ Phone:
Mailing Address: a 3 1 eM((- Il -[s n
Physical Address:
V
Facility Contact: LU S Title:
Onsite Representative:
Certified Operator:
Back-up Operator:
Location of Farm:
Latitude:
Integrator:
Phone: a Sy Ll 93 a C e [l
--------------
Certification Number:
Certification Number:
a
5 J5Z Longitude:
N e, w� i 4 S 1 L 4-Y j pr n'lPe, �C �--m on t_ .
V� .l
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 I I ::d
Design Current
Dry Poultry Capacity Pop.
La ers
Non -La ers
Pullets
Turkeys
Turkey Poults
Other
Dischar es and Stream Impact
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?
S O b . / /SS_ Z/
Design' Current
Cattle Capacity Pop.
)Oairy Cow
Dairy Calf
Dairy heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes [SKoo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
® No
❑ NA
❑ NE
[:]Yes
Wo
❑ NA
❑ NE
Page I of 3 21412014 Continued

Facilit Number: - Date of Inspection:
Waste Collection & Treatment
4. is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ENI'No ❑ NA ❑ NE
a. If yes, is waste level into the structural Freeboard? [] Yes ❑ No ❑ NA [] NE
Structure 1 Structure 2 Structure 3 Structure 4
Identifier: N5k
Spillway?:
� U
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?
Structure 5 Structure 6
1 —
❑ Yes [ j„N0
❑ Yes Wo
❑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 DWR
7. Do any of the structures need maintenance or improvement? ❑ Yes [R"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 eNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes j2TNo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes WO
❑ 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): . MI A_ U 4C� A AA-0 IAA.,4 A - —
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box.
❑ Yes A< ❑ NA ❑ NE
❑ Yes 12No ❑ NA ❑ NE
❑ Yes J Vo ❑ NA ❑ NE
❑ Yes X No ❑ NA ❑ NE
[] Yes N�No ❑ NA ❑ NE
❑ Yes
b?l<o
❑ NA
❑ NE
❑ Yes
j5 .Wo
❑ NA
❑ NE
❑'WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. oes record keeping need rovement? date-hes-[meow- Yes ❑ No
Y
steAppiic on ,u,{ eekly Freeboard Waste Analysis oil Analysis Waste Transfers
nfall Stocking Weekly
Yield �0 Minute Inspections Egf,4onthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [] No
❑ NA ❑ NE
A Kweather Code
❑NA ❑NE
_pR'KiA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: 0Z q - t Date of Inspection: 1AMRolig
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 Da*KA ❑ NE
the appropriate box(es) below,
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes �rNo ❑ 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:
❑ Yes M�No ❑ NA [] NE
❑ Yes Wo ❑ NA ❑ NE
❑ Yes Io ❑ NA ❑ NE
❑ Yes Nr&o ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes , To_ ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes a No ❑ NA ❑ NE
34, Does the facility require a follow-up visit by the same agency? ❑ Yes Wo ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
a l, Soil f�S i- r L) n 20 ( 7
a q. Njib na4i6rr i �� d �� ao c 7. '
�
7 *M c%A,t �1 —to �,o r� 5 l c �' v� e u� �roo 'e-r-5 � 1 U a ray
q1'q$1-z'0)s
Reviewer/Inspector Name:
6,to =L5J
0
Reviewer/Inspector Signature:
Page 3 of 3
o, 79 _ LS 6
Phone: —1
Date: D
21412014

Division of Water Resoure
Facility Number - 1 0 Division of Soil and Water Conservation
0 Other Agency
Type of visit: 0 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: 7-ZZ-Zoi Arrival Time: 60 Departure Time: % 5 County: a wi-ston
Farm Name: 6,gm le Owner Email:
Owner Name: Ae S xG �I�-r/'� Phone:
Mailing Address:
Physical Address:
54 PW,
Facility Contact: Zl S /C !,/ e Title:
Onsite Representative:
Certified Operator: � 6wwxG
Back-up Operator:
1,0g16 /liC' .2 7oZ9,Z
Region:
Phone: 331'1S0- %23Z eell
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: �� S� Longitude: ?0 ov 5s
we wr /v e e;a,s Rol, ip;eW470
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 -La er
Design Current
Dry Poultry —Capacity Pop.
Layers
Non -Layers
Pullets
Turkeys
Turkey Poults
Other
Discharges and Stream Impact
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)?
Design Current
Cattle Capacity Pop.
Dairy Cow
1110
ill
Dairy Calf
Dairy Heifer
Cow
—.Dry
Non-Dai
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes JZ No ❑ NA ❑ NE
❑ Yes
F] No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes ❑ No ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? ❑ Yes 0 No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes 5-No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

Facility Number: - Date of Inspection:
�Z�S
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storageplus heavy rainfall) less than adequate?
❑ Yes
Jallo
❑ NA
❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes
❑ No
❑ NA
❑ NE
Structure I Structures 2 Structure 3 Structure 4
Identifier: PUs�d ?01 elor-_
Structure 5
Structure 6
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): 36
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
[KNo
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
allo
❑ 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
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 Q No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window/ ❑ Evidence of Wind Drift ❑ Application Outside of Approved Area
12. Crop Type(s):ti�%� ,
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
[]Yes
ZNo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
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
ffl No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
N No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
M No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
® No
❑ NA
0 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 4 No ❑ 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 -Eallo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No ` aNA ❑ NE
Page 2 of 3 21412014 Continued

Facili Number: - . Date of Inspection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes EjNo ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes ❑ No 2] NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes 'El No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ELNo ❑ 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?
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 Z.No ❑ NA ❑ NE
❑ Yes J.No ❑ NA ❑ NE
❑ Yes J�j No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes 21 No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes 2LNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes QNo ❑ 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).
V0." -cs onP olprn ? s 'J,dAs��/ s e'V ,,�5 ! S' tvaf ;/ eA /`r'4lev/ ? 1 GS ,rt LS
Z � Q-
21. So; l fps cat ,2 017.
Ct- 2 z
d' y3 N z ,K N-0'51 102
Reviewer/Inspector Name: _X/f dat
Phone: 3 34 / %4 —V 1 7
Reviewer/Inspector Signature:
Page 3 of 3
Date: Z-ZZ -Ze1S
21412014

wision.o€ Water..Quality xn
y `Factli#y Number Division o€Sail and Water irvation
0 Other Agency
Type of Visit. Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visi : Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: J f J� Arrival Time:"`_j Departure Time: County: Region:
Farm Name: C7 Owner Email:
�'Ou �e_a, e Far of
Owner Name: Phone:
Mailing Address: U
Physical Address:
Facility Contact:
Title: Phone:
Onsite Representative: t
Certified Operator: �Iv
Back-up Operator:
Location of Farm:
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Latitude:
Integrator:
Certification Number:
Certification Number:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Dry Youltry
Layers
Non -Layers
Pullets
Turkeys
Turkey Pouits
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?
Longitude:
Design Current
j Cattle Capacity Pop.
Dairy Cow
7Z
Dai Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
J
❑ Yes gNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
[:]Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes YNO
o
❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
[]NA ❑NE
Page 1 of 3 21412011 Continued

Facili Number: jDate of Inspection. 020
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes WNo ❑ 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: PU 5 keSf_�
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes 9No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes D�No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes 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 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?
❑ Yes ,ff�No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes �KNo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes j�No
❑ NA
❑ NE
acres determination?
T�
17. Does the facility lack adequate acreage for land application?
❑ Yes ,�fNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes A No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes [�No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes NrNo ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21 oes record keeping ne;7')�Icekly
rovement? ❑Yes No ❑ A ❑ NE
��ainfall
te Application Freeboa Waste Analysis5onthly
Soil Analysis rans ers �eather Code
�tocking Crop Yield 120 Minute Inspections and 1" Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 9No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No I (NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: jDate of Ins ection:
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes JAr No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes ❑ No WA ❑ NE
the appropriate boxes) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes C2KNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes D3�No ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes �No ❑ NA ❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes �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
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tite drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
[:]Yes XNo ❑ NA ❑ NE
❑ Yes �(No ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes LK No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes XNo ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes D3, 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).
0.14
V 4t4v vU-� IZ 0t-(6 A-
1 y1
�- Oez
T w t U- a, 4, ya
fo/a�Ir3 -- 0..�_3 L6w.�+r ��a7-Ll
-
3 lj'r aR CO - 0 ' a-) 1 caw �- s, 16 = U pp,
Reviewer/Inspector Name: '5-sro f✓ i Phone:
Reviewer/]nspector Signature: Date: / _32
I
Page 3 of 3 21412014

Division of Water Qui;lity >-
Facility Number ®- 0 Division of Soil and Water Cot ervati
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: [5123 o I Arrival Time: Ejj� Departure Time: aunty: 'Da .Vid on Region: - 1
Farm Name ( r'n a -SPA 0..1/�P_- Farm
M _
Owner Name: L,&5 � l Pi (- r O U5 e,
Mailing Address:
Owner Email:
Phone:
NO
Physical Address:
Facility Contact: Title: Phone e, A d 'i a- 3 a---
Onsite Representative: integrator:
Certified Operator: Certification Number: 1.1 � 31 f2 0 1S
Back-up Operator:
Certification Number:
Location of Farm: Latitude: ass `f 0 SD Longitude: gQ O 4 5-,;-
Swine
I (Dq S, ) d a-,r- S P 1 nos f� d Fo_r-m o ri
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop..
Layer
Non -Layer
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Po
Non-L
Pullets
Poutts
Design Current
Design Current
Cattle Capacity Pop.
Dairy Cow
f
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
Discharges and Stream impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
XNo
❑ NA
❑ NE
Discharge originated at: ❑ Structure ElApplication Field ❑ Other:
a. Was the conveyance man-made?
0 Yes
0 No
❑ NA
❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
❑ Yes
❑ No
❑ NA
❑ NE
2. Is there evidence of a past discharge from any part of the operation?
❑ Yes
o
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412011 Continued

Facili Number: a - Date of Inspection: j
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: S �p��,�OT_
d 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 CR No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ YesK/No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks) �Z<
9. Does any part of the waste management system other than the waste structures require ❑ Yes o ❑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?>(No
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes
❑ 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
0
12. Crop Type(s): AAAd=1—
AA
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
Wo
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
%'fio
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes
�eo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
0 No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
XNo
❑ NA
❑ NE
Reauired Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes o ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check ❑ Yeso ❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
V
es record keeping need t provement? I es ❑ No ❑NA ❑ NE
ste Applic ion LYJ �' ekly Freeboard Waste Analysis Soil Anal s' Waste Transfers ❑ Weather Code
Rainfall Stocking Crop Yield ❑ 120 Minute Inspections onthly and 1" Rainfall Inspections ❑­Swge e„ P,�
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes �o ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes 0 No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

T-P-4 - pa5s(ija-d? U_)eb
Facility Number: - Date of Inspection: 3 5,3 O
24. Did the facility fail to calibrate waste applica ion equipment as required by the permit? ❑ Yes
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31 . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
51�t-
)dNo ❑ NA ❑ NE
❑ No 0 NA ❑ NE
❑ Yes]
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�f No
❑ NA
❑ NE
❑ Yes M No ❑ NA ❑ NE
❑ Yes >(No ❑ NA ❑ NE
[:]Yes XNo ❑ NA ❑ NE
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes k(No ❑ NA ❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes q No ❑ NA ❑ NE
34. Does the facility require a follow-up visit by the same agency? ❑ Yes VNo ❑ 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 pates as necessarv).
No ® P,.AL4- L ' �-
G
D
b
M
AA
I/a"Iad13
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
0 . ;2 3 E ri s
�1a�1 aal�
5VjAAje Wi--tt� Ve-Y-6
z- 51D = i 3 � © l t- -5 4 w©
Phone: ���— S oZ-
Date: 3[�
21412011

Division of Watei'Quality
Facility Number Division of Soil and Water Conservation
O Other Agency
Type of Visit: Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral Emergency Other Denied Access p�
Date of Visit: rrival Time: Departure Time: County: b&Vit�O/1 Region: )SPV
Farm Name: i ro u 5 ,P_ale . Owner Email:
Owner Name: t? S (i e— C -Q— Phone:
Mailing Address: 1 ,yL 3 k G eC1 CAL`— J Q f I h a S f tf [
Physical Address: \k
Facility Contact: e5 1� V S _Jitle: Phone:
Onsite Representative: Integrator:
Certified Operator: Certification Number: ,
Back-up Operator:
Location of Farm:
Certification Number:
Latitude: 4 �a Longitude: q r
N �oq S .1 L af- S r i n_v . ro_v- m a A- L
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 Capacity POD.
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)?
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.
ai Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
[:]Yes dNo ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes No
❑ Yes [XNo
❑ Yes � No
NA ❑ NE
❑ NA ❑ NE
❑ NA [] NE
1
Page I of 3
21412011 Continued

Facili Number: - • Date of Inspection:
a
Waste Collection & Treatment
/4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA [] NE
a. If yes, is waste level into the structural freeboard? ❑ Yes No ❑ NA ❑ NE
Structure 1 Structure 2 - Structure 3 Structure 4 Structure 5 Structure 6
Identifier: Clx (or
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? O�Yes No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes [)(No ❑ NA ❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes KNo ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes OR�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 A<0 ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need [] Yes belool ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes VNo ❑ 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): be,5&O 2 H
✓13. Soil Type(s):
nat YL (!'o rr n-
14. Do the receiving crops differ from those designated in the CAWMP? —{Lj Yes a[] No
15. Does the receiving crop and/or land application site need improvement? ❑ Yes I N` o
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes �X o
acres determination?
17. Does the facility lack adequate acreage for land application? ❑ Yes PNo
18. Is there a lack of properly operating waste application equipment? ❑ Yes
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available? ❑ Yes f�0
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yeso
the appropriate box.
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ WUP ❑ Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑ Other:
21 Does record keeping need A provement? If ye check t e appropriate box belo Yes ❑ No ] NX ❑ NE
aste Applica on Freeboar aste Analysis it Analysis aste Transfers 111���iii Weather Code
�infa. StockingP4eokylyi
Crop eld 120 Minute Inspections onthly and V Rainfall Inspections
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes P<qo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No DeA ❑ NE
Page 2 of 21412011 Continued

[Facility Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste appli�on equipment as required by the permit? ❑ YesA<O ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check [] Yes ❑ No XNA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge? ❑ Yes NNo ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes o ❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes N 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?
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 ;R"No
❑ Yes io
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below. ❑ Yes
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? Yes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative? Yes
34. Does the facility require a follow-up visit by the same agency? ❑ Yes
❑ No
Z
�No
No
❑NA ❑NE
❑ NA ❑ NE
[DNA ❑NE
❑NA ❑NE
�] NA ONE
❑NA ❑NE
omments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
se vt gs of facility to better explain situations (use additional pages as necessary).
�t72 6 L Cad b c-a_4 i on —
r;� l
4/l0,
r
9/a �/,261I = go . Y 7
rocLJ east B z - 2.7
Reviewer/Inspector Name: Akt_ ` b
Reviewer/Inspector Signature:
Page 3 of 3
Phone:
Date:
21412011

Facility -_ __ Division_of Water Quality -
Number Y a l Q Division of Soil and v4'ater Cor.rvation O p
r _ _Q Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit XRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: b 11 ( Arrival Time: SS Departure Time:
Count}:
)�SO
Region: 7
/�2
Farm Name: l—n us t" d d ie- c m
Owner Email:
/
Owner Name: Le.s h e eV ou'se-
Phone:
3 3 4o S_'
9 - 3.3 q .2_
Mailing Address: �- 3 [ C IQ� S E2 r i n j•5
LQ i n
a `6 n
%,-) C ,;� 727 a
Physical Address: V
Facility Contact: e 5 I 1 2. o�,xS e. Title:
Phone No:
6 2 SO — 4 u2 3 2
Onsite Representative:
Integrator:
Certified Operator:
Operator Certification Number:
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: LU O ®' [�« Longitude: ®n 0 6 �Ld
4C, �t i Q 5c;�h 1 L onto C_ect cad' S pri +i dS ,D J. c r1-n O t t L
l
' Designs-
Swine Capacity
❑ Wean to Finish
It ❑ Wean to Feeder
t ❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
• ❑ Farrow to Finish
❑ Gilts
❑ Boars
Current.
Population Wet Poultry
❑ Layer
� Non -Layer
er
1744, "VI
rElDrr Poultry
Layers Non -La ers
Pullets
� "I ❑ Turkev Poults
Other ! _-JLJ Other
y
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?
Dairy Cow
Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non-Dai
i
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood [
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 P No ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes ❑ No
❑ Yes A No
❑ NA
❑ NE
❑ Yes �Ko
❑ NA
❑ NE
Page 1 of 3 12128104 Continued

Facility Number: — Ti . Date of Inspection i aIo .
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: p o f)) Pour l o
Spillway?:�
Designed Freeboard (in):
Observed Freeboard (in): 3 �"
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 kNNo
❑ Yes ❑ No
Structure 5
El NA El NE
El NA El NE
Structure 6
❑ Yes ffNo ❑ NA ❑ NE
❑ Yes hIo ❑ 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 16"No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes J�No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes WNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes to No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
[]PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) �.rj c-V e—
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
Yj Yes
El No
El NA
El 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
N�No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
INo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ 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):
t-r_tec� now
Tavlj
e� 0j-x5 +remove_ 500
Reviewer/inspector Name �— — 5. (� Phone:
Reviewer/inspector Signature: Date: 4 l
Page 2 of 3 ` v 1 12128104 Continued

Facility Number: a — j *e of Inspection
Re uired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 0 No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes O(No El NA ❑ NE
ElEl❑ Design El El the appropriate box. WUP Checklists
21.D,oes�r cord keeping need im ovement? I�ee ropria e box e Yes ❑ No ❑ NA ❑ NE
Lld'Waste Applic on L►J Wee y Freeboard Waste Analysis Soil A alysis Waste Transfers n
[STRainfall Stocking Crop Yield [1/60 Minute Inspections 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? (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?
❑ Yes
b No
❑ NA
❑ NE
❑ Yes
❑ No
ONA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
❑ No
NA
❑ NE
No
❑ Yes
❑ NA
❑ NE
❑ Yes
C�No
❑ NA
❑ NE
❑ Yes too
❑ Yes
❑ NA ❑ NE
❑ NA ❑ NE
❑ Yes
j!(0
��/XN""
❑ NA
El NE
El Yes
o
❑ NA
❑ NE
❑ Yes
,N�No
❑ NA
❑ NE
❑ Yes
�fNo
❑ NA
❑ NE
Additional Comments and/or Drawings: n \,� L
a LolD Sol 1 S0,_ t4Ee� { ��1 i1J1l C �Ve_ uh b
J A z
a O[b [ bra �on Cowletic ? e5, bv'r re5ui �s aey-,-� v
herd �m fvtPAS u r� r i n C�.i c�l'Y►e-�-e-r- �-
t iS r �S P ' � r' .�
C` 5, t�
F - �o 5' �5 e.drrecV
SC) R e_e.dl � l � o� a�- b �� /� �} �o r 5 M&2 1 f-0J rl
s� la'q � �
-old F-d
� �. [ S T i 3 3 <� f- a 3 ? Q4-
Page 3 of 3 12128104

l C q„t
F Division of Water Quality
Facility Number `Z� 1 Division of Soil and Water Conservation
Q Other Agency
Type of Visit X.Compliance Inspection Q Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit XRoutine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: f
!i Arrival Time: Q . % Departure Time: a Count}': ��1 �ri Region: �9d
Farm Name: 66, sP_.�f a le- F—zarM Owner Email:
Owner ;Same
Lis/r'e Phone:
r ! `
Mailing Address: Z Ct' Lr fAl rr i �• �K.f r< N G 27 Z 7_
Physical Address: SA E
Facility Contact: Led"-" t 0k;-e— Title:
Onsite Representative: ; `'�� G o 0.�.e
Certified Operator: Lr-s j•�e 6ta kc-e-
Back-up Operator:
Location of Farm:
Phone No:Q Z5D— LI23Z
Integrator•
Operator Certification Number:
Back-up Certification Number:
Latitude: 0 ° ® n 11 Longitude: Sd ° r� .
1IC 44wi Ceclaf SPrh+al �i.� Fr+ti, a�, Lzr4-, `
Design Current Design Current
Swine Capacity Population Wet Poultry Capacity Population
❑ Wean to Finish I Layer
❑ Wean to Feeder I❑Non-La er
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
Design Current
Cattle Capacity Population
Dairy Cow
Z I
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
Number of Structures: >�J
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)
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 xNo ❑ NA ❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes ❑ No
❑ NA
❑ NE
❑ Yes XNO'
❑ NA
❑ NE
❑ Yes XNo
❑ NA
❑ NE
Page I of 3 12128104 Continued

Facility Number: Z - ) • Date of Inspection 0 L O
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes XNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 tructure 3 Structure 4 Structure 5 Structure 6
Identifier: h r ! r off
Spillway?:
Designed Freeboard (in):
j� 3aU
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 XNo ❑ 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 No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) X
9. Does any part of the waste management system other than the waste structures require ❑ Yes ANo El NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes 1XI No ❑ NA ❑ NE
maintenance/improvement?
i I. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes kNo ❑ 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 Hare Soil
❑ Outside of Acceptable Crop Window El
Evidence of Wind Drift ❑ Application Outside of Area 1,
12. Crop type(s) 6 f ✓` f SMfc! ! -'e, j�, tt � . , L , � (�l'4h ,
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes No
❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes �N0
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes "ER�4o
❑ 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):
y7 U-ron 1e- &ie_ z-r1Cf�� &,k 7'trl�f � n� ) LrM6 .�� on lov--er e*-d,
!i 0"k On �i��Ol�1 "P"'4-
Reviewer/Inspector Name Phone: 336-TV -SZg57-
Reviewer/Inspector Signature: j� Date: �0 Z� z41 D
Page 2 of 3 1.2128104 Continued

I.Facilky Number: z — Oe of Inspection Z / •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ElNA ElNE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ElYes XNo ❑ NA ❑ NE
the appropriate box. ❑ WUp ❑ Checklists ❑ Design ❑Maps El Other �/
21. Does record keeping need improvement? ❑ Yes ,J�J No ❑ NA ❑ NE
Was e Application Weekly Freeboard Waste Analysis oil Analysis rs' Waste Transfet� A. tim -' Gen tion
ainfall Stocking Crop Yield s onthly and 1" Rain Inspections Weather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes kNo
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑No
24.
Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes
No
'''❑\\\No
25.
Did the facility fail to conduct a sludge survey as required by the permit?
❑ Yes
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
*No
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
Wo
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:
❑ Yes *o
❑ Yes XNo
❑ Yes N(No
❑ Yes �No
❑ Yes gNo
❑ NA ❑ NE
�YNA ❑ NE
❑ NA ❑ NE
ONA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑NA [I NE
❑ Yes NrNo ❑ NA ❑ NE
2 f, So'rf aAq�f% `for ZDO? ? &v% f�1� IV�rd, 2a1Q, f
zV C411,bf 6m d>� 0c-4�l 2010• %fie Scams e-� S4
afi Sar►�OE�1
4- J"A"_
leAe�I
2- �, Be �� fayf1 f ddr� � y MA_ �r~t � Zb [ 4
C",a it 2010
y �
�AO-8_ "&'
a� mid — 0,6'_�� — �'� a�
/I, i5d bit Pus4 0*
0 /Io r 111
Z1111
'"'-ESN
Page 3 of 3 12128104

I,.
•
e
�0� VIA-r incident Report
OF
> 14�3 r'
a 'C
Report Number: 201001683
_ _
to f G f ©S 5
Incident Type: Non -Compliance Reporting
On -Site Contact:
Category: APS - Animal
FirsUMid/Last Name:
I nc ident.Sta rted--0211512010
Company Name:
County: Davidson
Phone:
City: Lexington
Pager/Mobile Phone:
!
Farm #: 029-0014
Responsible Party:
Reported By:
Owner:
First/Mid/Last Name:
1?em—flt 7TWC290014
Company Name:
Facility: Crousedale Farm
Address:
First Name: Leslie
Middle Name: R
City/State/Zip:
Last Name: Crouse
Phone:
Address 1231 Cedar Springs Rd
Pager/Mobile Phone:
1
City/State/Zip: Lexington NC 2729218
Phone:
Material Category: Estimated Qty: UOM
Chemical Name
Reportable City. lbs. Reportable City. kgs.
DD:MM:SS Decimal Position Method:
Latitude:
Longitude:
Location of Incident: Cedar Springs Road
Address:
City/State/Zip
Position Accuracy:
Position Datum:
Report Created 05/14/10 12:48 PM Page l

•
•
Cause/Observation:
Action Taken:
Incident Questions:
Did the Material reach the Surface Water? Unknown
Surface Water Name?
Did the Spill result in a Fish Kill? Unknown
If the Spill was from a storage tank indicate type.
Containment? Unknown
Cleanup Complete? Unknown
Water Supply Wells within 1500ft
Access to Farm
Structure Questions
Directions:
Comments:
Conveyance :
Estimated Number of fish?
(Above Ground or Under Ground)
Unknown Groundwater Impacted : Unknown
0 Animal Population 0 Spray Availability
Report Created 05/14/10 12:48 PM Page 2

•
•
Access to Farm
Farm accessible from the main road?
Animal Population
Confined?
Depop?
Feed Available?
Mortality?
Spray Availability
Pumping equipment?
Available Fields?
Structure Questions
Breached?
Inundated?
Overtopped?
Water on outside wall?
Poor dike conditions?
Waste Structure Type Waste Structure Identi inches
Waste Pond PUSH -OFF 15.00
Waste Pond RUN-OFF 15.00
Event Type Event Date
Incident closed
Requested Additional Information
Report Received
Referred to Regional Office - Primary Contact
Report Entered 2010-05-13 01:29:14
Incident Start 2010-02-15 08:00:00
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA ❑ NE
❑ Yes
❑ No
❑ NA ❑ NE
❑ Yes
❑ No
[DNA ❑ NE
❑ Yes
❑ No
❑ NA ❑ NE
Plan Due Date Plan Recieved Date Level OK Date
10-02-17 08:00:00
10-02-17 08:00700
Due Date Comment
Report Created 05/14/10 12:48 PM Page 3

Standard Agencies Notified:
Agency Name Phone First Name M.I. Last Name Contact Date
Other Agencies Notified:
Agency Name Phone First Name M.I. Last Name Contact Date
DWQ Information:
Report Taken By: Report Entered By: Regional Contact:
Melissa Rosebrock
Phone:
DatefTime: 2010-05-13 01:29:14 PM
Referred Via:
Did DWQ request an additional written report?
If yes, What additional information is needed?
Report Created 05/14/10 12:48 PM Page 4

ivision of Water Quality
Facility Number LaRDivision of Soil and Water Conservation (}
Q Other Agency {_
IType of Visit `�Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit VRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
D�te of�'i rival Departure Time: County: :f ` d Region:
Farm Name: (1J Mu5edak 1 :dxn no „ _ Owner Email: r
Owner Name: C 'e_5 l+ _Q ex-o uone: A7" s � Ph — 3 -3 19-
Mailing Address: C Le t o i�-�--- 7 r
Physical Address:
Facility Contact: �' e5 tie, 6-0 USA Title: Phone No:�3�--
Onsite Representative: �� ll 0—F6 Integrator:
E NAMA b h r5
Certified Operator: Lt � L/r► 005 Operator Certification Number: O�
1
Back-up Operator:
Location of Farm:
Loa
can �e4.
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: [M' r4zl ' F—;M« Longitude: M°
of n ► e on4o Ce ter S.Qrt n q5 J�d
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
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?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
aLro/t
Design Current
Cattle Capacity Population
Dairy Cow
oZ
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? (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
0
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes 9,No ElNA ElNE
ElYes No ❑ NA ❑ NE
12128104 Continued

Facility Number: — .1 Ve of Inspection a q •
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El maps El Other
21
Doe ecord keeping need i
aste Ap2�king
n CS[2 Rainfall
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 fait 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
❑ Yes OZO ❑ NA ❑ NE
❑ Yes b ❑ NA ❑ NE
/ ((( Yes ElNo ElNA ElNE
Waste Transfers
" Rain Inspections Bather Code
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?
❑ Yes [ k o ❑ NA
[--]Yes
[--]No
9 NA
❑ Yes
P(No
❑ NA
❑ Yes
❑ No
[�NA
❑ Yes
�dNo
❑ NA
❑ Yes [)INo ❑ NA
❑ Yes �/N�o
NA
ElYes ❑ NA
❑ Yes `"Ko ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
❑ Yes A<O ❑ NA ❑ NE
❑ Yes �XNo ❑ NA ❑ NE
El�� Yes '1Vo ❑ NA ❑ NE
l a
v
Page 3 of 3 12128104

Facility Number: — O Date of Inspection $ [3
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I / Structure 2 Structure 3 Structure 4 Identifier: - QOt.Y O Mr
Spillway?: 110 O N b
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ic/ 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 0 No
❑ Yes ❑ No
Structure 5
❑ NA ❑ NE
El NA ❑NE
Structure 6
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes 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 No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes �Io ❑ NA ❑ NE
maintenance/improvement?
1 1. Is there evidence of incorrect application? if yes, check the appropriate box below, ❑ Yes )�No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable �Crop Window ❑ Evidence of Wind Drift ❑ Appliiccation Outside of Area l
12. Crop type(s) _AAAJ J�WL&IZ . A rA h,) _ 10 AIJO J kx) [ _ � A,. 1
13.
Soil type(s) V U
"
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ Yes
No
ElNA
ElNE
17.
Does the facility lack adequate acreage for land application?
❑ Yes
Wo
❑ NA
❑ NE
18.
is there a lack of properly operating waste application equipment?
❑ Yes
VNo
❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
Reviewer/Inspector Name �� rd Phone: _1_1 -Sv2S
Reviewer/Inspector Signature:' -A Date: J6
12128104 Continued

k
a i Q,DI�IsiO[l of Water Qualm
7 rim r .5. i._ ✓ S
FactLty Number 1 ODr�rsion of Soil and V4'ater eonserration
J &ther Agency.
Type of Visit %Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit yRoutine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: D Arrival Time: 10 eparture `fime: County: bay Id'50n Region:
Farm Name: t._ (_0L) S e- ao- le P7Q Ir`VYl Owner Email: (A0��
Owner Name: l-5 l I e � rd U St? PhonkW ) .m& $ S�9
o•-
Mailing Address: � � 3 �c inzha
Physical Address: y ry1
5 c.— .33� as0
Facility Contact: I. e I P_ [!rn U� Title: Phone To)
'estte CrpUS� Integrator:
Onsite Representative:- g
Certified Operator: 5i 1 e V s Q-- Operator Certification ]Number:
Back-up Operator:
Back-up Certification `lumber:
Location of Farm: Latitude: EE-0 ® l E" Longitude: ® n � �
Y 161 So t'fh g4Waxj5 ion l-e � o n t-a Cad nX
S Prcr S Road - Va rIran (5r)
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer
Dry Poultry
❑
Layers
❑
Non -Layers
❑
Pullets
❑
Turke s
❑
Turke Poults
❑
Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?.
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
Design Current
Cattle Capacity Population
Dai Cow
DairyCalf
❑ Dairy Heifer
E]Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
Number of Structures: F4
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 4No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [ No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ N E
12128104 Continued

Facility Number: — • Date of Inspection IN c76
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes X 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
Identifier: U5boEp RLU n—'n t
Structure 5 Structure 6
Spillway?: NO _ _. _ NO
Designed Freeboard (in):
Observed Freeboard (in): 3690
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes qjNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes 0 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 eat, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes ��,//No El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes OQ,No ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) !l
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement? 44
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes >rNo ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes Ao ElNA ElNE
ElExcessive Ponding [IHydraulic Overload ElFrozen Ground ElHeavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes �(No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ElYes *No ❑ NA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes 9No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes *0 ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes LYNo ❑ 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):
I - 0-6� _-Q� 7% a7L-- ja,9T,)
lor WsP..
IReviewer/Inspector Name I Phone: — I
Reviewer/Inspector Signature: Date:
Page 2 of 3 " 1
12128104 Continued

0
Facility Number: — Ltjw Date of Inspection 4
Required
Records & Documents
19.
Did the facility fail to have Certificate of Coverage & Permit readily available?
❑ Yes
*o
[INA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
El Yes
No
❑ NA
❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
j
21.
Does record keeping need improvement? If yes, check the ppropriate box below.
Yes
�No
❑ NA
❑ NE
❑ Waste 41 lication ❑ WE#�lfly Freeboard ❑ Wa�Analysis ❑ Soil alysis ❑ W
Transfers
❑ tnfall ❑ �ing ❑ Cr 1 Yield ❑ 120 Minute Inspections ❑ MoM y and 1"
Rain Inspections
❑
her 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
to
KNo
❑ 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
9No
❑ NA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
KNo
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
O�'No
❑ NA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
,�No
No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
rr
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
FNo
❑ 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
PNo
❑ NA
❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32.
Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
WNo
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
N[No
❑ NA
❑ NE
additional Comments and/or Drawings:
AL
A 4.
�$ uP S`4-i LI needs f-o be 1ioa-w Lu rre + a2-re4_�eS�
[Ylo AS o9 o1.-pf icam(3n l OL bt- FMA ta5rri k
,o,P<
a I . ate4'jo Y__ " _60-d"rad. /
$� I SloS LAJ 0_,<)+e eLr,Oj ys1 = P,1,,r a o.Ss7 Pushog. !�, 3
Page 3 of 3 12128104

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 290014
Facility Status: Active Permit:
n
AWC290014 Denied Access
Inspection Type: fomplianoe Inspection
Inactive
or Closed Date:
Reason for Visit: BQutine
County: Davidson
Region: Winsto - alem
Date of Visit: 02(13(20QZ_
Entry Time:10:05 6M Exit Time: 11:30 AM
Incident #:
Farm Name: Crousedale Farrn
Owner Email:
Owner: Leslie R Crouse
Phone: [phone]
Mailing Address: 1231 Cedar $prinas
Rd Lexington
NC 272921820
Physical Address:
Facility Status: ❑ Compliant
❑ Not Compliant Integrator:
Location of Farm:
Latitude:
Longitude: 80°04'55"
NC HWY 109 south towards Denton: Turn left onto Cedar Springs Rd. Farm is on left.
Question Areas:
Discharges & Stream Impacts
Waste Collection & Treatment
Waste Application
Records and Documents
Other Issues
Certified Operator: Leslie R Crouse Operator Certification Number: 20939
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
On -site representative Leslie Crouse Phone: [phone]
24 hour contact name Leslie Crouse
Primary Inspector: *'ss sebrock
Inspector Signature
v
Secondary Inspector(s):
Phone: [phone]
Phone:
Date: a 3 0
Inspection Summary:
7. Still need to cut small trees on dam of push off waste pond.
28, Check with tech specialist to see if February can be listed as application month for corn.
28, PAN listings on "Summary page" in WUP don't match individual field pages. See tech specialist.
28.. T-7335 F-10 Is PAN 150 or 200? Is listed differently.
28. T-7335 F-12B and F-43, need to add pasture as a crop.
28. T-7345 F- 6 A-G need to add small grain crop to broadcast pages.
28. Is PAN 80 or 120 for irrigated small grain?
12/15/06 waste analyses:
Irrigation=0.21 lbs. N11000 gal.
Slurry=1.9 lbs. Nl1000 gal.
Page: 1

• i
Permit: AWC290014 Owner- Facility: Leslie R Crouse Facility Number: 290014
Inspection Date: 02/13/2007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations
Design Capacity
Current Population
Cattle
Q Cattle -Milk Cow 190 176
Total Design Capacity: 190
Total SSLW: 266,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
aste Pond
PUSHOFF
18.00
26.00
aste Pond
RUNOFF
18.00
33.00
Page: 2

• O
Permit: AWC290014 Owner -Facility: Leslie R Crouse Facility Number: 290014
Inspection Date: 02113/2007 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 (I.e./ 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 Ap lid catio€1
Yes
No
NA
NE
10. Are there any required buffers, setbacks, or compliance alternatives that need maintenance or
❑
■
❑
Cl
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

i •
Permit: AWC290014 Owner - Facility: Leslie R Crouse Facility Number : 290014
Inspection Date: 0211312007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application Yes No NA NE
PAN? ❑
Is PAN > 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 Fescue (Hay, Pasture)
Crop Type 3
Crop Type 4
Crop Type 5
Crop Type 6
Soil Type 1
Soil Type 2
Soil Type 3
Soil Type 4
Soil Type 5
Soil Type 6
14. Do the receiving crops differ from those designated in the Certified Animal Waste Management.
❑
■
❑
❑
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

i i
Permit: AWC290014 Owner - Facility: Leslie R Crouse
Facility Number.
290014
Inspection Date: 02/13/2007 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?
Cl
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?
❑
■
❑
❑
Other Issues
Yes No
NA
N
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
■ ❑
❑
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those
❑ ■
❑
❑
mortality rates that exceed normal rates?
3o. 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: AWC290014 Owner- Facility: Leslie R Crouse Facility Number: 290014
Inspection Date: 02/13/2007 Inspection Type: Compliance Inspection Reason for Visit: Routine
Otherissues 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 fallow -up visit by same agency?
Page: 6

Facility Number
act✓ MVj-
Division of Water Quality
Division of Soil and Water
O Other Agency
So-;,(- LL� K
° Gf-
on r0AIM 4JU
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 ❑ Denied Access
Date of Visit: I nt I 1 't IU 1 Arrival Time: Departure Time: Q County:
Farm Name: �x e F—a-irm Owner Email:
Owner Name: L1 e [' 1ro US 2� Phone: S 3 3 'f
Mailing Address:
Physical Address:
Region: JAI&
Facility Contact: (_��`l� Title: PhoneNo
Onsite Representative: ��3 Q Integrator:
Certified Operator: e �ti L-r Q us 42_ Operator Certification Number: 493�
Back-up Operator:
Location of Farm:
I 0q 5. t0
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: i 4-V ®"
L� f onto Ccdowr S Arj Kas
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ La er
❑ Non -Layer er -I _ -
Dry Poultry
❑ Layers
❑ Non -La ers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State'? (If yes, notify DWQ)
Longitude: ® ° am ` I
rip-W. Farm ari fe-f+
Design Current
Cattle Capacity Population
RSLDairy Cow
❑ 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: FL ]it
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 XNo ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes t/00-
❑ NA ❑ NE
ElYes ❑ NA ❑ NE
Page I of 3 12128104 Continued

Facility Number: Q— ! • Date of inspection .
Waste Collection & Treatment
4_ Is storagcapacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes � o
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No
\ Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: V rN
/b 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?
❑ NA ❑ NE
❑ NA ❑ NE
Structure 6
❑ Yes O�No ❑ NA ❑ NE
❑ Yes XNo ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? VkYes ❑ No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes 4No ❑ 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 El Yes No ❑ NA ❑ NE
mainter►ancelimprovement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 11,3 Alt I k 0 IkAiA V-
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes 6 No ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes [� No El NA ❑ NE
11
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? El Yes ,N` 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 %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):
Add Feloruaq �o U-)u�or C,brh ?
I
`
0,4y,
DAe—i Y� W Up a t7PS �- rW'&'�-C'-i�1 l
d
Tyr D • � I �jl Ur . � • � � � � � s l o � � -7 3 3
ReviewerAnspector Name ,s I Phone: To�G]
Reviewer/Inspector Signatur , Date:
2 of 3
a� .�3 35 F- \o
• 4 1 Y V
qT_ ? 3 S- _' g 5 M j Continued

Facility Number: — { Ote of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes X No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes OfNo ❑ NA ❑ NE
the appropriate box. ❑ WUP ❑ Checklists ❑ Design El Maps Other
21. Do s record keeping need limp/rovement? sly ❑ Yes PNo ❑ NA ❑ NE
Waste Application fry'W kiy Freeboard Waste Analysis Analysis I`J� Waste Transfers
Rainfall 2 Stockin Crop Yield 120 Minute ins ections Monthly and V Rain Inspections Weather Code
g P P
22.
Did the facility fail to install and maintain a rain gauge?
El YestNo
o
[3 NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
El Yes
>(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
'gNA
❑ NE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
XNo
//❑`` NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
)yA
❑ NE
Other Issues
f
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
9Yes
❑ No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
P<No
❑ NA
❑ NE
and report the mortality rates that were higher than normal?
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
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
o❑NA
ElNE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
rNo
❑ NA
❑ NE
Additional Comments and/or Drawings:
1G) re25 "X'jrvL ? N �d �o fie`} is Spr t h
9-
`1`13�� F.�.I
F.
oZ� Irr1 a� a1) SM.6c- r4i n gb or 106
Page 3 of 3 12128104

Division of Water Quality
Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 290014 Facility Status. Active Permit: AM29 d14 ❑ Denied Access
Inspection Type: Compliance lasgection
Reason for Visit: Routine _ _ County
Inactive or Closed Date:
Davidson Region: Winston-Salem
Date of Visit: 10/24/2006 Entry Time:12:55 PM Exit Time: 02:30 PM Incident #:
Farm Name: Crousedale Farm Owner Email:
Owner: Leslie R_Crouse
Phone: [phone]
Mailing Address: 1231 Cedar .Springs Rd 1-9xington NC 272921820
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 35"40'50" Longitude: 80°04'55" _
NC HWY 109 south towards Denton. Turn left onto Cedar Springs Rd. Farm is on left.
Question Areas:
Discharges & Stream Impacts jj Waste Collection & Treatment Waste Application
Records and Documents W Other Issues
Certified Operator: Leslie R Crouse
Secondary OIC(s):
On -Site Representative(s): Name
On -site representative Leslie Crouse
24 hour contact name Leslie Crouse
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Operator Certification Number: 20939
Title Phone
Phone: [phone]
Phone: [phone]
Phone:
Date:
Inspection Summary:
7. Need to cut trees on dam of "push -off WSP."
21. Some slurry applications in Spring 2006 were slightly outside of the 60-day sample window. Same thing happened with Irrigation
this Fall.
21. Zinc (Zn) levels seem to be increasing in soil test results. Suggest sampling at 6" on the 2006 samples to check. Prior samples
may have been taken too shallow?
24. Calibration complete. Not due again until Oct. 2008.
28. May need to add fescue pasturethay option for all fescue fields.
8/1/06 waste analyses: LSD=0.38 lbs. N/100 gal and LSD=2.87 lbs. N11000 gal.
Page: 1

•
•
Permit: AWC290014 Owner • Facility: Leslie R Crouse Facility Number: 290014
Inspection Date: 10/24/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
Cattle - Milk Cow 190 166
Total Design Capacity: 190
Total SSLW: 266,000
I l 1__a- &.-..-a._--_
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
ste Pond
F
PUSHOFF
18.00
28.00
k1ste Pond
RUNOFF
18.00
36.00
Page: 2

•
Permit: AWC290014 Owner- Facility: Leslie R Crouse Facility Number : 290014
Inspection Date: 10/24/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Discharges & Stream Impacts Yes No NA NE
1. Is any discharge observed from any part of the operation? ❑ ■ ❑ ❑
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?
■
❑
00
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: AVVC290014 Owner - Facility: Leslie R Crouse Facility Number : 290014
Inspection Date: 10/24/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Application
Yes No NA NE
PAN? ❑
Is PAN > 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 Fescue (Hay, Pasture)
Crop Type 2 Corn (Silage)
Crop Type 3 Corn (Grain)
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?
n
■
n
n
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
n
■
n
n
17. Does the facility lack adequate acreage for land application?
n
■
n
n
18. Is there a lack of properly operating waste application equipment?
n
■
n
n
Records and Documents
Yes
No
NA
NE
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
n
■
n
n
20, Does the facility fail to have all components of the CAWMP readily available?
❑
■
❑
❑
If yes, check the appropriate box below.
WUP?
rl
Page: 4

•
•
Permit: AWC290014 Owner- Facility: Leslie R Crouse Facility Number :290014
Inspection Date: 10/24/2006 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?
❑
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?
❑
❑
■
❑
Other Issues
Yes
No
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
■
❑
❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those
❑
■
❑
❑
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air
n
■
❑
❑
Quality representative immediately.
Page: 5

•
r1
Permit: AWC290014 Owner - Facility: Leslie R Crouse
Facility Number: 290014
Inspection Date: 10124/2006 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 Reviewerlinspector fail to discuss reviewlinspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
0 M 0 0
Page: 6

Q- � I C'V-0UsP_@,LA
e�oCA r✓1
Facility Number
Division of Water uality
0 Division of Soi nd Water Conservation
0 Other Agen
r Prq
Type of Visit �C.fompliance Inspection 0 Operation Rev! e 0 Structure Evaluation 0 Technical Assistance
Reason far Visit yp Routine 0 Complaint O Follow up Referral O Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: FT-01.5 5 _� DepartyTime-, fl County' O Region:
Farm Name: O'rO US P_ [ de- �Q Y-0 Owner Email: �naiCP (M13M)
'50Owner Name: 3 (1-r'Lf1 Phone: + .�� /)-s 6 '
ailing Address: Lestie, .Ire, ouSe 1 Le Y t Y)q -[or)t r �� a 7 ;zq
Physical Address: a](1 Ale /0,-) ma l Ili r4
Facility Contact: ,A S r' t_1f l� P_ Title: Phone No:((� — �a o�
Onsite Representative: Integrator:
Certified Operator: t e s I I e 1C ' /� ,, �T dU'5e__ Operator Certification Number:y 1�5 9
Back-up Operator:
Location of Farm:
Back-up Certification Number:
Latitude: 5�10 ® I © i! Longitude: V(51 ° ffq 1 13j"
1 b9 jCw4x -b `bRA�on • L e k on -to Ge a4- 5 P r I n j5 - Form
b+n le R-
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La er
❑ Wean to Finish
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (if yes, notify DWQ)
Design Current
Cattle Capacity Population
MPairy Cow
I a? S—
L1 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? (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
El Yes
El No
El NA
El NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
J<No
❑ NA
❑ NE
❑ Yes P.No ❑ NA ❑ NE
Page 1 of 3 12128104 Continued

Facility Number: Date of Inspection
Waste Collection & Treatment '4
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ElYes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
\-,4.3 Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
v Identifier: P V,V
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
KNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
* ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? %Yes
El No El NA El NE
8. Do any of the stuctures lack adequate markers as required by the permit? D Yes
o ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes
>:No ❑ NA ❑ NE
maintenance or improvement?
_Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
KNo ❑ NA ❑ NE
maintenance/improvement?
I I . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
0�0 ❑ 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) 0 M_o i J—M"- ( �_ 56.4 , , 9�� I
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
Wo
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
IX 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 #): 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):
AuA L* Lre.e5 o n p us {n op &arn a
lid
Reviewer/Inspector Name p r Phone:
Reviewer/Inspector Signatur : 4 LLA12 Date: I Qla-4
Page 2 of 3 1 1 V '' " - - 12128104 Continued

Facility Number: — late of Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes RNo ❑ 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 El Maps ❑Other
21. Doe record keeping nee7i'm vement? ❑ Yes PNo ❑ NA ❑ NE
aste Applic lionkl Freeboard LN Waste Analysis S;zthly
ysis Waste Transfers
YRainfall wtocking rop Yield 120 Minute Inspections and 1" Rain Inspections L7 Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes DN. ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No )KA ❑ 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? ❑ Yes ❑ No XNA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes Jto ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No t�NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes XNo ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes XNo ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes N No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes XNo ❑ NA ❑ NE
General Permit? (iel discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes No ❑ NA ❑ NE
Additional Comments and/or Drawings:
o�
o.3K 000 ��s.N/��y
8�(Yl a M.ee,d��N 0 (1 lei
���� 3,,,�l/�
iel S�
V r'" � ao�G 1,cae-4P
(U) 5*0't� .� ost d"o 1A2L:�'�j
Page 3 of 3 11 fJ a cog . 12128104

I
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 220014 Facility Status: Active _ Permit: AWC290014 __ ❑ Denied Access
Inspection Type: Ccomoliancelnsnection Inactive or Closed Date:
Reason for Visit: Routine County: Davidson— Region: Winston-Salem
Date of Visit: /ujg/22005 ^ . Entry Time:01:05 PM Exit Time: 03:00PM Incident #:
Fann Name: Crousedale Farm
Owner: Leslie R Crouse
Owner Email:
Phone: [phone]
Mailing Address: 1231 Cedar Springs Rd Lexington NQ 272921820
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 35°40'50" _. Longitude: 80"04'55"
NC HWY 109 south towards Denton. Turn left onto Cedar Springs Rd. Farm is on left
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Leslie R Crouse Operator Certification Number: 20939
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
On -site representative Leslie Crouse Phone: [phone]
24 hour contact name Leslie Crouse Phone: [phone]
Primary Inspector: Melissa Rosebrock Phone: [phone]
Ext.383
Inspector Signature: Date:
Secondary Inspector(s):
Page: 1

O O
Permit: AWC290014 Owner - Facility: Leslie R Crouse Facility Number : 290014
Inspection Date: 11/09/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Inspection Summary:
14. Several minor additions/revisions are needed for the WUP:
T-7335 F-42 add this field to fescue pasture broadcast.
T-7345 F-5A, B, C & E need to add to small grain broadcast list.
T-7335 F-10 add to fescue hay broadcast list.
T-7345 F-6A-F add to small grain broadcast list.
T-7345 F-6A-G add to corn silage list.
Check T-7345 F-1A through 4B, may need to be added to all broadcast lists (small grain, corn, fescue).
21. Operator is pulling soil samples for 2005 at this time. Check results next visit.
21. 8/9/05 waste sample results:Run-off=0.67 lbs. N/1000 gal and Push-off=5.51bs. N/1000 gal.
21. Operator's records look great! Keep up the good work!
28. Operator ask about applying waste to fescue in June and uly. Could not find this in the WUP. See tech specialist for possible
addition.
Page: 2

0 •
Permit: AWC290014 Owner - Facility: Leslie R Crouse Facility Number: 290014
Inspection Date: 11/09/2005 inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Cattle
Cattle - Milk Cow 190 155
Total Design Capacity: 190
Total SSLW: 266,000
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
Waste Pond
PUSHOFF
18.00
32.00
aste Pond
RUNOFF
18.00
36.00
Page: 3

•
•
Permit: AWC290014 Owner - Facility: Leslie R Crouse
Facility Number:
290014
Inspection Date: 11/09/2005 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?
❑
■
Cl
❑
Discharge originated at:
Structure
Q
Application Field
Q
Other
❑
a. Was conveyance man-made?
Q
■
Q
Q
b. Did discharge reach Waters of the State? (if yes, notify DWQ)
❑
■
❑
Q
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 Q
■
Q
❑
discharge?
Waste Collection, Storage & Treatment
Yes
No
NA
NE
4. Is storage capacity less than adequate?
Q
■
Q
❑
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
❑
■
Q
❑
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?
Q
■
Q
Q
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?
Q
Heavy metals (Cu, Zn, etc)?
❑
Page: 4

Permit: AWC290014 Owner - Facility: Leslie R Crouse
Facility Number : 290014
Inspection Date: 11109/2005 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yes No NA NE
PAN?
❑
Is PAN > 10%/10 lbs.?
Q
Total P205?
Cl
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 Fescue (Hay, Pasture)
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?
0
■
❑
❑
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?
Q
■
❑
0
17. Does the facility lack adequate acreage for land application?
❑
■
❑
0
18. Is there a lack of properly operating waste application equipment?
11
■
❑
❑
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?
❑
■
❑
Q
If yes, check the appropriate box below.
WU P?
❑
Page: 5

•
•
Permit: AWC290014 Owner - Facility: Leslie R Crouse Facility Number : 290014
Inspection Date: 1110912005 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 a 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?
❑
■
❑
Cl
OtherIssues
Yes
No
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP?
❑
■
❑
❑
29. Did the facility fail to property 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 001111
Quality representative immediately.
Page: 6

0 •
Permit: AWC290014 Owner - Facility: Leslie R Crouse Facility Number: 290014
Inspection Date: 11/09/2005 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?
r
❑ ■ ❑ Cl
Page: 7

16
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation O Technical Assistance
Reason for Visit 1, Routine 0 Complaint Q Follow up 0 Referral Q Emergency 0 Other ❑ Denied Access
Date of Visit. Arrival Timer Q� Departure Time: ®Count: >_)ri 11 i��f311 Region:
Farm Name: [�rOVs� F T1 Owner Email ��t c P i Mntl�t�C 1 �SATZI
A
Owner Name: L C'JIrQ1a5 Phone: �� ��Z�
Mailing Address: cep r l n � `f l h4 +t7 n t NC_ R 72 rQ
Phvsical Address:
Facility Contact: J 5�'je Title: Phone 4C-) — L4D
Onsite Representative: t _'o-S6 e- Crouse— Integrator:
Certified Operator: �5 1 y� • ��V�- Operator Certification Number:[_��_
Back-up Operator:
Location of Farm:
l09 S00%
on le4.
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Le-C+
5� +0
Back-up Certification Number:
Latitude: I Jul o I ®" Longitude: We]) ° ©�
o n+a c3 �C P r L vi�s Q rh�1
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
F
La eNon-La er
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
i
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
Dairy Cow
Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocket
❑ Beef Feeder
❑ Beef Brood 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? (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 4No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
t*No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
12128104
Continued

Facility Number: A9— ! 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
1 ` Identifier:
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.) 11
6. Are there structures on -site which are not properly addressed and/or managed ElYes o ElNA El NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
o
rNo
ElNA
ElNE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes
❑ NA
❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
p o
❑ NA
❑ NE
maintenance/improvement?
11111
11. Is there evidence of incorrect application? If yes, check the appropriate box below. El Yes �'No El NA El NE
El Excessive Ponding ❑ 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)
', vl� S ( 1 1>
14.
Do the receiving crops differ from those designated in the CAWMP?
[Yes
El No
15.
Does the receiving crop and/or land application site need improvement?
((❑��Yes
No
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination%❑
Yes
No
17.
Does the facility lack adequate acreage for land application?
❑ Yes
o
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
o
y
.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):
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Reviewer/Inspector Name jIf E=Qfr= hr0c1L— I Phone: 7 -11 , � tn�)t~
Reviewer/Inspector re`.M.j Date: Q
12128104 Continued

Facility Number: a. — iof Inspection
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage R Permit readily available? ❑ Yes A No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ YesNo ❑ NA ❑ NE
the appropirate box. ElWUP El Checklists El Design El Maps El Other
21. lerecord keeping need�provement? If yes, chee • the appropriate VSC'l
elow. ❑ Yes No ❑ NA ❑ NE
'aste ApYSt(
ation kly Freeboard Waste Analysisnalysis Waste Transfers
Rainfallcking Crop Yield l20 Minute Inspections Monthly and 1" Rain InspectionsVweather Code
22. Did the facility fail to install and maintain a rain gauge? El Yes
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment9 ❑ Yes
Dom' ,
24. Did the facility fail to calibrate waste application equipment as required by the permit? b'$'—*o O'lO ❑ Yes
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes
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 pen -nit 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 Pen -nit? (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?
❑ Yes
❑ Yes
LXINo
❑NA
El NE
/❑ No
kA
❑ NE
No
❑ NA
❑ NE
❑l No
1XNA
❑ NE
dNo
❑ NA
❑ NE
❑ No VN A ❑ NE
❑ Yes
o
[]NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
�No
❑ NA
❑ NE
❑ Yes
; No
❑ NA
❑ NE
❑ Yes
X No
❑ NA
❑ NE
❑ Yes
)dNo
❑ NA
❑ NE
Additional i 1 40
/.
` S
OR
4 a6U
�+ I
Mad
`L ra
7 3 F &nAjet
f�
s J
J 1 !
!. � I
+r ,
L-1

ision of Water Quality
—E. rvision of Soil and Water Conservation
O Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Z9 l4 Date of Visit: 3/23/2004 Time: 0900
O Not Operational O Below Threshold
® Permitted ® Certified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ....- -_
......... County: VAyjd�an-•--------•-•........ Farm Name: Gxausedahw.l arlUn....................................................:.... ...._.... YYS.B.O--•---
O►vner Name: lr�slie- - - ----- ----- - �rtutse--- - ----- ----- - - - - - Phone No: -
Mailing Address: l)<..Ged;itr..Apri�ngs..ltoa.d............................................................... L.1mingta►I.Ac........ .............................................. UZ92 ..............
Facility Contact: ......................Title:............................................... Phone No: $59,0589.Oara...............
Onsite Representative: 1l�.GX4U5�---- ----- _------- - ----- ----- ---- integrator: ---- - --- ----- --- - _ - --- ----- - - -
Certified Operator: LgS>R.R................................. Crmsg .............................................. Operator Certification Number: ZO9�.9.............................
Location of Farm:
YC HWY 109 south towards Denton. Turn left onto Cedar Springs Rd. Farm is on left.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 35 • 40 SO Longitude 80 • 04 55 64
Design Current
Swine Capacity Poaulation
❑ 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 215 190
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 215
Total SSLW 301,000
Number of Lagoons 1 0 1
., .. .-r-- 2
Discharges & Stream Impacts
l . Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) ❑Yes ❑ No
c. I f 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 6
Ide�uifier:_._..Push:ofllSP......_Run:aff_1�'SP_... ._
r
. ........................... --•--•-----•--------•-. ...........................
Freeboard (inches):. 3_8 42
12/12/03 � Q,/�h /Conti�tued

Facility Number: 29-14 Date of Inspection 3/23/2004
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 Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes ® No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type Corn (Silage & Grain) Fescue (Hay) 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
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 ff): 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 j
7. Operator is still working on filling in the low area on the embankment.
16. Need gauge on irrigation gun to calibrate equipment.
23. Operator has sent waste sample for Feb./Mar, `04 applications and is awaiting results to be able to determine PAN balance.
2.3. 2003 soils ok. need a little lime on a few fields.
29. Need date on revision for allowable PAN.
?9. T-7345 F-7A is in irrigation part of WUP. Needs to also be listed in the broadcast section since operator is applying waste with
Loney wagon.
10/24/03 waste analyses: Irrigation WSP=0.81 and Broadcast WSP=4.9 lbs. N/1000 gal.
Reviewer/Inspector Name Melissa
Reviewer/Inspector Signature:
Date:
12112103 Continued

Facility Number: 29- 14 l�of Inspection 3/23/2004 .
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available? ❑ Yes ® No
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.) ❑ Yes ® No
23. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ® No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes ® No
25. Did the facility fail to have a actively certified operator in charge? ❑ Yes ® No
25. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application) ❑ Yes ® No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ Yes ® No
28.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
29.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
® Yes
❑ No
NPDES Permitted Facilities
30.
Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
® No
31.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
32.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
33.
Did the facility fail to conduct an annual sludge survey?
❑ Yes
❑ No
34.
Did the facility fail to calibrate waste application equipment?
❑ Yes
❑ No
35.
Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ Stocking Form ❑ Crop Yield Form ❑ Rainfall ❑ Inspection After V Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
1211210.3

vision .. -
ion of Water Quality,
ofSoil.and'Water Conservation � y
O.Other'Agenc3' .
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit V Routine Q Complaint Q Follow up Q Emergency Notification Q Other ❑ Denied Access
Facility Number Date of Visit: B Time:
10 Not Operational O Below Threshold
Permitted ❑ Certified 13 Conditionally Certified p Registered Date Last Operated or Abbov Threshold: ...................•.....
Farm Name: Brous 1e_ Fam... County: 5N.!...1.................................
Owner Name: 1� � .-4.�.L U ......... Phone No: _.. _.. � 5_1..... J_3 ..L.. �..
Mailing Address: ... ` .
1... .. _1...... .� r�.jo . �..................}....�,.� .�.. .....�. ti ......... ? 9 Z
o u e�
�L e 5 Phone No:
Facility Contact. .......,1...............................•--..I....--•--...............Title. _._....... _.1-�'�`!._......... ..1......... J
Onsite Representative...... , g5 e. b U S 'e - ................. Integrator:.......
..............................................
1�'
Certified Operator:._. L.� G� !?0,� ............... Operator Ce • c tion Number:
..........................................
Location of Farm: -a oy 3
I Ive, f Ew� 104 5wlh , Le. F4 onio Cede 5Fri nV ea.
❑ Swine ❑ Poultry lycattle ❑ Horse Latitude ®• 1 ®f6 Longitude ®• 6 &
:.. Design _ , Current,
Current .
,;Swine _, =.f'Ca aci Po ulatioa.' Poultry «.' Cpac :Pop atibn, Cattle_ Cap ic�ity, `Pop lation '
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
E
`} Niirtiber of Lagoons
Diseharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes �No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made'? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) El Yes ❑ No
c. If discharge is observed, what is the estimated flow in gatlmin'?
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
Struct ^ uc e 2 eture 3 Structure 4 Structure 5 Structure 6
Identifier: .. �h...... w .�.�} .�� ....................................................................... ........... I ...........
..
......... .................. .........................
nQ
Freeboard (inches): .� 3
12112103 ) � Continued

Facility Number: — D e of Inspectionis
I I
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
0
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
23. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
�k/o
❑ 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?
ElYesYes
No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
El Yes
.� O
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
o
28. Does facility require a follow-up visit by same agency?
ElYes
40
29. Were any additional problems noted which cause noncompliance of the Certified AWMP?
Ayes
[:]No
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
❑ Yes
�[
p9 No
31. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
El 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 Farm ❑ Crop Yield Form [:]Rainfall ❑ Inspection After 1" Rain
❑ 120 Minute Inspections ❑ Annual Certification Form
113 No violations or deficiencies were noted during this visit You will receive no further correspondence about this visit.
dditi6hi I Comments and/or Drawtngs
12112103

Facility Number: — Date of Inspection
• 5. Are there any immediate threats to the Vieggrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
KNO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
)<No
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes
k10
8. Does any part of the waste management system other than waste structures require main tenance/improvement?
❑ Yes
o
�R
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
❑ Yes
�
$< No
elevation markings?
/ `
Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes
M<O
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
ANO
❑ Excessive Ponding ❑ PAN Hydraulic Ov rload ❑ Frozen Ground ❑ Copper and/or Zinc
12. Crop type 61 t5mall oraiq
I
13. Do the receiving crops differ with those designat " the UifiedAnimal Waste Man Bement Plan (CAWMP)?
❑ Yes
o
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?
El Yes
No
16. Is there a lack of adequate waste application equipment?
❑ Yes
1KNo
Odor I.sues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below .
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes o
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes o
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 XNO
Air Quality representative immediately.
Comments (refer t, question #} _ Explain any YES answers and/or any recommendati6ns or.any other comments:: ,•
se;drof awjngs facility to better ezplain':situations (use additional pages as-fiecessary) - Field p ❑ Final Notes
:U
3 X0 3
-b
a� T-73 �15 F- 7 P x m' ,4, �
Pq
Reviewer/Inspector Name
Reviewer/Inspector Signatu A7 Date:

-T—ochnical Assistance Site Visit Report
DilMn of Soil and Water Conservation
Natural Resources Conservation Service
Soil and Water Conservation District
Other...
Facility Number Date: 8113103 Time: $:50 Time On Farm
Farm Name Crousedale Farm
County Davidson
120 WSRO
Phone: [phone]
Mailing Address 1231 Cedar Springs Road Lexington NC 27292
Onsite
Representative Leslie Crouse 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
Design Current
Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder.
❑ Farrow to Finish
❑ Gilts
❑ Boars
* Routine
O Response to DWQIDENR referral
O Response to DSWC/SWCD referral
O Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
® Dairy
❑ Non -Dairy
* Routine
O Response to DWQIDENR referral
O Response to DSWC/SWCD referral
O Response to complaint/local referral
O Requested by producer/integrator
O Follow-up
O Emergency
O Other...
Design Current
Capacity Population
❑ Layer
❑ Non -Layer
® Dairy
❑ Non -Dairy
® Dairy
❑ Non -Dairy
2151
179
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes ® no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached ❑ yes ® no
surface waters or wetlands?
3. Does any problem pose an immediate threat to the integrity of the waste structure (large trees, ❑ yes ® no
seepage, severe erosion, etc.)?
4. Is there evidence of nitrogen over application, hydraulic overloading or excessive ponding ❑ yes ® no
requiring DWQ notification?
6- Is there evidence of improper dead animal disposal that poses a threat to the environment ❑ yes ® no
and/or public health?
6. Is the waste level within the structural freeboard elevation range for any waste structure? ❑ yes ® no
Structure1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier Pushoff WSP 11 Runoff ^
Level (Inches) 24 31
CROP TYPES Icorn, silage Ismail grain silage Fescue -graze Fescue -hay
SPRAYFIELD
SOIL TYPES BaD
BaE
GeB
UwD
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

•
Facility Number 29 - 14 Date:
8/13/03
PARAMETER
O No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
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 wlproducer
❑
❑
❑ 12. Waste structure integrity compromised
El13. Waste structure needs maintenance
28. Forms Need (list in comment section)
❑
❑
29. Missing Components (list in comments)
❑
❑
❑ 14. Over application >= 10% & 10 lbs.
❑ 15. Over application < 10% or < 10 lbs.
30. 21-1.0200 re -certification
❑
❑
❑ 16. Hydraulic overloading
31. Five & Thirty day Plans of Action (PoA)
❑
❑
32. Irrigation record keeping assistance
❑
❑
❑ 17. Deficient irrigation records
❑ 18. Late/missing waste analysis
33. Organizelcomputerization of records
❑
❑
❑ 19. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
❑ 21. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22. Crop inconsistent with waste plan
36. Sludge removal/closure 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
❑
❑
❑ Referred to NCDA Date
43. Irrigation design/installation
El
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 updated for crop windows of
47. Evaluate WAD certification/rechecks
❑
❑
48. Crop evaluationtrecommendations
❑
❑
application.
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

•
�7
Facility Number 29 - 14 Date: 1 8/13/03
ICOMMENTS:
Waste analysis: 3-19-03 LSD 0.60 Lbs.N11000 gals. I, LSD 2.2 Lbs.N11000 gals
Soil analysis dated 1-22-03 was mailed in Dec. 2002.
Suggest having the maximum liquid marker checked on the pushoff waste pond. The fop of the marker appears to be
gher than the fop of dam. There may need to be some fill material added to the embankment for some low areas.
Facility and records look good overall. Mr. Crouse has done a good job managing the waste pond levels with all of the rain
is year.
TECHNICAL SPECIALIST Rocky Durham
SIGNATURE
Date Entered: 8/15/03 1 Entered By: JRocky Durham
3 03/10/03

` vision of Water Quality
rvision of Soil and Water Conservation
t 0 Other Agency
f
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 29 14 Date of Visit: 03/03/2043 "Time: 1035
r Not Operational 0 Below Threshold
® Permitted ® Certified 0 Conditionally Certified © Registered Date Last Operated or Above Threshold : ...................
.. Farm Name: Gi:n>aSedal�.farun.................................................................................... .. County: Qaxid5.91I....................... ...................... 1tA........
OwnerName: Wfip....................................... GraUSe.............................. .......................... Phone No: ( .C%. 59.: QZ........................ ........... .....................
Mailing Address: f2�1.G��.a1t..SRxArxgs.ltQ.a�............................................................... Lukaton... 1N.C...................................................... Z7.29.2 ..............
Facility Contact: ............................................Title:................................................................ Phone No:aro.�n�S.9..QS�...........
Onsite Representative: f.�S11�.GJrt?.US�....................................................Integrator: ......................................................................................
Certified Operator:Ltsjlfe.&................... Cromw .............................................. Operator Certification Number:2.09.39 .............................
Location of Farm:
NC HWY 109 south towards Denton. Turn left onto Cedar Springs Rd. Farm is on left. +
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 50 .f Longitude F SO • 04 55
Design Current
Swine Canacitv Panulation
❑ 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 215 188
❑ Non -Layer JE1 Non -Dairy
❑ Other
Total Design Capacity 215
Total SSLW 301,000
Number of Lagoons 0 JE1 Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps 2 ❑ No Liquid Waste Management System
Dischari!cs & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed. was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Stnucture G
Identifier: ... P.ushmf .W.SP.... ....Rstn.off:.WSP..... ................................... ....... I-:......................... .... .................... ........... ............... I...................
Freeboard (inches): 27 23
05103101 ���� � Continued

Facility Number: 29-14 0 Date of Inspection 03/03/2003
is
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? I❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Fescue (Hay) Corn (Silage & Grain) Small Grain (Wheat, Barley,
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑Yes NNo
❑ Yes N No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes N No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes N No
b) Does the facility need a wettable acre determination? ❑ Yes N No
c) This facility is pended for a wettable acre determination? ❑ Yes N No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes ® No
❑ Yes ® No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes ® No
❑ Yes N 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 Copy N Final Notes
I9. Waste sample ok for Jul./Aug. 2002 applications. 2002 soil analysis ok.
19. Tract 7335 Field 46 received waste from broadcast application but is list in CAWMP under irrigation.
19. Need different waste record form for each crop.
19. Need to obtain waste analysis for Feb./Mar. 2003 applications. Check next visit.
9/11/02 waste analysis :#1 WSP irrigated = 3.4 lbs. N/I000 gal. and broadcast = 3.7 lbs. NI1000 gal. #2 WSP = 1.1 lbs. NI1000 gal.
DWQ sent operator the computer version of the waste spreadsheets.
Reviewer/Inspector Name Melis Rosebrock
Reviewerllnspector Signature: kAiflAdltl I Date:
05103101
Continued

I. Facility Number: 29-14 I of Inspection 031a3/2003
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
P3'No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
ANo
roads, building structure, and/or public property)
24. 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 pemnanent/temporary cover?
❑ Yes
❑ No
Additional omments and/orDrawings:
A,
05103101

Division of Water Quality "
0 Division of Soil sod Water Conservation
0 "other °Agency
iType of Visit W Compliance Inspection O Operation Review O Lagoon Evaluation I
ReasonforVisit Routine Q Complaint O Follow up O Emergency Notifleat}on.i O Other ❑ Denied Access
Facility Number Date of visit: Time:
Ly Permitted %CD
ertified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: u5 e, oU I e- Fa rrh) County N 11d5c'n
Q
Owner Name: La!!�} ( I P anu5 e- Phone No: 3314 • , �� 1 . 33171L _
Mailing Address _ 12� I fed �r �IJ I' i. L r
Facility Contact: z14 Cato U5d Title: Phone No: r) a�g9
Onsite Representative: Les 1.1 e_ 110 b V's e Integrator:
Certified Operator: L� �, e— L' , •,_ "� Operator Certification Number: qO
Location of Farm:
IJ wy 5. 4& befrton Lef4 on46 " Sp r 1 ng5 p_d .
❑ Swine ❑ Poultry Cattle ❑ Horse Latitude 1:3�' [�• ®" Longitude ®e�
Design Current Design Current Design Current
�Pw'tne Ca acity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
Poultry Ca aciri• Population Caple Capacity. Population
❑ Laver i Dairy
❑ Non -Laver { Non -Dairy
❑ Other ti
Total Design Capacity S
Total SSLW
Number of Lagoons - I❑ Subsurface Drains Present JO Lagoon Area
Holding Ponds f Solid Traps ❑ No Liquid Waste Management System
[]_Spray Field Area
_.
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
❑ Yes
PNo
Discharge originated at: El Lagoon ❑ 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 yes, notify DWQ)
El Yes
❑ No
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
❑ Yes
❑ No
2. Is there evidence of past discharge from any part of the operation?
El Yes
No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
❑ Yes
XNo
Waste Collection & Treatment
kqNo
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
❑ Yes
Structure 1„Siruc e 2 ccture 3 Structure 4 Structure 5
Structure 6
Identifier: f " 41J.�
Freeboard (inches):
05103101
Continued
I y,

Facility lumber: — Date of lnspectimi
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? [—] Yes kNo
o
23. Is there anv evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt. ElYes
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.) E3--f2s— o
31. Do the animals feed storage bins fail to have appropriate cover? = o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
omments
Wes 4-torn, a7oo2 : -
a�oa
g/ll/o2 waste Rr�tl ysis
V
� 8
w y n n n com
�/
\1A- -�335
vAIL
n r,,
� 6 i
r r r
FA
a2 /�� aoo3

... , gyp, 0
Facility Number: — Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion.
❑ Yes Vo
seepage, etc.)
I
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
No
closure plan? (If any of questions 4-6 was answered yes, and the situation poses an
❑ Yes )K
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
❑ Yes ANo
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
❑ Yes '1C`0
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes NINo
Waste Application
`
10. Are there any buffers that need maintenancelimprovement?
❑ Yes VNo
11, Is there evidence of over pplication? Excessive Ponding ❑ P Hydraulic Overload
ElYes No
v
12. Crop type
13. Do the receiving crop iffer with those designate the Certified Animal Waste Manag ent Plan (CAWMP)?
❑ Yes No
14. a) Does the facility lack adequate acreage for land application?
El Yes No
b) Does the facility need a wettable acre determination?
El Yes No
c) This facility is pended for a wettable acre determination?
El Yes No
15. Does the receiving crop need improvement?
El 1
16. is there a lack of adequate waste application equipment?
❑ Yes KNo
Re uired Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes kNo
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps. etc.)
❑ Yes E hio
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes �To
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes T
21. Did the facility fail to have a acrively 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)
ElYes .kNo
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 o
25) Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes 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 expliin situations..(use additional pages as necessary): Field Conv v❑ Final Notes i
Reviewer/Inspector Name - -CibrD
Reviewer/Inspector Signature: Date: c�
211
05103101 1 q , V`" Continued

'`. Q r' 'sion of Water Quality
4019sion of Soil and Water Conservation
O Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 29 14 Irate 01, Visit: 8/27/2002 Time: t0:15
Q Not O erational 0 Belo►►• Threshold
®Permitted ®Certified 0 Conditionally Certified [3Registered Date Last Operated or Above Threshold: .... ......... .
Farm Name: C1CQ>x cdaAR Fartlt3...................................................................................... ... Countv., Va'dds ix.......................................... W—SR.0........
OwnerNome: L.tslae....................................... C.r.Q.U;R ........................................................ Phone No:(1.SS9-.9.2........................................................
Mailing Address: 12..1. siax..SRxAt s.12Q.ad............................................................... Lui»ilrtotl... Pi.C.............................................I........ 2.7,29.2 ..............
Facility Contact: ....................................... .................... . Title: .. Phone No:
Onsite Representative: �S�IIe.rSl.uS�.............................................................................. Integrator: ......................................................................................
Certified Operator:Luric.8.................................. cjr.quag .............................................. Operator Certification Number:2.09,39 .............................
Location of Farm:
NC HWY 109 south towards Denton. Turn left onto Cedar Springs Rd. Farm is on left. l
_J,I
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 35 • 40 S4 Longitude 1 80 • 04 SS
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Soars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer a I ® Dairy 215 179
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 215
Total SSLW 301,000
Number of Lagoons ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds 1 Solid Traps 2 ❑ 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 ElOther
a. if discharge is observed, was the conveyance man -[Wade? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes. notify DWQ) [f 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 6
Identifier: ...Push.-.a£f.52V.SP... ... .Rurt-.off.w. SP..................................................................................................................................................
Freeboard (inches): 36 30 _
05103101 Continued

Facility Number: 29-14 hate of Inspection 8/27/2002
5. Are there any immediate threats to the it grity of any of the structures observed? (ie/ troevere 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 Aanlication
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type Fescue (Hay) Corn (Silage & Grain) Small Grain (Wheat, Barley,
❑ Yes ® No
❑ Yes ® No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes N No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes N No
b) Does the facility need a wettable acre determination? ❑ Yes N No
c) This facility is pended for a wettable acre determination? ❑ Yes N No
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Pernvt or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20, is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N No
❑ Yes N 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 Copy N Final Notes
Will need to send off a waste sample soon for the July and Aug. applications.
+
Other records and facility look good.
* Remember to get the 2002 soil samples in before the end of the year.
Mr Crouse is planning on leaving the sand/sludge clipped out of the push -off wsp this Fall.
T
Reviewer/Inspector Name Rocky Durham
Revie,iverllnspector Signature: Date:
O5103101
Continued

Facility Number: 29-14 Date -f Inspection 8/27/2002
0 0
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
Additional omments and/orDrawings:
Waste analysis: 3-17-02 (1) LSD 1.6 lbs.N/1000 gals. I, (2) LSD 4.2 ibs.N/1000 gals. 1, 4.6 lbs.N/1000 gals. B +
J
O5103101

vision of Water Quality
iSion of Soil and Water Conservation
Q Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 29 14 U""" of v"it= 3I1/20U2 Tim.. I045
Not Operational Q Below Threshold
■ Permitted ■ Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: Cxowedaltt.Farm...................... .. County: paxi&wx.......................................... W.SRQ........
.......................... ..............................
OwnerName: Wlat....................................... Crowe....................................................... Phone No:QQW.8159..N92 ........................................................
MailingAddress: i2 1.Co ax.,S �A�S.RQ�sI.............................................................. L9x1mgtA.n...NC...................................................... 2.7.292 .............
Facility Contact: USLk.CxouS�.................................................Title:................................................................ Phone No: >lar.a.3,36A5.9..QS89...........
Onsite Representative: Colic.CxQlAst.............................................................................. Integrator: .................................................... ................... I..............
Certified Operator: CeAie—R................................. G7tR�t��.............................................. Operator Certification Number: Z09.39......................
Location of Farm:
VC HWY 109 south towards Denton. Turn left onto Cedar Springs Rd. Farm is on left.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude Longitude 80 • 04 55
Design Current
J W 111C
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 215 19E}
Non -Layer Non -Dairy
❑ Other
Total Design Capacity 215
Total SSLW
Number of Lagoons 0 ❑Subsurface Drains Present ❑ Lagoon Area ❑Sprat Feld Area
Holding Ponds / Solid Traps 2 10 No Liquid Waste Management System
Dischar'ees & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: []Lagoon ❑ Spray Field []Other
a. if discharge is observed, was the conveyance man-made`' ❑ Yes []No
b. If discharge is observed. did it reach Water of the State? (If yes. notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes. notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? - ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .... Pushoff.W. SP..... ......Parlor... .S.E.........................
Freeboard (inches): 28 27
05103101 Continued

-1 0
Facility Number: 29-14 Date of Inspection 1 3/1/2002
0
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenancelimprovement?
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?
r
❑ Yes
® No
❑ Yes
® No
® Yes
❑ No
❑ Yes
® No
❑ 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 Fescue (Hay) 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
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 reviewlinspection 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.
Comm ntsj(refereto question #): Explain any YES answei s many recommendations.or anyR_other.comments:` s.. _.
Use drawings of facility to',be't'&7explaintsituations (u_senadditional pages6s"; eves`sa y)
, ❑ Field COPY ®Final Notes :fa
w "..�:;r���b
7. Top of dam of #1 is somewhat bare and denuded from farm machinery traffic. If this area doesn't vegetate this Spring, operator will
_
re -seed.
19. Some of the 2002 soil samples have been sent. Results have not been returned yet.
19. Will need to get waste sample for 2/25/02 applications.
25, Tract 7340 and Tract 7335 Field-10 are listed under "irrigation" in the CAWMP but operator also applied waste to these "pulls" by
"broadcast." 1 cautioned operator about potential over -application if he irrigates and broadcasts wastes onto the same area. So far,
the areas that are irrigated have not received broadcast waste in the same season.
Reviewer/Inspector Name jMeossa Rosebrock
Reviewer/Inspector Signatur . Date: Q
05103101 t Continued

ti
Facility Number: 29-14 Dief inspection 3/1/2002 •
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation`?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ❑ No
05103101

•
I I AM
Type of Visit ,
Reason for Visit
Division of Water. Quality
�'�Divislon of'Soil and Water Conservation
0 Other Agency
nce Inspection 0 Operation Review 0 Lagoon Evaluation
ne 0 Complaint 0 Follow up 0 Emergency Notification 0 Other
❑ Denied Access
FacilityNumber Date of Visit: L'] j_LJ Time:
_ TT —
Not O eratinnal Below Threshold
Permitted Certified D Conditionally Certified 0 Registered Date Last Operated or AbF_ Threshold:
Farm Name: �, r-0 0 S-Q_ 610,1 e, R r ry� y� L L C County: ill V t Q1� Q
Owner Name: Le 5 ` e, (2, r6 U:J -e' Phone No: 3� 8S % [ Z
Mailing Address: 1 C 'Q� S U f t n4S F—C� ' i 1 x; �'laT� F a 7� !
�
Facility Contact: __ L LS it 42- O''r0 Uy (2— Title: Phone No: 11i rn 336. _99- C 9�
Onsite Representative: I _.e ! ff k /a&O oSL Integrator: 2
Certified Operator: _ Le5 i I Q f_ r(� l55 Operator Certification Number: J9
Location of Farm:
NC �y 109 Sots---h +z Ee o-r S psi Ts P v +V rn '4. Farrn a n
F.,
❑ Swine ❑ Poultry 1� Cattle ❑ Horse Latitude ' 1 ®« Longitude ®* 4 I S�1.
Design Current
Design Current
Design Current
Swine Ca acity Population
Poultry
Capacity Population Cattle
Capacity Population
❑ Wean to Feeder
❑ Layer
I
N—Dairy
a _
❑ Feeder to Finish
❑ Non -Layer
I
I
JLJ Non -Dairy
❑ Farrow to Wean
❑ Farrow to Feeder
❑Other
❑ Farrow to Finish
Total Design Capacity
js
❑ Gilts
Total SSLW
❑ Boars
Number of Lagoons 10 Subsurface Drains Present I ❑ La oon Area 1EJ S rav Field Area
Holding Ponds 1 Solid Traps EJ ❑ No Liquid Waste Management System
Discharges &c Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes P<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)
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 (n]Structure 2 Structure 3 Structure 4 Structure 5
Identifier: Y?U
m I t_lc f1 a'_0
Frceboard (inches):
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ Yes
No
Structure 6
05103101 0,% 1 Continued

Facility Number: Date of Inspection 1 a
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
ANo
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
El Yes
)1 No
T�
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
A 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
1
elevation markings?
Cl Yes
gNo
Waste Application
10. Are there any buffers that need maintenance/improvement?
❑ Yes
No
11. Is there evidence of over application? ❑ Exec ive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
No
12. Crop type 7 i
f
13. Do the receiving crops differ with thosiVdesignated in the Certifi d Animal Waste Management Plan (CAWAP)?
❑ Yes
No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
W 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
A No
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
_KNo
I & Does the facility fail to have all components of the Certified Animal Waste Management Ian readily available?
(ie/ WUP, checklists, design, maps, etc.) /
❑ Yes
)<No
XNo
19. Does record keeping need improvement? (ie/ irrig tion, freeboard, waste analysis & soil sample reports)
❑ Yes
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?
❑ Yes
AN 0
(ie/ discharge, freeboard problems, over application)
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?
El Yes
<O
F13—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 Couv El Final Notes
Reviewer/Inspector Name r — ~ e FVWE
Reviewer/Inspector Signature V 4,46 AY Date:
05103101 1, Continued

Facility Number: aq— Date of Inspection
dor 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?
mments a
caw
❑ Yes .,kfNo
❑ Yes XNo
�T- 73q0 .�o.� � TIC e
L4,w
05103101

' ton of Water Quality
Q�E`ision of Soil and Water Conservation
Q Other Agency
Type of Visit- O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit IS Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
Dale of Visit: 14/10/2001 Tints: 1100 Printed nn: 10/10/2001
29 14
O Not Operational 0 Below Threshold
® Permitted ® Certified [3 Conditionally Certified © Registered Date Last Operated or Above Threshold: .........................
Farm Name: Crousedate.k:arm................................................................................ County: Vuldsai.......................................... !'.['SRO........
Owner Name: U51b ...........................
............ . t:Huse.........................................
Mailing Address: 1231.Otwdar.5R1I ug5.RSA............................
Facility Contact: I,,.Stir-C1'OUSp.................................................. Title:..........
Onsite Representative: LC.51j,C.C.rQ.U5C......................
........................................
Certified Operator:L4Wje...................................... Gx411715�....................... ................ ........
Location of Farm:
Phone No: 33.12-559..7,392...........
Ua;juts*tm-KC....................................................... 2.7.292 ..............
Phone No: bara.3,3.6.859.,339Z ...........
Integrator:._.
... Operator Certification Number:20939
109 north of Denton 5 miles. Ceder Springs Rd. 1 mile, farm on left at top of hill.
❑ Swine ❑Poultry ®Cattle ❑Horse Latitude 35 • 40 50 11 Longitude 80 ' 04 55
Design Current
Swine Caz)acity 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 215 180
❑ Non -Layer JE1 Non -Dairy
❑ Other
Total Design Capacity 215
Total SSLW
Number of Lagoons 0 ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps 0 10 No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed. did it reach Water of the State? (If yes. notify DWQ)
c. If discharge is observed. what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system'? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge'?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure I Structure 2 Structure 3 Structure 4 Structure 5
Identifier• 1?atshaff M;IL arlor
El Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes
❑ No
❑ Yes
CM No
❑ Yes
® No
❑ Yes
Do No
Structure 6
...... p................................................................................................................................. I.................
Freeboard (inches): 24 78
05103101 Continued
.J�oi! 7l�

Facility Number: 29-14 Date of Inspection 10/10/2001 Is Printed on:
5. Are there any immediate threats to theTntegrity 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?
10/10/2001 ►_ -
❑ Yes ® No
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
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, 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?
❑ 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? (iel irrigation, freeboard, waste analysis & soil sample reports)
® Yes
❑ No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® 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
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 adtlitional pages as necessary): ❑ Field Copy ® Final Notes
19. Operator needs to revise acreage on application forms.
_
Need to add T-7340 (and associated fields) to charts in WUP. Could only locate this tract on the map. T-7345 is only outlined on the
map, not listed in chart in WUP. May want to check other irrigation fields as well. Suggest contacting SWCD for assistance,
ent operator a change of ownership form.
Reviewer/Inspector Name Meli� Rosebrock
Reviewer/Inspector Signature: 'AbDate: t
05103101 v F 1 Continued

1. Facility, Number: 29-14 1 D*Inspection 10110/ZOOI 0 Printed on: 10/10/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
3I. 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
l`_' ' itiona 1,'omments an
or _rawings::.� 11 '' _ T, �.,�,
`u !'-, f/ W1
7
05103101

ofrWater Quality, .,•
. > ° z
A rvision of Soil and Water Conservation.
�
• . Other A I
Q 6
{� b
�
Type of Visit
Compliance Inspection O Operation Review Q Lagoon Evaluation
Reason for Visit
xRoutine O Complaint O Follow up O Emergency Notification
O Other
❑ Denied Access
Facility Number Date of Visit: 10 0 Q Time:
Q Not Operational O Below Threshold
4 Permitted #Certifled [3 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:
Farm Name: f Q U S Q..t? m L l� County:.............................................................. ( 1 G�.......................
.... ...... �% p........ �f.. p ......................
Owner Name: .......... . (= ....... ............ ......... :. v" �.f �C�..... Phone No: 3.3�P • 8S9 • 33. .................:.
Facility Contact: �r?:�,�. C—rou ...Title• Phone No: r►1 , 3�t $S`
•ty ........ ......�S...... .....:................................................................ SS
Mailing Address: ........ I a 3 C eat ...... n1fl.3.......I� L �xt -�.. � n N � a.. .......... ...............
......... .............. .............�....... �...............
Onsite Representative: -. (L.-..r..................................................... Integrator:.......................-.........-....................................................
Certified Operator•. ..- QS �trr7 �— Operator Certification Number: •, ••
Location of Farm:
109.4
❑ Swine Poultry ')2f Cattle ❑ Horse Latitude �• ©� Sb Longitude ®• �� SS "
Design Current
Swiine CaDacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design . Current
Design Current
Poultry
CapacityCipacity Population Cattle
Capacity ' Po ulation '
❑ Layer
Dairy
a
❑ Non -Layer
Non Dairy[
❑ Other
Total Design Capacity
Total SSLW
3 0 + a p 0
Number of. Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑Spray Field Area
Holding Ponds / Solid Traps. vi ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes XNO
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 S ucture 2 „� Structure's Structure 4 Structure 5
1 Yy` Identifier:...�.5.......- 4 ....................... ......;.... ..... .. . ...................................................................................................
Freeboard (inches):
�kL tl kL(lor
5/00
❑ Yes ❑ No
❑ Yes No
ElYes No
❑ Yes �No
❑ Yes >(No
Structure 5
Continued on back

Facility Number: — .0 Date of Inspection faQ%1
5. Are there any immediate threats to the integrity of any of the structures observed? (ic// trees, vere erosion, ❑ Yes j 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 4No
8. Does any part of the waste management system other than waste structures require maintenancelimprovement? ❑ Yes XNo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes X No
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes No
11. Is there evidence of over application? Q Excessive PondinglI❑ P��A__N'' ^0 Hydraulic Overload ❑ Yes �l�To
12. Crop type ///���
13. Do the receiving crops differ with those 'designated in the Certified Animarwaste
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?
Plan (CAMP)? ❑ Yes
❑ Yes
!jdNo
� No
❑ Yes
9No
❑ Yes
tirNo
❑ Yes
00
❑ Yes
X 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.)
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?
tQ yiQla iQ> s oi- d� cienc{es i re pQte� during this;visit; Yoiit will receive 06 futlhOt:
correspondence. about this visit«
❑ Yes VNo
[]Yes �(No
Yes ❑ No
❑ Yes Wo
❑ Yes �No
❑ Yes WNo
❑ Yes XNo
❑ Yes J No
❑ Yes o
Comments (refer to question #}: Explain any YES answers and/or any recomMendatlons brainy other comm
Use =�
..... .... a .. y ..
Use drawings of facility to better explain situations. (use additional pages as necessary)
=s.
i
Reviewer/Inspector Name
Reviewer/Inspector Signaturei,///I A A y I ,4,A 4 JIVAW I f k .b lP ) Date: 10/ IO/ 0 1 5100

Facility Number: oZ — "of Iirspcction
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below El 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? ❑ Yesx] No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes 010
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ANo
31. Do the animals feed storage bins fail to have appropriate cover? $'1�zs�No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 1-Ycs--EJ
T- 73 q-a
T - 7 3 Y�S
Ade—
5100
IV

*tvher
ision of Water Quality
vision of Soil and Water Conservation Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number
),Ile of Visit: 5/8/2401 "lino: 11:04 Printed on. 10/2/2001
29 14
Q Not Operational O Below Threshold
® Permitted ® Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
Farm Name: 1KimlASI:[Aakkarm....................... ...... County: J),axjd5jQ.jj .......................................... W.$RQ........
Owner Name: Bay ........................................... .GrAUSe........................................................ Phone No: b-139-92..............................
.............................
Mailing Address: t231..(:.t dar_5,prjD,gS.Rd.................................................................... U7tingGS?.[1..AC........ ......................... ..................... 27.29.2 ..............
FacilityContact:..............................................................................Title:................................................................ Phone No:...................................................
Lt�S
Onsite Representative: IAe.. OmSe.................................................. ........................... Integrator:......................................................................................
Certified Operator:Ii,.e.SIAc...................................... C QIASt<.............................................. Operator Certification Number:ZQ9 Q9 .............................
Location of Farm:
109 north of Denton 5 miles. Ceder Springs Rd. 1 mile, farm on left at top of hill.
V
I —
[I Swine ❑ Poultry ® Cattle ❑ Horse Latitude F 35 • 40 50 Longitude 80 ' 04 55
Design Current
Swine Capacity 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 215 185
❑ Non -Layer I I JE1 Non -Dairy
❑ Other
Total Design Capacity 215
Total SSLW 301,000
Number of Lagoons I I ❑ Subsurface Drains Present 1113 Lagoon Area 10 Spray Field Area
Holding Ponds 1 Solid Traps 1 2 ❑ No Liquid Waste Management System
Discharges R 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? ElYes ❑ No
b. If discharge is observed. did it reach Water of the State? (It yes. notify DWQ) ❑yes ❑ No
c. If discharee is observed. what is the estimated tlow in Ural/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ) El Yes El 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 6
Identifier: ..........1'.ttstwff..............---- ..Ruaaff........... ....................................
Freeboard (inches): 40 20
05103101 Continued

Facility Number: 29-14 D..itc of Inspection 5/$/Z[1[II Printed on: 10/2/2001
Vesrity
5. Are there any immediate threats to the of any of the structures observed? (ie/ tre0evere 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
[I Yes
® No
12. Crop type Sinai] 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
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?
(iel discharge, freeboard problems, over application)
❑ Yes
® No
21
Did Reviewer/lnspector 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
[] 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
4. The runoff pond is getting close to the max. liquid mark. Mr. Crouse is planning on irrigating it out as soon as he finishes cutting
_
small grain silage. He has been cutting silage this week.
9. Recommend a graduated marker to be able to record weekly holding pond levels.
Overall records and facility are in good shape.
Application windows for crops have been adjusted since last year.
Reviewer/Inspector Name Rocky Durham
Reviewer/Inspector Signature: Date:
05103101 Continued

Fad?lty Number: 29-14 Duf Inspection 5/8/2001 Printed on: 10/2/2001
0
Odor Issues
26, Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanenUtemporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ®No
❑ Yes ® No
[]Yes ® No
❑ Yes ❑ No
Additional omments and/orDrawings:
Waste analysis: 3/29/01 LSD 0.59 lbs.N/1000 gals. I, 5.8 Ibs.N/1000 gals. I, 6.3 Ibs.N/1000 gals. B
1 1 /22/00 LSD 1.60 " ", 4.6 " ", 5.0
05103101

r� vision of Water Quality
t tston of Soil andWateir-Conservation
O ther Agency
Type of Visit OO 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 29 14 Dale or visit: t3i23/2000 'rime: 1025 Printed on-- 8/24/2000
O Not Operational O Below Threshold
® Permitted ® Certified 0 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ...................
Farm Name: Cx wcdakfarm......
Owner Name: PAx........................................... CKQusg.........................
Facility Contact: ..............
Mailing Address: 1.G�da>il�><xn��.st..............
County: Dayidsatnt.......................................... lYSRt?........
.. Phone No: .................................................
Title: ................................................................ Phone No:arnt.Sx�S�,QS19...........
la%Kbag.tQ,n..XiQ...................................................... 27.292 ..............
Onsite Representative:L.4P.AWXjr.9m.5c................ . Integrator: .............................................................................
Certified Operator:,the.%................................ GA:Rwc................. ....... Operator Certification Number: ..
.. ..........................
Location of Farm:
109 north of Denton 5 miles. Ceder Springs Rd. l mile, farm on left at top of hill.
❑ Swine ❑ Poultry ® Cattle ❑ Horse Latitude 35 • 40 L 5066 Longitude 80 • 04 6 55 C{
Design Current
Swine Canacitv Ponnlatian
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Cauacitv PoiDulation Cattle Capacity Population
:1Layer ® :Dairy 215 15$
❑_d
Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 115
Total SSLW 301,000
Number of Lagoons 0 ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps 1 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, did it reach Water of the State? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ® No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ....... ..Push.D.ff........:......Mille: Paxl ar.....:.......................:...............:.................:.......................:..................................:........................:..
Freeboard (inches): 36 24
5100 Continued on back

Facility Number: 29-14 Date of Inspection 8/23/2000 Printed on: 8/24/2000 a
5. Are there any immediate threats to the4grity of any of the structures observed? (ie/ troevere 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, Fescue (Hay) Timothy, Orchard, & Rye
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination? - - - -
❑ Yes--®
No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15.
Does the receiving crop need improvement?
❑ Yes
® No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
® No
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
0; �4*1olations'or- deficiencies •were noted :dueing this: visit.:You:rvill ir&ijy4e-h&furtlter-
correspondence: abouf this'visit. • : • : • : • : :
CoFnments (referto'question #) Ekplam any YES aan�sywers and/or any recommendations or any other comments.
Use d�rawwiings of.facilrty�to, better explain situatioh9.'!(use'additional pages'as necessary)
�. Suggest putting in horizontal bars for easier weekly reading.
19. Corn silage application in March and orchardgrass application in August were both outside of the application window. A waste
analysis was not available within 60 days for 2/26/00 and 3/l/00 applications.
copy of freeboard form to Leslie.
1W

Facility Number: 29-14 D�of Inspection 8/23/z000 . Printed on: 8/24/2000
• dQQr lssues
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 ]and application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes IS 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
Additi6tfal ° ommentsian„ or rawings:
•
5100

of Visit
Reason for Visit
ivision of Water Quality
ivision of Soil and Water Conservation
'*
Q Other Agency
Compliance Inspection O Operation Review O Lagoon Evaluation
Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date- or visit: 'imr: Printed on: 7/21/2000
Q Not O erational Q Below Threshold
J�rlermitted,Certified ❑ Conditionally Certified © Registered Date Last Operated or Above Threshold
Farm Name: ........ .l V ... .1.t.......Fa.r ...... Count`:..... i.61_5.a.....................................
...... ..............
Owner Name:........ ................ Cr01.i.C`�......................................................... Phone No: ......3_5 a.a....X�..L....... .. ..L `-.
Facility Contact: ....... ..L. Title: ''P6orie'No: 44 ...� :..-7rg.....
^B•S
Flailing Address: ...................... Qlr"......ri..................� ..........�.�°.�.....!?... /L� a7zq
Onsite Representative: •�,��Q, �L.t... .... XIL. �j..t5......................................... integrator:............. Certified Operator:...] e., ..�.�. '.......�o.L)541e ................................ Operator Certification Number: ....�bf ..�' •..I........
Location of Farm:
l q, Norte o j•e,sn+on, S m r 5 . , o­v- Sprt. n4S fn r e_�
❑ Swine ❑ Poultry V.Cattle []Horse Latitude 1 0 �J1 1 Longitude 1 01
1 1J«
Design Current
Swine Capacity Pnnnlation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population C ttte Capacity Population
❑ Layer airy I a1
❑ Non -Layer 1 1 10 Non -Dairy
❑ Other
Total Design Capacity
Total SSLW 301 1 000
Number of Lagoons 1❑ Subsurface Drains Present �1❑ Lawn Area
Holding Ponds / Solid Traps a.. ❑ 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, %vas the conveyance man-made?
h. If discharge is observed. did-it-lr-each Water of the State'? (If yes, notify DWQ)
c. If disc:harLe is observed. what is the estimated flaw in gal/min ?
i
Spray Field Area
d, lanes 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 Strpucturc 2 {S-tructure Structure 4 Structure 5
Identifier:... ....�t�1�..d.�............r...............................................................................................
Freeboard (inches):
5100
[-]Yes �No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ,No
ElYes IINo
❑ Yes ANo
Structure 6
Continued on back

Facility -Number: — Date of lnspection ,2 0 Printed on: 7/21/2000
5. Are there any immediate threats to the 04rity of any of the structures observed? (ie/ trcevere erosion, ❑ Yes EYNO
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? Cl Yes VrNo
(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 pan 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 0-DM Si 1CcCiI Vt { kne--
13. Do the receiving crops differ vMh those designati'.`t!' in the Certified Animal Waste Managemcit 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'?
(ic/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement'? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit'?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
0: �Vo violations o;r defencies were noted- during •this:visit'. - Yotk Will receive iio further. .....
corresoondeitce. about. this visit ......... . . . . . . .
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
[:]Yes XNo
❑ Yes ko
❑ Yes VNO
❑ Yes b—iKo
❑ Yes ,, 50
OrC�Vl�JIZt53
❑ Yes N No
❑ Yes Vo
❑ Yes o
❑ Yesr
o
❑ Yes YNo
❑ Yes VNO
❑ Yes P(No
❑ Yes No
//////Yes ❑ No
❑ Yes XNO
❑ Yes No
❑ Yes No
❑ Yes �JNo
❑ Yes ® No
❑ Yes No
tE
%V -
Csm $Ii a-Ppl�cal-rdil In rcj�IraSS , ,n flu � .
Gas 00+51de o PiI c(X+l can wind-o"i , ��b . a�,aM
Was+e_ to n «J d o aof�
Reviewer/inspector Name i f l D I 1 S ,kMcj V__
Reviewer/Inspector Signature -'/// & / 1,1,IA , /V AW,9 IN qy FJ J Date: /DU 51()o

Facility Number: — I of I1zspection ��J/o?�j /[i� Printed on: 7/21/2000
Odor Issues 0
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge allor below
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
2$. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes YNO
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 P 0
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes A No
31. Do the animals feed storage bins fail to have appropriate cover? _[:IN o
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? 1
No des
-Tf kc+or5 Y-Vu.ared 7
Ctom � V 1T ] eAjej5 ?
'�Sa4J b��t
n3
5100

fotvherW4aterauY ,siorroiland�Water ConservatiAgency
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: 5/3t/2000 Time: 10:30 Printed on: 8/21/2000
29 14
Not Operational O Below Threshold
® Permitted ® Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold: .......................
Farm Name: Cx:RBIm:d01UAriA1.....................................................................
Owner Name: Ray ........................................... Crous.e ....................................
Facility Contact:.............................................................................. Title:.....
Mailing Address: 1231.Ctda1r-5Pr D9S.Rd............................
Onsite Representative: RaYA.U51k.Cxouse................
County: Dayidsolk.......................................... wsm........
PhoneNo:9.2 ...........................................................
PhoneNo:... .................................. ..............
L,cAntoa...HC...................................................... 2.729.2 ..............
Integrator:
Certified Operator- Lg,Flie.R................................. Q:me... ........................................... Operator Certification Number: ZQ939.............................
Location of Farm:
109 north of Denton 5 miles. Ceder Springs Rd. 1 mile, farm on left at top of hill.
❑ Swine ❑ Poultry ®Cattle []Horse Latitude 35 • 40 ' S046 Longitude 80 ' 04 ' S5 44
Design Current
Swine CanaCity Population
❑ 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 Po ulation
❑ Layer
I
I®
Dairy
215
190
❑ Non -Layer
I
I
Non -Dairy
❑ Other
Total Design Capacity
215
Total SSL W
301,000
Number of Lagoons ❑ Subsurface Drains Present 110 Lagoon Area I0 Spray Field Area
Holding Ponds / Solid Traps 1 2 10 No Liquid Waste Management System
Discharees & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the Stale? (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?
Structure 1 Structure 2 Structure 3
Identifier:....:......Pushoff:... :...... ...... Mille.P.arwr....... ............... :.............
Freeboard (inches): 18 60
5100
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Spillway [:]Yes ® No
Structure 4 Structure 5 Structure 6
Continued on back

-s_
Facility Number: 29-14 Date of Inspection 5/31/2000 Printed on: 8/21/2000
5. Are there any immediate threats to the integrtty of any of the structures observed? (iel trees*ere 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/improve men t? ❑ Yes ® No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Corn (Silage & Grain) Fescue (Hay) 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?
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?
(iel 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?
o vi. . . . ris. d. . . .n. . .were Hated during•this: visit.• ;You:will ir&ieive•no-further-
• • . • correspondence: abouf this :visit:
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Imments.
19. Need to start keeping weekly levels on the holding ponds per General Permit. Also, document any commercial fertilizer applied
iste application fields. Records look good overall.
ish off holding pond needs pumping. Waiting on tractors to be repaired so that irrigation can be done on corn.
•r
Reviewer/Inspector Name jRocky Durham 1
Reviewer/Inspector Signature: Date: 5100

Facility Number: 29-14 a of Inspection 5/31/2000 ® Printed on: 8/21/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge actor below ❑ Yes [:]No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
2$. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? . ❑ Yes ❑ No
Additional Comments and/orDrawings:
5100

A - OsDivision tCand.Water Conservation -peration
0
[3{DivisionlWO
il�and Water.Conservation —Compliance Wection
;Division of Water Quality - Compliance Inspection
[3Other Agency - Operation; Review
140 Routine O Complaint O Follow-up of DWQ inspection Q Follow-up of DSWC review Q Other
Facility Number 29 Iq Date of Inspection 9/8/99
Time of Inspection 0830 24 hr. (.hh:mm)
Permitted ® Certified ❑ Conditionally Certified 0 Registered 113 Not O erational Date Last Operated:
Farm Name: Cmu sicdate.Farm...........................................................................
OwnerName: RaY............................................c.ro.m e...........................................
FacilityContact:.............................................................................. Title:...................
Mailing Address: 1231.Qedar.,Spt'11t1g5.Rd............................................
Onsite Representative: Lv,hjjg.R,.C.r.9jthc............................
Certified Operator: �, ��j�g,ti,............
Location of Farm:
I .... ... UR>.lhc.............
County: Uayidsmix.......................................... !' SRO ........
Phone No: 336::859..-3.39x..................................................
Phone No:
la>rAngton..NYC....................................................... U.292 .............
.........I ............... Integrator: .........................................
...I .................. Operator Certification Number:2Q939...
Latitude 35 • 40 ' S0 1. Longitude i30 • 04 ' S5 Li
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current
Design Current
Poultry
Capacity Population Cattle
Capacity Population
❑ Layer
I
I
® Dairy
170
215
❑ Non-Layer.I
I
JEI Non -Dairy
❑ Other
Total Design Capacity
170
Total SSLW
238,000
Number of Lagoons ❑ Subsurface Drains Present ❑Lagoon Arc. ❑ Spray Field Area
Holding Ponds / Solid Traps 1 2 1 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gal/min'?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: lower (parlor) upper (scraped)
Freeboard(inches): 4..........................24............._............................................................................................................. ...
....
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
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
11Y_�- �

Facility Number. 29-14 1 ate of Inspection
6. Are there structures on -site which arle 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
12. Crop type Fescue (Graze) Corn (Silage & Grain) Small Grain (Wheat. Barley,
3/8/99
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination'?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available'?
(ie/ WUP, checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21_ Did the facility fail to have a actively certified operator in charge'?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AWMP?
®; No•violations:or deficiencies•wefe'niDted;duriiZgjhis: visit. ;You;will :recei:ve•i1o•further•.
corres�&idence about this .visit. • . • . • .
17 Have not yet received General Permit
[-]Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Reviewer/Inspector Name IJennifer Frye
Reviewer/Inspector Signature: Date: 'j l

rFacility Number: 29-14 a of Inspection 31$I99
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
® No
liquid level of lagoon or storage pond with no agitation?
27.
Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
® No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
® No
roads, building structure, and/or public property)
29.
is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
® No
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
® No
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
® No
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes
® No
tttona ' ^ omtnents and/or rawmgs:

Division of IS� i1 and Water Conservation ❑Other AgencyMS.
r Division of Water QualityF�.�l
Routine . O Complaint O Follow-up of D%VQ inspection O Follow-up of DSkVC review O Other
Date of Inspection
Facility Number
Time of Inspection E� 24 hr. (hh:mm)
© Registered xCertified (3 Applied for Permit O Permitted 113 Not Opera tional Date Last Operated :..............
l
Farm Name:... .)...O..i.�..s .QI Q.L .......�_:. fj'�. County:............gY��/; 7......................................
Owner Name: ....................................... Phone \o: ...
......�.�..............................1........ ..o.s ............................... ...r--3.36�...... .5q....:3 ..�
Facility Contact: Title:.,... . Phone No:
Mailing Address:... tTt..... jCadar L—r A.1 %j..... rC�s....�.. a ................
Onsite Representative :........ A!t.......c.rotl.,..t.............I.......n yI........ Integrator:......................................................................................
Certified Operator,.--- { -)-i >o......... ............ C`�..14—. _e................... Operator Certification Number-,....
Location of Farm:
g...Qn.....[.
...n.. .... n;.s......e A(:..... ...........
'... te
e .........1.r.l....r........................................................................................................................................................................................................ .
Latitude ®• EW Longitude E4a]• W1,
Design ..Current. Design Current
`Design " Current
Swuze ` ` '' Capacitv'�Population �. ,Poultry �: Capacity ,Population ., Cattle -
Capacity •Population
ElWean to Feeder [] Layer Dairy
J. ❑ Feeder to Finish ❑ Non -Layer I I ❑ Non-Dai ry
❑ Farrow to Wean`'
`
'
❑ Farrow to Feeder ❑Other
❑ Farrow to Finish Total Design Capacity;
1, 910:1V
A ❑ Gilts
ElBoars Total SSM
ODa
Nutnberaof La' ,n goons 1 Holdtng'P,nds' �, ❑Subsurface Drains Present ❑Lagoon Area IDSpray Feld Area
❑,No Liquid Waste Management System
�M
� +��
... fN
General
1. Are there any buffers that need maintenancelimprovement?
❑ Yes 0 No
2. Is any discharge observed from any part of the operation?
❑ Yes [� No
f
Discharge originated at: El Lagoon El Spray Field [I Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes ❑ No
b. If discharge is observed• dill it reach Surface Water? (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
3. Is there evidence of past discharge from any part of the operation?
❑ Yes %No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes No
maintenancelimprovement?
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?
❑ Yes No
7/25/97
Continued on back

J •'z
Facility Number: S. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (LaEoonc,Holding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure l Structure 2 Structure 3
Identifier: .� Q 3.,.Of..
Freeboard (ft):................................... .......
10. Is seepage observed from any of the structures?
e
Structure 4 Structure 5
i 1
❑ Yes KNo
❑ Yes ANO
Stricture 6
....................... ................................................. ....... I ...... I.....................
❑ Yes ANO
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes No
12. Do any of the structures need maintenance/improvement? ❑ Yes No
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? ❑ Yes 1ANo
Waste Application ��` \\\\
14. 1s there physical evidence of over application? ❑ Yes �No
(If in excess of WNW, or runoff entering waters of the State, notify DWQ) r
15. Crop type ...... e..61Q.(A.-e.... &L.r...._Z--V11 ....... J.t�IlCty.t..... r�......................................................
16. Do the receiving crops differ with/those designated in the Animal Waste Management Plan (AWMP)? ❑ Yes 'R No
17. Does the facility have a lack of adequate acreage for land application? ❑ Yes 5?�No
18. Does the receiving crop need improvement? ❑ Yes )1kNo
19. Is there a lack of available waste application equipment? ❑ Yes gNo
20. Does facility require a follow-up visit by same agency? ❑ Yes No
21, Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑Yes No
22. Does record keeping need improvement? ❑ Yes VNo
For Certified or Permitted Facilities Onl
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. Were any additional problems noted which cause noncompliance of the Permit? ❑ Yes No
No.violatians-or deficiencieswere-notedduririg this.visit. You.will receive no•fdrther .'
correspondence about this. visit:: _ .
mat a..&rv- an ; -. ,., ; ttaae
CbmmettEs (refer to question #) Explain arty YESansKers and/or an}�reco" nn ilatrtns or an v�other comments
Use;draivtn s off M to better ex lam situations use additional a e� as:necessary s.
g y P f pg�p
,.-Y','.'. �%n, a ... N F:E, .x _ : ', a i+:..`.m ix-w :fi. -'�' . 'vF. :".A„ `.+ ? :Yd. i-EiRs`�r r�+ n 1.'.it',emi
p
E`u
a obvie�t4
P
7/25/97
Reviewer/Inspector Name f Ma
s?
Reviewer/Inspector Signature: Date: