410016_INSPECTIONS_20171231

Division of Water :Resource ,: e
Facility Number - 0 Division of Soil and Water erratioii: -
x 0 Other Agency � .spn
rype of visit: tP 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: 1 Arrival Time: )(� Departure Time: County: C Ul� id Region:�is�
Farm Name: . Nvm bl `& Owner Email:
Owner flame: `V Phone: .�156` (k j_ 149-61 - FAYM
,flailing Address: L bE)5 Sm d-hy\/QOG�A 1 be +�( , N 01 j-D q 9]
Physical Address:y
Facility Contact:SJCej t lUiYl bl� Title: ..�� Phone:
Onsite Representative: Integrator:
_* b h urs �Ntedie b�
Certified Operator: V Certification Number: 308 ed -�b�2?
Back-up Operator: Certification Number:
Location of Farm:
Latitude:
Longitude:
l 0 tr -b kvvj b 1 5 IZ M+o "W1 o- try l+ IG 0) oYft Srvl I kh wo o01 .
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 POD.
La ers
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 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
Dairy Calf
Dairy Heifer
Dry Cow
Nan -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ Yes
No
❑ Yes
No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Paige 1 of 3 21412015 Continued

Facility Number: L -16 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: t j Q VU—
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �{� u
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
4No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
7t
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
No
❑ NA
❑ NE
waste management or closure plan'?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
N No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
® No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
T`
9. Does any part of the waste management system other than the waste structures require
❑ Yes]
No
❑ NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No
❑ NA
❑ NE
maintenance or improvement?
11. is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes 4No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.f
❑ 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):-f-t—TV [X7&b(&
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'?
❑ Yes
No
❑ NA
❑ NE
❑ Yes
LON No
❑ NA
❑ NE
❑ Yes
R No
❑ NA
❑ NE
❑ Yes
[ No
AI
❑ NA
❑ NE
❑ Yes
[ No
❑ NA
❑ NE
❑ Yes rV No
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check [] Yes LX No
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes �3 No
Waste Application �D Weekly Freeboard tAWaste Analysis [Soil Analysis [1 V&A r_... r rs
%Rainfall PStocking ❑ V g120 Minute Inspections "oMonthly and 1" Rainfall Inspections
22. Did the facility fail to installandmaintain a rain gauge? ❑ Yes '% No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment'? ❑ Yes ❑ No
Page 2 of 3
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Weather Code
❑ NA ❑ NE
NA ❑ NE
21412015 Continued

Facili Number: - Date of Ins ection:
24. Did the facility fail to calibrate waste apptZl�tion equipment as required by the permit. ❑ Yes No
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check ❑ Yes No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
DNA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
NA ❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
]% No
[DNA
❑ NE
❑ Yes 0 No
❑ Yes � No
❑ Yes tA No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
15 5{-a+-uS 6f TieiC1 , 6, ? Sujed 31rA5S Cun,,� ne, u�, lo0IL +6ct,
I- Art- wea+her oodes recarcl�d? s� ,yt,k t,�sv �
U
I t h CAS Yl(� VX)OS c,- �1is 4� rv\_' , eve r�►�`� I d-�, "Ni n�
/10X o av" Ma-i
WWI
j9 0.6b
Reviewer/Inspector Nami
Reviewer/Inspector Signi
Page 3 of 3
Phone:1j 05
Date:
21412015

Division of Water Resources
Facility Number - 0 Division of Soil and Water Corvation
0 Other Agency
Type of Visit: & Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: "% t Arrival Time: Departure Time: County: 6yi`fqoCp Region: &jt,4Z `I
Farm Name: 6gue — "UMsty Owner Email:
Owner Name: Phone: (33G) 4.0
,Mailing Address: SrAr7hI0000 2Q_ , Liwl, tie 972019
Physical Address:
Facility Contact: &Plu '& tf w g" Title: U w NB,R Phone: rG ) 3 - 2 44 - /a q4'
Onsite Representative: Integrator: C iRotrwR- i kaw+sR 1P
?C H6 ex: &-eJ Fa r at S
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Latitude:
Certification Number:
Longitude:
:i u()E TO rtWj Gi Sow• Rte+rr OAO 6;O`WY. 6rtrT 141041 t-CO-r 0N70 Se" rnituoe1)
Design Current Design Current
Swine Capacity Pop. Wet Poultry Capacity Pop.
Wean to Finish
Wean to Feeder
v'Peeder Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
La er
Non -Laver
Non-[_,
Pullets
Other
Poults
Design Current
t'o
Dischariles 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 advcrse impacts or potential adverse impacts to the waters
of the State other than from a discharge? .
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
7
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes &o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [:]No ❑ NA ❑ NE
❑ Yes ❑ No
❑ Yes [ No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page 1 of 3 21412015 Continued

Facilitv Number: - Date of Ins ection: 7 1
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes � No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes [:]No ❑ NA ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: dPPQ71 to6.3QT,
Spillway?: N 0 VG.S
Designed Freeboard (in):
" 37
Observed Freeboard (in):-
5. Are there any immediate threats to the integrity of any of the structures observed? 0 Yes gg No [DNA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
® No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWR
7. Do any of the structures need maintenance or improvement?
❑ Yes
" No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
r" 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
jZrNo
❑ 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 rWNo ❑ NA ❑ NE
° osp o
�S!lZ id�+ rift � f'{ ili,i flf A,p7 rn+Pt AYP'a
12. Crop Type(s): E5L` Ug T
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
[g No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
FZJ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
CK No
❑ NA
❑ NE
18. Is there a tack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
[ff NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
XNo
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available'? If yes, check
❑ Yes
KNo
❑ NA
❑ NE
the a ro riate box
PP P
� �s.. Design is
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
Yes
M] No
❑ NA ❑ NE
ree oar II Wasto " •
❑ Waste Transfers
r o e
s
. '
s
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
CK'No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
KNA ❑ NE
Page 2 of 3
21412015 Continued

Facili Number: ktj- Date of Inspection:
24. Did the facility fail to calibrate waste appli�Tion equipment as required by the permit?
❑Yes
Lr'Qf No
ip
❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes
XNo
❑ NA ❑ NE
the appropriate box(es) below.
❑ 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
puf
IC� No
❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
[gNo
❑ NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes � No ❑ NA ❑ NE
❑ Yes � No [3 NA ❑ NE
❑ Yes [ffNo ❑ NA ❑ NE
❑ Yes FS No ❑ NA ❑ NE
❑ Yes �No
❑ Yes LNo
❑ Yes �g No
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
a5� 2-om ii.►✓AB.*- swu6y ccmPE&?sA ? &F& • t&o 'FRS sal 0. OVE a.�'d0
2o l u• cAf_IISPAZTMV • 050 C 7LOIG/ Q uE AtA 03 9017 -
, ►5 r/¢RiG crow +DL°SIBu ,4ai¢rt $Lt ? »PTr) PUMP f&1FdMAKXC M1AtLAgL .
Fk �vgRCH �+S l�sew> t0 2&14 4pPLt a7r& f s Dn0 ua T
h*Vee AWWS1 J w/I v ►atw S . cp- e A�h�YStS com'pc' F0P__ a.Dk5
al•� So r c_ T&S0_ Dut aol 6 .
a'S ! AQPr�cr r [o N IRK 6"14MOIJ vf'` 5 "0 6-4 '5"Z tl 'ZLo [ 6 ,
a} w 1i 62 e c ra a E +rJD t CA-• 6,0 C0'?P S
o�� Nb cR�P Yl C--cA B1C FtC-0�s AXZ CMZt-00
Reviewer/Inspector Name:
Reviewer/inspector Signatur
Page 3 of 3
Phone: 33 % - Pb� - cvc l 3
Date: :2 1 %
21412015

Division of Water Resources 1p
Facility Number l� - O Division of Soil and Water Conservation ' OM
p Other Agency
Type of Visit: Compliance Inspection 0 Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit: Routine O Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: 131 J Arrival Time: Departure Time: pp yW County: , r Region: LcJ S �O
Farm Name: Owner Email:
4
Owner Name: 1V Phone:�O-
Mailing Address: tC 3 /v C ;�L 7
Physical Address:
Facility Contact: Title: bu-7� Phone: Lt 21 J 3 (n I DA
I^��
Onsite Representative: Integrator: a 1`�'�1
d/ j-&kA
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Swine
Latitude:
Certification Number:
Longitude:
� 45 7th #tA_1 y 641 �J, lW y E4j+ Igo
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
Pullets
Turkey Poults
Other
Design Current
t; a
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)?
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes
❑ 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 x No ❑ NA ❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters ❑ Yes �No ❑ NA ❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

Facili Number: 3 7- 1 Date of Inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? Yes
a. If yes, is waste level into the structural freeboard? ❑ Yes
Structure 1 Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
waste management or closure plan?
❑No [DNA ❑NE
❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes 0 No ❑ NA ❑ NE
❑ Yes 0 No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? )5 Yes ❑ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes MIo ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes J�LNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes ONo ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes *No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window f ❑ 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
<o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
ArYes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
A Yes
❑ No
❑ NA
❑ NE
acres determination?
17. Does the facility tack adequate acreage for land application?
❑ Yes
�TNo
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
56o
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
IM"No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? if yes, check
❑ Yes
XNo
0 NA
❑ NE
the appropriate box.
❑ WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need i provement? U k-I1�Yes ❑ No ❑ NA ❑ NE
VRa
asteApplica oneekly Freeboard Waste Analysis Soii Analysis suers Weather Code
infall Stocking Crop Yield ❑ 120 M nute Inspections Monthly and 1" Rainfall Inspections Judge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes D jrNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes 0 No NA ❑ NE
Page 2 of 3 21412014 Continued

Facility Number: - / Date of Inspection: 3
24. Did the facility fail to calibrate waste application equipment as required by the permit? WYes ❑ No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 'Yes [:]No ❑ NA ❑ NE
the Dpropriate box(es) below.
ailure 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 2No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes J< No NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes 6 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)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes �No ❑ NA ❑ NE
NfYes L—ffw-,No ❑ NA ❑ NE
❑ Yes N 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/inspe o ' h an on -site reprrsentativg9 ❑ Yes gjNo ❑ NA ❑ NE
C�
34. Does the facility require a follow-up visit by the same agen �i� h S �p�C VN Yes ❑ No ❑ NA [] NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use -drawings of facility to better explain situations (use additional pages as necessary).
rs
r
A I
r �
[i
A i r
EA
Reviewer/Inspector Name: Mp.,{ I _'S50Q kma f O C�V_ Phone: 7
Reviewer/Inspector Signature: �� VI ��/� Date:
Page 3 of 3 � �[ �• 4L� " G�'" � ��� (� 2/L� �l

& Division of Water Resourc
Facility Number -ERI O Division of Soil and WaterIonservation
Q Other Agency
Type of Visit: 0 C—opliance Inspection Operation Review p Structure Evaluation Q Technical Assistance
Reason for Visit: Routine Q Complaint Q Follow-up Q Referral Q Emergency Q Other Q Denied Access
Date of Visit: Arrival Time: � Departure Time: County:
Farm Name_ rD _ A , kiow lo—,_ _ � Owner Email:
Owner Name: 'So"e1 Mailing Address: �� (� s " r4-" wL-j P'_j L—,
Physical Address: _ f {
It
Phone: (K]
c Z_qz98
U II
Facility Contact: 'R 0 61'e Title: OWN
Onsite Representative:
Certified Operator:
Back-up Operator:
Integrator:
Region: W5P'O
1r-331p-.26g-lq?g
Phone: iM 7 Jw Q1 14q 1p
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
Feeder to Finish 14
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
La er
Non -La er
Pullets
Turkey Pouets
Other
Design Current
Design Current
Cattle Capacity Pop.
Dairy Cow
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
No
❑ NA
❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
❑ Yes
❑ No
NA
❑ NE
' b. Did the discharge reach waters of the State? (If yes, notify DWR)
❑ Yes
❑ No
NA
❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) ❑ Yes
❑ No
NA
❑ NE
2. is there evidence of a past discharge from any part of the operation?
❑ Yes
dNo
❑ NA
❑ NE
3. Were there any observable adverse impacts or potential adverse impacts to the waters
❑ Yes
E]�No
❑ NA
❑ NE
of the State other than from a discharge?
Page I of 3 21412014 Continued

Facili Number: IDate 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 []�A ❑ NE
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Spillway?:
to 0 GS
Designed Freeboard (in):
Observed Freeboard (in): t/MMj4V
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes C5"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 [2/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 threit, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ❑✓ No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes [f 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? I•� vve�
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑Yes /dNo ❑ NA ❑ NE
maintenance or improvement?
I I I�tere evidence of incorrect land application? If yes, check the appropriate box below. Yes ❑ No ❑ NA ❑ NE
cessive 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): a v %
t
13. Soil Type(s): NO
It Q
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
ENo
❑ 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
E� No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
E3/No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes
PNo
❑ 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
EdNo
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes [2f No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ Rainfall ❑ Stocking O Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1 " 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 Eq No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA �NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facility Number: jDate of Ins ection:
24. Did the facility fail to calibrate waste app ication equipment as required by the permit? ❑ Yes [ / o ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check ❑ Yes [ No ❑ NA ❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes
No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes
❑ No [DNA ❑ NE
Other issues
Did the facility fail to properly dispose of dead animals with 24 hours and/or documentNA
�esdNo
❑❑28. 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?
'es
E?"/No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes
0 No ❑ NA 0 NE
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes
[Z/No ❑ NA ❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes E]�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 E2/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 pates as necessar_y).
2� — C�i��r•�►o� ? d
,, aL z-,lU� 5- 6'3. 1 ! zn) L
ti i��4u 0zo I LA
evt�b ���3�Ly� S�I�-- Ih ��s--7.a Q17A'
rt-k S �f r IJ� � l
M0 jo, 4 W
. .<
(Ld 1 ei/,1_tc DV 1tiv+Dt = — AD Y-J ;irr t' y� -;ArC4, -)
Reviewer/Inspector Name:
ReviewerAnspector Signature:
Page 3 of 3
jis ;- - wAJe )
n)� 1-31
Phone: 0 •.I V' Szog
Date: -*- 24 14
21412011

Division of Water Quality
Number `{ 1 - 1 ' O Division of Soil and Water
i
0 Other Agency
Type of Visit: 0 Compliance Inspection 0 Operation Review Q Structure Evaluation Q Technical Assistance
Reason for Visit: l3�Routine O Complaint 0 Follow-up () Referral Q Emergency ( Other O Denied Access
Date of Visit: Arrival Time: Departure Time: 7 : County: Region: W 5RQ
Farm Name: Q L►C A . k)f" al- c Owner Email: K
Owner Name: it Phone:
(h) 33V • to $ 5 . i_t 2 fo 1
Mailing Address: (,Ak S M'L', yu • � L, 6xx-4,i -4 L 2'* 2 9 iy
Physical Address:
Facility Contact: L_�r,, ee. to b1 C. Title:
Onsite Representative:
Certified Operator: e
A~
Phone:Cw) -53& • 26q W �i 4,
Integrator: CO�a 1 ky'%o . 4
Certification Number:
Back-up Operator: Nr)Ae- _ _ _ Certification Number:
Location of Farm: Latitude:) S Sy Sj`Pj Longitude:
Swine
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
Layer
Non -La er
Wean to Finish
Wean to Feeder
Feeder to Finish
14 4D
IDSO
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Non-L,
Pullets
Other
Poults
Design Current
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Design Current
Cattle Capacity Pop.
Dairy Cow
Daia Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes 1� No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No
[:]Yes []� No
❑ Yes [ No
❑ NA ❑ NE
❑NA ❑NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facility Number: l - i . Date of inspection: to I at
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes [Z No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No Ej NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: U p--C)L a(! -
Spillway?: S
Designed Freeboard (in): ytl a
Observed Freeboard (in): Au 'W;Vt' �1
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes [�No ❑ NA ❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a ❑ Yes C]rNo ❑ 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 l_J No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? [—]Yes gNo ❑ 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 [Z No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes [- 5 No ❑ NA ❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes [Ef 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): rts(N&
13. Soil Type(s).
14.
Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
[Z No
❑ NA
❑ NE
15.
Does the receiving crop and/or land application site need improvement?
❑ Yes
[f No
❑ NA
❑ NE
16.
Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
Q 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
(2 No
❑ NA
❑ NE
Required
19.
Records & Documents
Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
ff No
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
Q No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑Design ❑ Maps ❑ Lease Agreements ❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes EA No ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis D Waste Transfers ❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections [:]Monthly and V Rainfall Inspections ❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes [� No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes [.f No ❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: i l - 1 Date of Inspection: 1,6
24. Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes ff No ❑ NA ❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? if yes, check [:]Yes E�fNo ❑ 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 E�No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes ❑ No ff NA ❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
34. Does the facility require a follow-up visit by the same agency?
❑ Yes E, No ❑ NA ❑ NE
❑ Yes E3"No ❑ NA ❑ NE
❑ Yes dNo ❑ NA ❑ NE
❑ Yes 2� No ❑ NA ❑ NE
❑ Yes No
❑ Yes YNO
o
Yes
❑ NA ❑ NE
[DNA ❑NE
❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments. 1
Use drawings of facility to better explain situations (use additional pages as necessary). 1
2,5- Slot-z0[. S"'�aJC/ u_(3111y
.2,.4. Cc. / tck«t 6OLD-.a,lr`
g. �J1'isli � J CC f
lii'tG h'l� �J`tv�� ` �t7r� 67-'+D� Ya vd� �u X5. 5A14'- 40"'- flce
Cont. £J • )A4141 / Fcc JAN 144
waJ�e4-� -Wo� �%taiws+5 $jtq�t3 -
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
fie,- b.� vw lc.4)aow by tJ6lemavZ SIi.o13
L.
Phone: 33fo�- �j2$o
Date: c -Si t 3
21412011

' Division of Water Quality
Facility Number ! f - Division of Soil and Water C ,ervation
0 Other Agency ft,rti
(Type of Visit: 'R �mpliance Inspection C? Operation Review U Structure Evaluation Q Technical Assistance I
Reason for Visit: Routine Q Complaint p Follow-up O Referral O Emergency p Other O Denied Access
Date of Visit:
j Z
Arrival Time: r '
Departure Time: Z,' z,�
County: 6"il4fd
Farm Name:
�j It tGG
]t 4�
i� I e—
Owner Email:
Owner Name: 11
Mailing Address: & ( .3 Z
Phone: 68S 7 ZG f 6-tam-)
" I;r-r�".q, G
Region: WSRO
Physical Address: 4 53 1 1 / 1'
Facility Contact: 114C 0_� 4LVr V% ue Title: Phone: to 7-L. L%1 L/r, 6
Onsite Representative: Integrator: Gl fa 1, -1- fIrwa,
Certified Operator: Certification Number:
Back-up Operator:
Location of Farm:
Swine
Certification Number:
Latitude: 3.jraJ`�% �� �,f Longitude:
Design Current Design Current
Capacity Pop. Wet Poultry Capacity Pop.
La er
Non -La er
Wean to Finish
Wean to Feeder
Feeder to Finish
f r7t'
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 Poults
Other
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
DryCow
.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 x No ❑ NA ❑ NE
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other:
a. Was the conveyance man-made? ❑ Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (If yes, notify DWQ) ❑ Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does 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?
❑ Yes ❑ No
❑ Yes No
❑ Yes No
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
Page I of 3 21412011 Continued

Facili Number: - • Date of Ins ection: 2
`Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
0 Yes XNo
❑ 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: Ly wfT
Spillway?: (VIb�
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 A No
❑ NA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes No ❑ NA ❑ NE
8. Do any of the structures lack adequate markers as required by the permit? ❑ Yes No ❑ NA ❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require ❑ Yes No ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes XNo
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below. ❑ Yes XNo
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground
❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or l0 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
Evidence of Wind Drift
❑ Outside of Acceptable Crop Windo�wj
❑ Application Outside of Approved Area
- 1❑
12. Crop Type(s): � 1 i u,�c l ti 1 f—�1(,iv� M iX !
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ❑ Yes ANo
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes No
❑ NA
❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes 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
A��N o
❑ NA ❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21. Does record keeping need improvement? If yes, check the appropriate box below.
❑ Yes
No
❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis
❑ Waste Transfers
❑ Weather Code
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and V Rainfall Inspections
❑ Sludge Survey
22. Did the facility fail to install and maintain a rain gauge?
❑ Yes
�No
❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
�No
❑ NA ❑ NE
Page 2 of 3
21412011 Continued

Faci llry Number: 7 Date of Inspection: 11 Z
is
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑ Yes No
❑ NA
❑ NE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
❑ Yes No
❑ NA
❑ NE
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑ Failure to develop a POA for sludge
levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
❑ Yes '%No
❑ NA
❑ NE
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
❑ Yes ❑ No
('NA
�T
❑ NE
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
❑ Yes XNo
❑ NA
❑ NE
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes ANo
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
❑ Yes No
❑ NA
❑ NE
permit? (i.e., discharge, freeboard problems, over -application)
,4
✓✓✓✓`"`CCCC
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Yes XNo
❑ NA
❑ NE
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
32. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
❑ Yes
6No
No
❑ NA
❑ NE
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ NA
❑ NE
34. Does the facility require a follow-up visit by the same agency?
❑ Yes ® No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any additional recommendations or any other comments.
Use drawings of facility to better explain situations (use additional pages as necessary).
�urvzy ,s ,'ItX �- c .+✓ 1��31 �2�1 I'�t h44 bt�cc rls.
�a�, � �fi � v�j j; i �- l,.lq.� � r /tex�' ��:•�rAk>� ►,
Nam: r �� � 11�4l�I. L I,:%r
jeevi1ri
Nd��kf 281z S rrCe - c C 'wx� v�,
a�zcrz = a1,7 Ibll
ReviewerAnspector Name: 'k;
Reviewer/inspector Signature:
Page 3 of 3
Phone: (33L� '% % --- Ze
Date: Z- ! 2-
2/4/2011

Facthty Nttml er:
Type of Visit ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:��
Farm Name:
Owner Email:
Owner Name: hu� L4 )Q_4_tIu-lh Phone:
Mailing Address:
Physical Address:
Type of Visit ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit Routine 0 Complaint 0 Fallow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:��
Farm Name:
Owner Email:
Owner Name: hu� L4 )Q_4_tIu-lh Phone:
Mailing Address:
Physical Address:
Facility Contact:
Title: Phone No: V h r5• 1 31 jz
�J
Onsite Representative:
Integrator:01
Certified Operator:
Operator Certification Number: `'" �o -
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
m ❑ Boars
Back-up Certification Number:
Latitude: =o =I = Longitude: =0 0, ="
Design Current Design Current _
Capacity Population Vet Poultry Capacity Population
❑ Layer
❑ Non -Layer
d
Dry Poultry
Non-
Pulle
Otter ❑ Turkey Points
"❑ Other ❑ Other
Des��n S;�Current
Cattle Capacit}_ P,,opulatio
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cow
AR`�
. "Number of,Str4uctures, ���
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 o�p tential 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 2No ❑ NA ❑ NE
V(Yes ❑ No ❑ NA ❑ N E
Page I of 3
12128104 Continued

Facility Number_ is Date of Inspection '
Wasti' Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes 1XNo ❑ 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: U U
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes No ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes ❑ 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 ff No ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes VNo ❑ NA ❑ NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) �,J
9. Does any part of the waste management system other than the waste structures require El Yes LV No El NA ❑ NE
maintenance or improvement? ,`
Waste Application X
10. Are there any required buffers. setbacks, or compliance alternatives that need ElYes No ElNA ElNE
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. Croptype(s) ri��t1V�D m �►i►,a o eS[,Ve tU
13. Soil type(s)
Y_
14. Do -the receiving crops differ from those designated in the CAWMP?
❑ Yes
06o
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
LX1
No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
9Yes
11❑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
�fNo
❑ 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 S r Phone] ! — 9
ReviewerAnspector Signature: Date: 7. a0
jVage2 of 3 12128104 Continued

F
Facility Number: — *Of Inspection U�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes [�(No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAA
WMP readily available? If yes, check 9Yes El No ❑ NA El NE
El appropriate box. ❑ WUP Checklists Desi n
g El Maps El Other
21. Doe�rord keeping need impr vement? If yes, chec the appropriate box low. ❑YesNo ❑ NA ❑ NE
Application Weekly Freeboard Lld Waste Analysis Soil Analysis Waste Transfers rrrr� ton
L`] Rainfall tocking Crop Yield ❑ 120 Minute Inspections M Monthly and I" Rain Inspections Weather Code
22. Did the facility fail to insta I and maintain a rain gauge? ❑ Yes R(No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
33. Does facility require a follow-up visit by same agency?
❑ Yes
1XNo
❑ NA
❑ NE
❑ Yes
KNo
❑ NA
❑ NE
9yes
CANo
❑ NA
❑ NE
❑ Yes
PdNo
❑ NA
❑ NE
❑ Yes
❑ No
KN A
❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes �fNo ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes No ❑ NA ❑ NE
❑ Yes 6(No ❑ NA ❑ NE
Additional Comments and/or Drawings:
A6
e
Page 3 of 3 (1 12128104

Division Hof Water QualitytZ
FacilityNumber - 0`Division of Soil and Water Werva tion
0 Other Agency'�`�
Type of Visit: Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit. Routine 0 Complaint O Follow-up O Referral O Emergency O Other O Denied Access
Date of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: ty oLk le Owner Email:
Owner Name: `1r Phone:
Mailing Address: to C z a �l� I`
Physical Address: %t} 1n, 47
Facility Contact: WIUU'LL'elitle: ,
Onsite Representative:
Certified Operator:
Back-up Operator:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
a�a
a'?z
740 E&5fi&=-40 S o oi-�' f - Cob (may Le_-(- Onto Suru u bZ .
Design Current
Swine Capacity Pop.
Wean to Finish
can to Feeder
Feeder to Finish Q
arrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Othcr
Design Current
Wet Poultry Capacity Pop.
Layer
Non -La er
Design Current
Non-L
Pullets
Other
Poults
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ AppIication 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?
Cattle
Design Current'.. ,
Capacity . Pop.,
Dairy Cow
Dairy Calf
jDairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑Yes ❑No ❑NA ❑NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
Page I of 3 21412011 Continued

'1J Division of Water Quality
fFacility Number - „ , �0 Division of Soil and Water lovervation
:<r p Other Agency
Type of Visit: , Compliance Inspection 0 Operation Review p Structure Evaluation p Technical Assistance
Reason far Visit: (Routine 0 Complaint O Follow-up 0 Referral O Emergency O Other O Denied Access
Date'of Visit: Arrival Time: Departure Time: County: Region:
Farm Name: ri t Ge A . f! S..LP,d-lo h. Owner Email: �
Owner Name: `Y Phone:
Mailing Address: �p 1� ,� hA 1 4A 1 k Yr A . 1,16 VO-r L-A 1 V C_ I
Physical Address: �n /„ (111 I min I W� �(� .1 Ill lY s� ,t . , l uL_ ;
Facility Contact: r
Onsite Representative:
Certified Operator: J /
Back-up Operator:
Phone:
Integrator:
Certification Number:
Certification Number:
Location of Farm: Latitude: Longitude:
T' 40 EGLst&=. o S o Ot-11 , V —1 ovt� 9 � � - I.oe:j�f oonfo
Design Current
Swine Capacity Pop.
Wean to Finish
Wean to Feeder
x Feeder to Finish
'Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
Other
Design Current
Wet Poultry Capacity Pop.
La er
Non -La er
Design Current
Pullets;
Other
Poults
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?
Page I of 3
Design Current
Cattle Capacity Pop.
Dairy Cow
Dairy Calf
Dairy Heifer
Dry Cow
Non -Dairy
Beef Stocker
Beef Feeder
Beef Brood Cow
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes [::]No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
21412011 Continued

L Facility Number: Lit- Date of inspection:
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5
Structure 6
Identifier: - ) n� 1 p
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
❑ Yes
❑ No
❑ NA
❑ NE
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a
❑ Yes
❑ No
❑ NA
❑ NE
waste management or closure plan'?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health
or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
❑ No
❑ NA
❑ NE
(not applicable to roofed pits, dry slacks, 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?
1 I. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18. is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
❑ NE
the appropriate box.
❑ WUP ❑ Checklists ❑ Design ❑ Maps [:]Lease Agreements ❑ Other:
21. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers
❑ 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 ❑ No
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? [:]Yes ❑ No
❑ NA ❑ NE
❑ Weather Code
❑ Sludge Survey
❑ NA ❑ NE
❑ NA ❑ NE
Page 2 of 3 21412011 Continued

Facili Number: Date of inspection:qW
Waste Collection & Treatment
4. Is s�orage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes ❑ No ❑ NA ❑ NE
5 a. If yes, is waste level into the structural freeboard? ❑ Yes ❑ No [DNA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: )A flD y ,QLg.Q
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
6-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
[DNA
❑ NE
waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat,
notify DWQ
7. Do any of the structures need maintenance or improvement?
❑ Yes
❑ No
❑ NA
❑ NE
8. Do any of the structures lack adequate markers as required by the permit?
❑ Yes
[:]No
❑ NA
❑ NE
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
❑ Yes
❑ No
0 NA
❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
❑ No
❑ NA
❑ NE
maintenance or improvement?
11. Is there evidence of incorrect land application? If yes, check the appropriate box below.
❑ Yes
❑ No
❑ NA
❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs. ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into
Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application
Outside of Approved Area
12. Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
❑ No
❑ NA
❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ No
❑ NA
❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
❑ Yes
❑ No
❑ NA
❑ NE
acres determination?
17. Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
❑ NA
❑ NE
18.
Is there a lack of properly operating waste application equipment?
❑ Yes
❑ No
❑ NA
❑ NE
Required
Records & Documents
19.
Did the facility fail to have the Certificate of Coverage & Permit readily available?
❑ Yes
❑ No
❑ NA
❑ NE
20.
Does the facility fail to have all components of the CAWMP readily available? If yes, check
❑ Yes
❑ No
❑ NA
❑ NE
the appropriate box.
❑WUP ❑Checklists ❑ Design ❑ Maps ❑ Lease Agreements
❑Other:
21.
Does record keeping need improvement? If yes, 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 V Rainfall Inspections
❑ Sludge Survey
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
❑ No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
❑ Yes
❑ No
0 NA
❑ NE
Page 2 of 3
21412011 Continued

Facility Number: - Date of Ins ection:
• 24. Did the facility fail to calibrate waste appllation 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?
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)
3 I. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
❑ Yes
0 No
[DNA
❑ NE
[:]Yes
VNo
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ 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 ❑ 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 paves as necessarv).
e__ oh nozzle_?
r
a.010 .5011 +e5i
-R4- (!a ki b tire.Li�crn w" ief-ed -fir ?o [ / .
0
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: �pC
Date:
2/4/2011

Facili Number: 01 - j f n Date of Ins ection: 9 !2 1
24. Did the facility fail to calibrate waste app on equipment as required by the permit? ❑ Yes ❑ No
25. Islthe (facility out of compliance with permit conditions related to sludge? If yes, check ❑Yes ❑ No
the appropriate box(es) below.
❑ Failure to complete annual sludge survey ❑Failure to develop a POA for sludge levels
❑ Non -compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? ❑ Yes ❑ No
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? ❑ Yes Vi No
Other Issiies:r,
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document ❑ Yes ❑ No
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 D No
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the ❑ Yes ❑ No
permit? (i.e., discharge, freeboard problems, over -application)
31. Do subsurface the drains exist at the facility? If yes, check the appropriate box below. ❑ Yes ❑ No
❑ Application Field ❑ Lagoon/Storage Pond ❑ Other:
DNA ❑NE
❑NA ❑NE
❑ NA ❑ NE
❑ NA ❑ NE
❑ NA ❑ NE
0NA ❑NE
❑ NA ❑ NE
❑ 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 ❑ No ❑ NA ❑ NE
Comments (refer to question ft 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).
onto e o v) n oZ. z I e?
U `1
'2 010 i +e 5� ?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page 3 of 3
Phone: —7 11
Date:
2141201 � r 1

Facility Number'
4Z Division of Water Quality -
0 Division of Soil and Water Conservation
0 Other Agency
� Pry' -
Type of Visit to Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
i
Date of Visit: ` 1 ; Arrival Time: Departure Time: ' ounty: V r Region: 3.
Farm Name: br U C-e ft . HU h , Owner Email:
Owner Name: Phone:
Mailing Address: �3 ��m 1 i uDooCb
Physical Address: SUL
Facility Contact: I JrUU 1 Title: Phone No: a
Onsite Representative: Integrator.
Certified Operator: Operator Cert� ication Numbe
i
Back-up Operator: `_3 Back-up Certification Number:
Location of Farm: Latitude: Longitude: Eiiy ' rug—
IF-7 - 46,4 St f -a
NW y
I 4. f 01110 guy 6 Ceg6n10
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer I E:7d
Other
❑ Other
Dry Poultry
❑ La ers
4Z Division of Water Quality -
0 Division of Soil and Water Conservation
0 Other Agency
� Pry' -
Type of Visit to Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance I
Reason for Visit Routine O Complaint O Follow up O Referral O Emergency 0 Other ❑ Denied Access
i
Date of Visit: ` 1 ; Arrival Time: Departure Time: ' ounty: V r Region: 3.
Farm Name: br U C-e ft . HU h , Owner Email:
Owner Name: Phone:
Mailing Address: �3 ��m 1 i uDooCb
Physical Address: SUL
Facility Contact: I JrUU 1 Title: Phone No: a
Onsite Representative: Integrator.
Certified Operator: Operator Cert� ication Numbe
i
Back-up Operator: `_3 Back-up Certification Number:
Location of Farm: Latitude: Longitude: Eiiy ' rug—
IF-7 - 46,4 St f -a
NW y
I 4. f 01110 guy 6 Ceg6n10
Swine
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -Layer I E:7d
Other
❑ Other
Dry Poultry
❑ La ers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
Discharges & Stream Impacts
I . 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 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 otential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3
❑ Yes No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes 9No ❑ NA ❑ NE
Yes ❑ No ❑ NA ❑ NE
12128104 Continued

Facility Number: —
r Date of Inspection •
Waste Collection & Treatment -
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
❑ Yes KNo ❑ NA ❑ NE
a. If yes, is waste level into the structural freeboard?
❑ Yes ❑ No ❑ NA ❑ NE
Structure 1 Structure 2 Structure 3 Structure 4
Structure 5 Structure 6
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
,�f
(__1 Yes L�Y,No El NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
/ _
6. Are there structures on -site which are not properly addressed and/or managed
❑ Yes No ❑ NA Cl 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 16 No ElNA ElNE
8. Do any of the stuctures lack adequate markers as required by the permit?
ElYes KNo ElNA ElNE
(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
El Yes p(J No El NA El NE
maintenance or improvement?
/ -
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes KNo El NA El 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes to
o El NA [_1 NE .
15. Does the receiving crop and/or land application site need improvement? El Yes ❑ 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 {66 No ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment?
❑ Yes WNo ❑ 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):
�J� r
i
Reviewer/Inspector Name
MCI
Reviewer/Inspector Signature:
Date:
Page 2 of 3 v 1 12128104 ' Continued

Facility Number: —Ito I sofinspection 11011V1 0
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes LpLNo ❑ 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 iJ El Design ❑Maps El Other
21, oes reC ord keeping need improvement? Kwaste
❑YesNo ❑ NA ❑ NE
Waste Application 0 Weekly Freeboard Waste Analysis 0 Soil Analysis Transfers
Rainfall Stocking Crop Yield X 120 Minute Inspections Monthly and 1" Rain Inspections [Weather Code
22. Did the facility fail -to install and maintain a rain gauge? ❑ Yes JdNo ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
,28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (iel discharge, freeboard problems, over application)
32_ Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
❑ No
19NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
No
❑ NA
❑ NE
❑ Yes
)eNo
❑ NA
❑ NE
❑ Yes
o
tNo
[-INA
❑ NE
ElYes
❑ NA
❑ NE
❑ Yes LXNo ❑ NA ❑ NE
❑ Yes PfNo ❑ NA ❑ NE
❑ Yes KNo ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes XNo ❑ NA ❑ NE
Additional Comments and/or Drawings:
aOo9 y- as Co S ? zoo . l-Ld-e.ej ✓l<,ezJ
U tj 1-0 O-�P_ +`br a
;2 �ab4 ab 10
a Nov zoog —
Page 3of3 I _�bI oZC)1d — 5OLD 12128104

Facility Number
�
Type of Visit 0Compli 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:Z , K 7C Arrival fT�ime: �1 Departure Time: � County:
Farm Name: d i4 C -e �r7K -ir 131 e-- Owner Email:
Owner Name:
Mailing Address:
Physical Address:
Facilitv Contact:
Onsite Representative: r-
Certified Operator: 13 rt, {'�—
Title:
Phone:
/ Phone No:
Integrator: I�C L -5
Operator Certification Number:
Back-up Operator: Back-up Certification Number:
Location of Farm:
Region:
/Latitude: = e = L Longitude: ❑ ° ❑ 1
/ J
A
Design Current Design Current,:" ` �DesignC,urrentr
Swine Capacity Population Wet Poultry .Capacity-PopulAon. Cattle:- Capacity rop`ulatioi
❑
Wean to Finish
❑
Weanto Feeder
Feeder to Finish
0
❑
Farrow to Wean
❑
Farrow to Feeder
❑
Farrow to Finish
❑
Gilts
❑
Boars
Other
❑ Other
❑ Layer
❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ urkey Poults
❑ Other
❑
Dairy Cow
❑
Dairy Calf
❑
Dairy Heifer
❑
Dry Cow
❑
Non -Dairy
❑
Beef Stocker
❑
Beef Feeder
❑
Beef Brood Cowl
I
Y #» 4
� `Number�of Stri,
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 ZNo
NA ❑ NE
El Yes ❑ NA El NE
❑ Yes [2 NA ❑ NE
❑ Yes o ❑ NA ❑ NE
❑ Yes o ❑ NA ❑ NE
ElYes No ❑ NA ❑ NE
12128104 Continued

Facility Number: — f • Date of Inspection f 2 rp
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:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): �-`` 2-0 4
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes L.SNo NA ❑ NE
El Yes No ❑ NA ❑ NE
Structure 5 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 environment;No
re , notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes
:NA
A ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit?
❑ Yes;No
❑ 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 [DNA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes No NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 lbs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s) 1�- (2 S
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ? ❑ Yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment?
❑ Yes
/� No ❑ NA
El NE
'N ❑NA
El NE
NA
`
❑ NE
❑NA
El NE
❑ No ❑ NA
❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
,J ka 4 S .
AL
Reviewer/Inspector Name Phone: ��� - '7
Reviewer/Inspector Signature: ,¢� / Date: J 2 3 U
12128104 Continued

Facility Number: — @of Inspection
e
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes a 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. Does record keeping need improvement? If yes, check the appropriate box below. ❑ Yes o ❑ NA ❑ NE
❑ Waste Application ❑ Weekly Freeboard ❑ Waste Analysis ❑ Soil Analysis ❑ Waste Transfers ❑ Annual Certification
❑ Rainfall ❑ Stocking ❑ Crop Yield ❑ 120 Minute Inspections ❑ Monthly and 1" Rain InspectionZNo
eather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ YesNA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes N C31NA ❑ NE
24, Did the facility fail to calibrate waste application equipment as required by the permit? ❑ Yes NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? ❑ Yes NA El NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes o ❑ ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes No NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes No ❑ NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑ Yes ❑ No ❑ NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑ No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ❑ No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ❑ No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes ❑ No ❑ NA ❑ NE
Additional Comments and/or Drawings:
12128104

Division of Water Quali1W
Facility Number Division of Soil and Water Conservation . O4
O Other Agency
Type of Visit J& Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit y Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: /�Arrival �"Time:
Departure Time: 3. ount}': �V ►"+ Region:[
Farm Name: brute- A - I If—
i_ Owner Email: /
Owner Name: 1-/ r V c'� A- W 1_J`e- Phone: g s a 4 j 1 n6 tv�
Mailing Address: 3m i*l goody R6 •„1 L+ be 1 NC— a
Physical Address: fD 5rni r t�-L" C bex44 N C_
Facility Contact: ru co-0 9" 04' Title: Phone No: b
Onsite Representative: ICJ %_ U L1L. t-L "le— Integrator: IL LS
Certified Operator: J V' V Le 1-6 "k— Operator Certification Number:
Back-up Operator:
Location of Farm:
5-0E. Rwy6i 5oL*,
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: �o � . (a,, Longitude:
on-�O yb a Le-P+ o In+o 5 m N' h wows•
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
it
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifei
❑ 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: 121
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?
i
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes *o ❑ NA ❑ NE
`Yes No ❑ N ❑ NE
VV 12128104 Continued

Facility Number: —_ ® Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate? ❑ Yes �(No
ElNA ❑ NE
a. If yes, is waste level into the structural freeboard? ElYes ❑ No ❑ NA ❑ NE
r Structure 1 Structure 2 LStructure 3 Structure 4 Structure 5 Structure 6
Identifier. UPM 5 +*,qe. Lb w 'eT 5 Tn4 !j e-
`l Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): -4
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes VNo ❑ NA ❑ NE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes [( No ❑ NA ❑ NE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental th eat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes [WNo ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes ❑ NA El NE
(Not applicable to roofed pits, dry stacks and/or wet stacks) �(No
��,
9. Does any part of the waste management system other than the waste structures require ❑ Yes LNo ❑ NA ❑ NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes YNo ❑ NA ❑ NE
maintenance/improvement?
l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ YesA<1 ❑ 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 ;;^^
/t r' OUI
12. Crop type(s) FP-5cv� [ & raZe) . f ve ara�S�ln(� u , a raze/ . I1 ) YIe_,*� (ara
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP? ❑ Yes ZRNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement? ❑ Yes KNEl NA El NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ YesMiNo-
❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes V,
N0 ❑ NA ❑ NE
18. Is there a lack of properly operating waste application equipment? ❑ Yes I<No ❑ NA ❑ NE
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
U%krawings of facility to better explain situations. (use additional pages as necessary):
P
I
Reviewer/Inspector Name Phone: —7
Reviewer/Inspector Signature: dso 8/1 Se Date:
12128104 Continued

• 0
Facilitv Number: —' Date of Inspection
Rectuired Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other A
21. Does record keeping need i provement? If yes, ch k the appropriate bo elow. ❑ YesNo ❑ NA ❑ NE
�'aste Applica on Weekly Freeboard Waste Analysis Soil alysis Waste Transfersn
Rainfall Stocking El Crop Yield 120 Minute Inspections Monthly and 1" Rain Inspections Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes 19No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equip ent? El Yes No NA El NE
24. Did the facility fail to calibrate waste application equipment as required by the pe�-�OCFK ❑ Yes No `❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? e_LLLIn 1re4. r ❑ Yes No El NA El NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes o ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? ❑ Yes ❑ No �6A ❑ NE
Other lssues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ❑ Yes _)` No ❑ NA El NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document El l No ❑ NA ❑ NE
and report the mortality rates that were higher than normal? f
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes ❑ 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 jjNo ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? El Yes 0 N ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes �No ❑ NA ❑ NE
Additional Comments and/or Drawings:
a� a�� Soi15 7 13! f �008' 4o�g�t�1
aoo��$u�s
-7
N�n �m
a�
on �
12128104

I
Facility Number
Division of Water Qualit`1
Division of Soil and Water
0 Other Agency
nervation I— PM
F
f Visit ft �C/ompliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistancen for Visit d Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: Arrival Time: �Departure Time: • 020 County:
II
1
Farm Name: _,Oruc �_!_ �i Owner Email:
Owner Name: rums"_ 1(A ['1~' ��^- a Phone: S T q a rO
Mailing Address: 3 c� w I I r 1L L7000� f`d ' + t t bl2x t� 1 ��
l e aZ % oZ q
Region: IA b
r
Physical Address: 1 "J�"' !L'- 1
Facility Contact: "1 i���LQ L-6 Y1.k.t] te—„ Title: Phone No: —
Onsite Representative: �r ce 14:�2 "+ 'w Integrator: _ V 14
Certified Operator: ruc-e t' U Operator Certification Number: --2 dJ
Back-up Operator:
Location of Farm:
z- qb E&5+. -Lo Hwkj 6 1
� 0 y , S m it} -I vL0,od (A .
Design Current
Swine Capacity Population
Q Wean to Finish
❑ Wean to Feeder
Feeder to Finish 4:10
Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Other
❑ Other
Latitude:
Back-up Certification Number:
Longitude: F�Tqlo®' MJ-
O✓lfb HAAD, 6 a . Le--- j- `
Design Current
Wet Poultry Capacity Population
❑ Layer
❑ Non -La et
Dry Poultry
❑ La ers
❑ Non -Lavers
❑ Pullets
❑ Turkeys
❑ Turkey Poults
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
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 Stockei
❑
Beef Feeder
❑
Beef Brood Co
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
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes x No ❑ NA ❑ NE
❑ Yes DGo ❑ NA ❑ NE
12128104 Continued

,
Facility Number: 4,1— • Date of Inspection as D
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?
1 1 Structure 1 Structure 2 Structure 3 Structure 4
1� Identifier:
❑ Yes *10
❑ Yes ❑ No
Structure 5
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed? ❑ Yes
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed ❑ Yes
through a waste management or closure plan?
El NA ❑NE
❑NA El NE
Structure 6
Io ❑ NA ❑ NE
L](No ❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental t reat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes o ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes No ElNA ElNE
(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 �54o ❑ 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)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
❑ Yes
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination?❑ yes
17. Does the facility lack adequate acreage for land application? ❑ Yes
18. Is there a lack of properly operating waste application equipment? ❑ Yes
o ElNA
L14 No NA
LT1VNo E INA
o ❑ NA
ZNo ❑ NA
❑ NE
❑ NE
❑ NE
❑ NE
❑ NE
Comments (refer to question #E): 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):
1
Lam" T`
Reviewer/Inspector Name 1 SO 1&&P_hrpCX,
Phone: :Z Sa $Z
Reviewer/Inspector Signature:
Date: aA 0
12128104 Continued

Facility Number: — Date of Inspection a 0
s
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes :/No
❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check El Yes ❑ NA ❑ NE
the appropirate box. ❑ WUP ❑ Checklists ❑ Design El Maps El Other
21. Do record keeping need im vement: ❑ Yes C No ❑ NA ❑ NE
;;�
Waste Apptic tion Wee ly Freeboard Waste Analysis SVMonthly
alysis El Waste Transfers
hQ Rainfall 2stocking Crop Yield 2 120 Minute Inspections and I" Rain Inspections eather Code
22.
Did the facility fail to install and maintain a rain gauge?
❑ Yes
�No
❑ NA
❑ NE
23.
If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
0(k-1)
❑ Yes
❑jNA
❑ NE
24,
aIje
Did the facility fail to calibrate waste application equipment as required by the permit? a-L�O to
❑ Yes
N
❑ NA
❑ NE
25,
Did the facility fail to conduct a sludge survey as required by the permit? Dve, OCA' 11 '2W6
❑ Yes
No
ElNA
ElNE
26.
Did the facility fail to have an actively certified operator in charge?
❑ Yes
2/No
❑ NA
❑ NE
27.
Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
❑ Yes
❑ No
PdNA
❑ NE
Other Issues
28.
Were any additional problems noted which cause non-compliance of the permit or CAWMP?
ElYes
&No
❑ NA
❑ NE
29.
Did the facility fail to properly dispose of dead animals within 24 hours and/or document
❑ Yes
ElNA
ElNE
and report the mortality rates that were higher than normal?�No
30.
At the time of the inspection did the facility pose an odor or air quality concern?
❑ Yes
No
❑ NA
❑ NE
If yes, contact a regional Air Quality representative immediately
31.
Did the facility fail to notify the regional office of emergency situations as required by
❑ Yes
No
❑ NA
❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32.
Did Reviewer/inspector fail to discuss review/inspection with an on -site representative?
❑ Yes
N
❑ NA
❑ NE
33.
Does facility require a follow-up visit by same agency?
❑ Yes
Illd No
❑ NA
❑ NE
Ad(' 'onal Comments and/or Drawings:
a�bra UV_N 7
-�o14) n�d5o e.ie�,n—o�
r U AR
� l
e rr
12128104

•
•
Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 410016 Facility Status: Active Permit: AWS41QO16 ❑ Denied Access
Inspection Type: Compliance inspection Inactive or Closed Date:
Reason for Visit: Routine _ County: Guilford Region: Winston-Salem
Date of Visit: 0§12412006 Entry Time:01:00 PM Exit Time: 02:30 PM Incident #:
Farm Name: BBr ce A. Humble Owner Email:
Owner: Bruce A HumbIg
Mailing Address: 6632 SmithMod R Liberty NC 27298
Physical Address:
Phone: 33"85-4261
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm: Latitude: 35°54'58" Longitude: 79°3345"
From WSRO: 1-40 east to NG Hwy 61 south. Right onto Hwy 62. Left onto Smithwood Road.
Question Areas:
Discharges & Stream Impacts Waste Collection & Treatment Waste Application
Records and Documents Other Issues
Certified Operator: Bruce A Humble Operator Certification Number: 20382
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Bruce Humble Phone:
On -site representative Bruce Humble Phone:
Primary Inspector:
Inspector Signature:
Secondary Inspector(s):
Inspection Summary:
21. Still need to complete soil analyses for 2006.
21. Operator has not had to irrigate since last June due to low swine numbers. Will need to pump soon, though. New waste sample
will be needed also.
24. and 25. Don't forget to complete calibration and sludge measurements.
2/3/06 waste analysis= 0.63 lbs. N11000 gal
Page: 1

Permit: AWS410016 Owner - Facility: Bruce A Humble Facility Number : 410016
Inspection Date: 08/24/2006 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Swine
O Swine -Feeder to Finish 1,470 575
Total Design Capacity: 1,470
Total SSLW: 198.450
Waste Structures
Type Identifier Closed Date Start Date Designed Freeboard Observed Freeboard
agoon LOWER STAGE 21.00
agoon UPPER STAGE 18.00
Page: 2

•
L7
Permit: AWS410016 Owner - Facility: Bruce A Humble Facility Number: 410016
Inspection Date: 08/24/2006 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 Cl
■
❑
❑
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 lip cation
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

0
0
Permit: AWS410016 Owner - Facility: Bruce A Humble
Facility Number, 410016
Inspection Date: 0812412006 Inspection Type: Compliance Inspection
Reason for Visit: Routine
Waste Application
Yes No NA NE
PAN?
Cl
Is PAN > 100%/10 lbs.?
❑
Total P205?
Q
Failure to incorporate manure/sludge into bare soil?
❑
Outside of acceptable crop window?
❑
Evidence of wind drift?
Q
Application outside of application area?
❑
Crop Type 1
Fescue (Pasture)
Crop Type 2
Fescue (Hay)
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
❑
■
❑
Cl
Plan(CAWMP)?
15. Does the receiving crop and/or land application site need improvement?
Cl
■
Cl
Q
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?
❑
■
❑
it
18. Is there a lack of properly operating waste application equipment?
❑
■
❑
Q
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

•
0
Permit: AWS410016 Owner - Facility: Bruce A Humble Facility Number: 410016
Inspection Date: 06/24/2006 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?
❑
Cl
■
❑
Yns
No
NA
NE
28. Were any additional problems noted which cause non-compliance of the Permit or CAWMP? ❑ ■ ❑ ❑
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document and report those ❑ ■ ❑ ❑
mortality rates that exceed normal rates?
30. At the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air ❑ ■ ❑ ❑
Quality representative immediately.
Page: 5

Permit: AWS410016 Owner- Facility: Bruce A Humble
Inspection Date: 08/24/2006 Inspection Type: Compliance Inspection
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit?
32. Did Reviewertinspector fail to discuss review/inspection with on -site representative?
33. Does facility require a follow-up visit by same agency?
Facility Number : 410016
Reason for Visit: Routine
Page: 6

Division of Water Quality
Facility Number Division of Soil and Water Conservation �Vt
L i O Other Agency
Type of Visit Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit &Routine O Complaint 0 Follow up 0 Referral ()Emergency 0 Other ❑ Denied Access
Date of Visit:
a �}
Qn Departure Time: ount O U 1 1 � o rd Region: Ro
Arrival Ti p O Y g 1n15
Farm Name: �>rU C 2
`me:
'tu IYL.b 1�
Owner Email::/
Owner Name: A .
['t t.�t1l.�Q1�
p
Phone: i 0 OS—
f'
Mailing Address:
5 m l w ooa Ed •
L I N C
a 7 7 Q
Physical Address:)�dl
.
Facility Contact: V r oce—
1 �Q Title:
Phone No: 6_c) l
Onsite Representative: aruce,l�
Integrator: Y7
W
Certified Operator: t )'- Vc"e— lit_') V_ Operator Certification Number: do 3r—k
Back-up Operator:
Back-up Certification Number:
Location of Farm: Latitude: N�r ®, Eyl Longitude: ®e
a.
&-t5f it ►v _ tr y (a 1 S0 uM - h-F nnt6 1 Y � � . Ze-�'-� 5pri0
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
I
❑ La er
�! ❑ Non -Layer
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turke s
❑ Turkey Pouets
❑ Other
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
Design Current
Cattle Capacity Population
❑ DairyCow
❑ 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: EM
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of 3
❑ Yes %No ❑ NA ❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
75 No
❑ NA
❑ NE
❑ Yes
XNo
❑ NA
❑ NE
12128104
Continued

Facility Number: — • Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed
through a waste management or closure plan?
❑ Yes *o ❑ NA ❑ NE
❑ Yes ❑ No ❑ NA ❑ NE
Structure 5 Structure 6
❑ Yes �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? ❑ Yes X 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
El Yes
No ❑ El NE
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
❑ Yes
No ❑ NA ❑ NE
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below_
❑ Yes
No ❑ NA ❑ NE
❑ Excessive Ponding ❑ Hydraulic Overload ❑ Frozen Ground ❑ Heavy Metals (Cu, Zn, etc.)
❑ PAN ❑ PAN > 10% or 10 Ibs ❑ Total Phosphorus ❑ Failure to Incorporate Manure/Sludge
into Bare Soil
❑ Outside of Acceptable Crop Window ❑ Evidence of Wind Drift ❑ Application Outside of Area
12. Crop type(s)
13. Soil type(s)
14. Do the receiving crops differ from those designated in the CAWMP?
❑ Yes
XNo ❑ NA ❑ NE
15. Does the receiving crop and/or land application site need improvement?
❑ Yes
No ❑ NA ❑ NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination ?
❑ Yes
No ❑ NA ❑ NE
17. Does the facility lack adequate acreage for land application?
❑ Yes
KNo ElNA ElNE
18. Is there a lack of properly operating waste application equipment?
ElYes
1No ❑ 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):
e Un 3un 7
Reviewer/Inspector Name ris(;L r Phone: — Z
Reviewer/Inspector Signature: Date: Q
Page 2 of 3 V V1 J V12128104 Continued

Facility Number: — Ote of Inspection �4 • _ p�
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? Yes ❑ No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes *No ❑ NA ElNE
the appropriate box. ElWUP El Checklists Design ❑Maps El
Checklists
21 . Does r cord keeping need imp ovement? ❑ Yes [)(No ❑ NA ❑ NE
1; W ste Applica on W Weekly Freeboard L1K aste Analysis oil Ana ysis M 'w-w- exs Ion
ainfall Stocking IL 20 Minute inspections onthly and i" Rain Inspections pQ Weather Code
22. Did the facility fail to install and maintain a rain gauge? ❑ Yes )A No ❑ NA ❑ NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑ No XNA ❑ NE
24. Did the facilityfail to calibrate waste application equipment as re required b the permit? I O Yes No
PPq Y P � ❑ NA ❑ NE
25. Did the facility fail to conduct a sludge survey as required by the permit? @)[ o i t 2-OO(p ❑ Yes No ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes ® No ❑ NA ❑ NE
27. Did the facility fail to secure a phosphorus toss assessment (PLAT) certification? ❑ Yes (❑� No NA ❑ NE
Other Issues
28. Were any additional problems noted which cause non-compliance of the pen -nit or CAWMP? ❑ Yes ❑ No NA ❑ NE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document ❑Yes M No NA ❑ NE
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern? ❑ Yes No ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes No ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on -site representative? ❑ Yes ° No ❑ NA ❑ NE
33. Does facility require a follow-up visit by same agency? ❑ Yes (iNo ❑ NA ❑ NE
Comments and/or Drawings:
t .1 a1005r + a-00lp S O l f f�P_St re s U [f5 ? 0 S LQ 0+a
ala Pa-u\ d�&lc�-ins on F¢ fo✓Hpr�l 05 O�p(ica'o�ns?
d-13 10(o L.vasfe oLmV45 E5 = 0.6 3 L 6 s % N / 1()00
Page 3 of 3 12.128104

•
i
Vt
�e�

Division of Water Quality
❑ Division of Soil and Water Conservation
❑ Other Agency
Facility Number: 410016 Facility Status, Active Permit: AWS410016 ❑ Denied Access
Inspection Type: Compliance laspection Inactive or Closed Date:
Reason for Visit: Routine County: Guilford Region: Winston-Salem
bate of Visit: 05131 /2005 Entry Time: 09:15 AM Exit Time: 11:00 AM
Farm Name: Bruce A. Humble
Owner: Bruce AHumble
Incident #:
Owner Email:
Phone: 336&§kA261
Mailing Address: 6632 Smithwood Rd Liberty NC 27298 ^_
Physical Address:
Facility Status: ❑ Compliant ❑ Not Compliant Integrator:
Location of Farm:
Latitude: 35'54'58" Longitude: 79'33'45"
From WSRO: 1-40 east to NC Hwy 61 south. Right onto Hwy 62. Left onto Smithwood Road.
Question Areas:
0 Discharges & Stream Impacts
0 Records and Documents
(� Waste Collection & Treatment 0 Waste Application
0 Other issues
Certified Operator: Bruce A Humble Operator Certification Number: 20382
Secondary OIC(s):
On -Site Representative(s): Name Title Phone
24 hour contact name Bruce Humble Phone:
Primary Inspector: Melissa M Rosebro Phone:
336-771-4600
• Ext.383
Inspector Signature: Date:
Secondary Inspector(s):
Phone:
Phone:
Inspection Summary:
18. Must obtain pressure gauge for irrigation gun prior to next spray event. Potential NOVINOI.
18. Operator is using borrowed pump while his is being repaired. Borrowed pump does not have pressure gauge.
21. Waste application records for Oct. '04 through jan. '05 were not available. Operator has until June 15, 2005 to send copy of these
records to DWQ (freeboard, soils, irrigation).
21. Operator says that he obtained soil test results for 2004. Could not locate a copy of the report.
21. Operator still needs to obtain waste sample and PAN balane on F-2 and F-4 April 2005 applications. Check next visit.
2/7/05 Waste analysis=1.0 lbs. N11000 gal.
Page: 1

Permit: AWS410016 Owner - Facility: Bruce A Humble Facility Number: 410016
Inspection Date: 05/31/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Regulated Operations Design Capacity Current Population
Swine
O Swine - Feeder to Finish 1,470 480
Total Design Capacity: 1,470
Total SSLW: 198,450
Waste Structures
ype Identifier Closed Date Start Date Designed Freeboard Observed Freebow
agoon LOWER STAGE 42.0(
agoon UPPER STAGE 24.0C
Page: 2

Permit: AWS410016 Owner - Facility: Bruce A Humble Facility Number: 410016
Inspection Date: 05/31/2005 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? ❑ 0 ❑ ❑
Discharge originated at:
Structure ❑
Application Field ❑
Other ❑
a. Was conveyance man-made? ❑ M ❑ ❑
b. Did discharge reach Waters of the State? (if yes, notify DWQ) ❑ 0 ❑ ❑
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?
❑
yes
■
No
❑
NA
❑
NE
Waste Cnliertinn. Storage Treatment
4. Is storage capacity less than adequate?
❑
0
❑ Cl
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.l large trees, severe erosion,
❑
❑
❑
seepage, etc.)?
6. Are there structures on -site that are not properly addressed andlor 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
❑
0
❑
❑
andlor wet stacks)
9. Does any part of the waste management system other than the waste structures require maintenance or
❑
0
❑
❑
improvement?
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)?
❑
PAN?
❑
Is PAN n 10%110 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
Crop Type 3
Crop Type 4
Crop Type 5
Page: 3

E
•
Permit: AWS410016 Owner - Facility: Bruce A Humble
Facility Number: 410016
Inspection Date: 05/31/2005 Inspection Type: Compliance Inspection Reason for Visit: Routine
Waste Appliration
Crop Type 6
Yas
No
NA
NF
Soil Type 1
Soil Type 2
Soil Type 3
Sol] 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?
❑
0
❑
❑
17. Does the facility lack adequate acreage for land application?
❑
■
❑
❑
18. Is there a lack of properly operating waste application equipment?
■
YPc
❑
Nn
❑
NA
❑
NF
Records and Documents
19. Did the facility fail to have Certificate of Coverage and Permit readily available?
❑
■
❑
❑
20. Does the facility fail to have all components of the CAWMP readily available?
❑
■
❑
❑
If yes. check the appropriate box below
WUP?
❑
Checklists?
❑
Design?
❑
Maps?
❑
Other?
❑
21. Does record keeping need improvement?
■
❑
❑
❑
If yes, check the appropriate box below.
Waste Application?
■
120 Minute inspections?
❑
Weather code?
❑
Weekly Freeboard?
■
Transfers?
❑
Rainfall?
❑
Inspections after > 1 inch rainfall & monthly?
❑
Waste Analysis?
❑
Annual so!] 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)?
❑
Cl
■
❑
24. Did the facility fail to calibrate waste application equipment as required by the permit?
❑
■
❑
❑
25. Did the facility fail to conduct a sludge survey as required by the permit?
❑
■
❑
❑
26. Did the facility fail to have an actively certified operator in charge?
❑
■
❑
❑
27. Did the facility fail to secure a phosphorous loss assessment (PLAT) certification?
❑
❑
■
❑
Page: 4

Permit: AWS410016 Owner - Facility: Bruce A Humble Facility Number : 410016
Inspection Date: 05/31/2005 inspection Type: Compliance Inspection Reason for Visit: Routine
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 andlor document and report those mortality ❑ moo
rates that exceed normal rates?
30. Al the time of the inspection did the facility pose an air quality concern? If yes, contact a regional Air Quality ❑ M ❑ ❑
representative immediately.
31. Did the facility fail to notify regional DWQ of emergency situations as required by Permit? ❑ moo
32. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative? ❑ moo
33, Does facility require a follow-up visit by same agency; ❑ moo
Page: 5

Fac�itty`Nurnber
�
Division of lVa#er Quaht} i
Division of Soil and Water 'o nervation
0 Other Agency �f • !
,a
I Type of Visit tgj Compliance
pliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance I
Reason for Visit
Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
Date of Visit: V3 j O Arrival "rime: �1 Departure Time: 1 0 County: �L;U l { Region: �&O
Farm Name: fOi ucp— _ i Owner Email: ` d r f 1
Owner Name: 11rU Le— lUi�] Phone: (O
Mailing Address: & b -3 � 5m i�fl ��l I �,' I L! � � N�
Physical Address: � & & �� �I 'V
Facility Contact: ] r'U � [�1'LJ�A_.1r1L��'1'itle: Phone No: o' —6
On site Rep resentative: _ Bruce ce g�1� Integrator:
Certified Operator: � L )C,40 11 Operator Certification Num r: AO —66
Back-up Operator: Back-up Certification Number:
Location of Farm:
Latitude:
1 �71 o �' [U«
Longitude:
rU° 33
be � mi-0
F uSbn
��,'�-� 4 � !- I
Men V I � ,e ) . P-4
. o n fo
S al 1 if h �qi
Swine
Wean to Finish
Wean to Feeder
Feeder to Finish
Farrow to Wean
Farrow to Feeder
Farrow to Finish
Gilts
Boars
Other
❑ Other
Dry
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Layer
I' ❑ Non -La et
Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pouits
❑ Other
Design Current
Cattle Capacity Population
❑ Dairy Cow
❑ Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Cowl
I
Number of Structures: ©',
Discharges &Stream Impacts ko
1. is any discharge observed fromanypart of the operation? ❑Yes ❑ NA ❑ NE
Discharge originated at: [I Structure Cl Application Field El Other
a. Was the conveyance man-made? ❑Yes ❑ No ❑ NA ❑ NE
b. Did the discharge reach waters of the State? (]f yes, notify DWQ) ❑Yes ❑ No ❑ NA ❑ NE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system'? (If yes, notify DWQ) ❑Yes ❑ o ❑ NA ❑ NE
2. Is there evidence of a past discharge from any part of the operation? El Yes No ❑ NA ❑ NE
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State ❑Yes No ❑ NA ❑ NE
other than from a discharge?
5-Is- w CL uh +-0 wn !6+ . 12/28/04 Continued
�\j I Y1.S ion - ',So [P-M j lu C_ a -7 I 0 `]

Facility Number: —I& I Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure`I Structure 2 Structure 3 Structure 4
Identifier:) LLuv-4—
Spillway'?:
Designed Freeboard (in):
Observed Freeboard (in): p�
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 X No ❑ NA ❑ NE
❑ Yes ❑ No XNA ❑ NE
Structure 5 Structure 6
❑ Yes IVNo
❑ Yes qNo
❑ NA ❑ NE
❑ NA ❑ NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? ❑ Yes ko ❑ NA ❑ NE
8. Do any of the stuctures lack adequate markers as required by the permit? ❑ Yes V
No ElNA ElNE
(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?
NVaste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need ❑ Yes
�No ❑ NA
❑ NE
maintenance/improvement'?
1 l . Is there evidence of incorrect application? If yes, check the appropriate box below. ❑ Yes
�NoEl NA
❑ NE
❑ Excessive Ponding El Hydraulic Overload El Frozen Ground El 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 Wind w ❑ Evidence of Wind Drifl ❑ Application Outside of Area
12. Crop type(s) -q ra u
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, El Yes
No ❑ NA
❑ NE
17. Does the facility lack adequate acreage for land application? ❑ Yes
No El 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):'
Reviewer/Inspector Name
Reviewer/Inspector Signatu
Phone: fL
Date: 3
12128104
I�r
Continued

rV
Facility Number: — D of Inspection 3 d
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available? ❑ Yes 1%, No ❑ NA ❑ NE
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check ❑ Yes No El NA El NE
the appropirate box. ElWUP El Checklists El Design El Maps ❑Other
21. D s record kee in need im o e chec he appropriate box b Yes ❑ No Cl NA ❑ NE
aste A lication Wee �� and Waste Analysis Soil Anal sis
Rainfall ❑ Stocking Crop Yield 120 Minute Inspec�,�pns onthly and I" Rain Inspections Bather Code
grQ,ze_+ ha e0'.
22. Did the facility fail to install Ad maintain a rain gau, ? ❑Yes o El NA El NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? ❑ Yes ❑"No �( [-I NE
24. Did the facility fail to calibrate waste application equipment as required by the permit � oll ❑ Yes �No ❑ NA ❑ NE
C
25. Did the facility fail to conduct a sludge survey as required by the permit? (](p ❑ Yes KNo. ❑ NA ❑ NE
26. Did the facility fail to have an actively certified operator in charge? ❑ Yes 1f No El NA El NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? El Yes (❑ No K NA Cl NE
Other Issues gNo
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP? ElYes ❑ 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? XN
30. Atthe time of the inspection did the facility pose an odor or air quality concern? ❑ Yes o ❑ NA ❑ NE
If yes, contact a regional Air Quality representative immediately)(No
3 1 . Did the facility fail to notify the regional office of emergency situations as required by ❑ Yes ❑ NA ❑ NE
General Permit? (ie/ discharge, freeboard problems, over application) V
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 KNo ❑ NA ❑ NE
Additional Comments and/or Drawings:
Pute leis i5 i v� S hop s a eel
dw,4, 4t*t� 4&,,-e putw&�a
AW. -. y raw
c�� lS�
Free I�yr , Soe t rrr
All o 16s-N/ l000
:f
/f7t! I1js•;/, 1;r,/Rja•N �?. ;VIWXJ7� � �

vision of Water Quality
ision of Soil and Water Conse&ation
O Other Agency
Type of Visit Q. Compliance Inspection O Operation Review O Structure Evaluation O Technical Assistance
Reason for Visit OO Routine O Complaint O Follow up O Referral O Emergency O Other ❑ Denied Access
FDate of Visit: 10/21/2004 Time: 1040
acility Number 41 16
0 Not O erational Q Below Threshold
® Permitted ® Certified ❑ Conditionally Certified © Registered Date Last Operated or Above Threshold: ................
Farm Name:Bjrwg.&.k1=bJc ............................ .. ... County: G.0ford ........................................... ! SRIQ........
OwnerName: 13rusge.A. ............................... H umb.ltr....................................................... Phone No: Q. C1.6.8-.4�6>1...................................... ..................
Mailing Address: fiG nolitl�Yr49.d.F:sf.......................................................................... Uke':ty....KG................................... ..................... 2.7.29.8 .............
Facility Contact: I3ruCe..klU[lt.ble...............................................Title:................................................................ Phone No: ...0 ...07. ...............
Onsite Representative: R.r.jLzt:. uitl jg................... ............................................ Integrator:......................................................................................
Certified Operator:Bxac.ti.A ................................. Rtulil.flit;............................................ Operator Certification Number: ZQ.$2.............................
Location of Farm:
?rom WSRO: 1-40 east to NC Hwy 61 south. Right onto Hwy 62. Left onto Smithwood Road. +
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 1 35 • 54 ' S8 �6 Longitude 1 79 1@ 1 33 1 F 45
Design Current
Swine Canacitv Ponulation
❑ Wean to Feeder
® Feeder to Finish
1470
800
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer 10 Non -Dairy
❑ Other
Total Design Capacity 1,470
Total SSLW 198,450
Number of Lagoons 2
IE
.. ... — . . T 0
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ) 0 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? El Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ...... I.Ipper.slage...... .....Lrawjsr.sxagc ......................................... .........................................................................................................
Freeboard (inches): 0 23
12112103 Continued

Facility Number: 41-16 Date of Inspection 10/21/2004 •
5. Are there any immediate threats to theintegrity 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 0 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? N Yes ❑ No
8. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes N No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level ❑ Yes N No
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes N No
11. Is there evidence of over application? If yes, check the appropriate box below. ❑ Yes N No
❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Frozen Ground ❑ Copper and/or Zinc > 3000
12. Crop type Fescue (Graze) Fescue (Hay)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CA WMP)?
❑ Yes
N No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
N No
c) This facility is pended for a wettable acre determination? t
❑ Yes
N No
15. Does the receiving crop need improvement?
❑ Yes
N 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 orlagoonfail to discharge at/or below
❑ Yes'.,
❑ No
liquid leveVbf,lagoon or storage pond with no agitation? _ =''• `�' ''F",ty
"•
fie.rl�t`rfi, a. - t• ••._tj % !' r .i.
18. Are_-th&ie any dead animals not disposed of properly within 24- hours? . " .
•-
'❑ Yes"
r
®No
L•;....-�`rr,..�+:. .-• ,. ..-ram
19.=Is there,any-evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt; E],Yes
N•No t
roads, building structure, and/or public property) �? ' - ,'
y f
L`
' 20'Af-the'tit ie of the inspection did the facility pose an odor or air quality concern? If yis, contact a regional
f
❑ Yes
N No
Air Quality, representative immediately.
Y` q
'Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments +o
UscArawings of. facility to better explain situations. (use additional -pages as necessary): I ❑ Field Copy N Final Notes
3 lNeed`to monitor condition of cattle crossing. Looks ok today.
+
7:GIVIay. want to spray embankment with broadleaf weed control. Vegetation is about 24 inches tali today.
I 'erator is using borrowed pump since his is not working. Need pressure gauge for irrigation gun.
3. There was no waste analysis for the waste applications made in Spring 2004. NOV #,
Operator is to obtain waste analysis for Fall applications next week.?
•3.' Don't forget to obtain soil analysis results for 2004. `
6. Waste level in lower stage lagoon was above maximum liquid level during the the three hurricanes that came through this area this
Fall. Level was into storm storage about 2 inches but operator failed to call.
t '
/
Reviewer/Inspector Name
Reviewer/Inspector Signature: An,4 X7 Dater~ -
12112103
eontinued

Fi#cility Number: 41-16 DWf Inspection 10/21/2004 •
Required Records & Documents
I
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?
(iel WUP, checklists, design, maps, etc.) ❑ Yes ® No
23. Does record keeping need improvement? If yes, check the appropriate box below. ® Yes []No
❑ Waste Application ❑ Freeboard ❑ Waste Analysis ❑ Soil Sampling
24.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
25.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
®No
26.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel 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 facilityfail to calibrate waste application equipment?
Yee`s
❑ No
35.
Does record keeping for NPDES required forms need improvement'.Af yes, check the appropriate box below.
❑ YesF
❑ No
-r
❑ Stocking Form ❑ Crop Yield Form [:]Rainfall []Inspection After V Rain
I 1 1?0 Minute lnsnectinns n Annual Ceriifieation'Fnrm
S
12112103

�il, S' e v
Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date or v isit: Time: 1
0 Not Operational 0 Below Threshold
Permitted © Certified [3 Conditionally Certified © Registered Date Last Operated
/oj�r Above Threshold: _ w
Farm Name: County:Bruce
/ f
Owner Name: W ... ._.. !o. _... ........_...j... 'Phone No:.g�l�
Mailing Address:.._
Facility Contact:. . !-' `�__...wW Title: ---------------------•- Phone No: �,� �4� � a 7aoCTi�
Onsite Representative:,��„} _ _ , Integrator: _ _ .._..
Certified Operator:.r G . - _.... Operator Certification Number:.,, .aQ -3 ,U
Location of Farm:
Swine ❑ Poultry 0 Cattle 0 Horse Latitude
Design ,Current
Swine " (`an9CiiV aPADnlafiOn`
Le
Desk Current = Design . -Current
rY':Ca act Poilatson' Cattle ` . ..Caliacaty,.;Popiilatxon .. .
❑ Wean to Feeder
=`
❑Layer
Feeder to Finish
❑ Non -Layer
El Farrow to Wean
Farrow to Feeder
.
Orthe
Farrow to Finish
TOtaI Desij
r
_ . - A
x
Gilts
Boars
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) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated flow in gaurnin?
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
tt Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: V P ....-b........ . W ...
Freeboard (inches):
12112103 1 1 Continued

Fagility Number: 4— Date of Inspection '
P,
5. Are there any immediate threats to thelgrity of any of the structures observed? (ie/ tr4e severe erosion,
[J Yes
No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
❑ Yes
0
xl�
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public Stealth or eaviroam ntal threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
Yes
❑ No
8. Does any pan 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
XNO
elevation markings?
Waste Application
10. Are there any buffers that need maintenancelimprovement?
❑ Yes
5�No
11. Is there evidence of over application? If yes, check the appropriate box below.
❑ Yes
KNO
El Excessive Pon ' g ❑ PAN [Idraulic Overload Frozen Ground [ICopper and/or Zinc
12. Crop type1�jv,
r
13. Do the receivin�rops differ with th desi aced the ed Animal aste anagement Pl CAWW)?
❑ Yes
XNO
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
o
b) Does the facility need a wettable acre determination?
❑ Yeso
c) This facility is pended for a wettable acre determination?
❑ Yeso
JPN
15. Does the receiving crop need improvement?
❑ Yeso
16.Is there a lack of adequate waste application equipment?
)(Yes
0��
Odor Lssues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ,._2 4ces 2 Ne—
liquid level of lagoon or storage pond with no agitation? XT,
18. Are there any dead anim is not disposed of properly within 24 hours? ElYesqo
19. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ElYes �l�Io
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.
(refer to gaesfip #yracomm�anYii oan;s a��
Use rav_gs of fact�tiy to liettrr ca:pSa r%tuatzons. (:tse addibo>;a! p as wry) Reid Copy ❑Final Notes
r
t � �
Reviewer/Inspector Name
Reviewer/Inspector Signal
12112103
Date:
Continued

Facility Number: -» 110 D to of Inspection �2
Required Records & Documents
21. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
22. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WLP, checklists, design, maps, etc.)
❑ Yes
�to
23. D record keeping neeWiprovementl) yes, check the appropriate box below.
Yes
❑ No
Waste A licationreeboard Waste Analysis , Soil Sampling abD
PP y P C I oa `f
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
No
25. Did the facility fail to have a actively certified operator in charge?
❑ Yes
No
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
AYes
❑ No
27. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑Yes
*0
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 1 " 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.
�lddmonal Commants
IV
A"_4c. - -=t:�
UD
- r,
00,E tQe '/" Oz4u'l
I, VINJEn
is
Vi

technical Assistance Site Visit
• DNon of Soil and Water ConservatioW
O Natural Resources Conservation Service
O Soil and Water Conservation District
O Other...
Facility Number 41 - 16 Date: 127104 Time
Farm Name Bruce A. Humble
Mailing Address 6632 Smithwood Rd.
13:45 1 Time On Farm: 75 WSRO
County Guilford
Phone: [phone]
Liberty NC 27298
Onsite
Representative Bruce Humble Integrator Inde endent
Type Of Visit
® Operation Review
❑ Compliance Inspection (pilot only)
❑ Technical Assistance
❑ Confirmation for Removal
❑ No Animals -Date Last Operated:
❑ Operating below threshold
® Swine ❑ Poultry ❑ Cattle ❑ Horse
Purpose Of Visit
© Routine
O Response to DWQIDENR referral
O Response to DSWCISWCD referral
Q Response to complaint/local referral
O Requested by prod ucerlintegrator
O Follow-up
O Emergency
O Other...
Design Current Design Current
Capacity Population Capacity Population
❑ Layer
El
❑ Non -Layer
Wean to Feeder
® Feeder to Finish
1470
soo
❑ Dairy
❑ Non -Dairy
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes [K no
2. Is there evidence of a past waste discharge from any part of the operation that waste reached
❑ Other
GENERAL QUESTIONS:
1. Is waste discharging from any part of the operation and reaching surface waters or wetlands? ❑ yes [K 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?
I 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
Structurel Structure 2 Structure 3 Structure 4
Structure 5
Identifier Primary Secondary
Level (Inches) 1$ 25
CROP TYPES Fescue -graze Rye grass (graze) I Imillet
SPRAYFIELD
SOIL TYPES ApB HhB VaB
7. What type of technical assistance does the onsite representative feel is needed? (list in comment section)
03/10/03

a
s
Facility Number 41 - 16 Date:
4/27/04
PARAMETER
pO No assistance provided/requested
❑ 8. Waste spill leaving site
TECHNICAL ASSISTANCE Needed
Provided
❑ 9. Waste spill contained on site
25. Waste Plan Revision or Amendment
El
El 10. Level in structural freeboard
26. Waste Plan Conditional Amendment
❑
❑
❑ 11. Level in storm storage
27. Review or Evaluate Waste Plan w/producer
❑
❑
❑ 12. Waste structure integrity compromised
28. Forms Need (list in comment section)
❑
El
El 13. Waste structure needs maintenance
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
❑
❑
[119. Late/missing lagoon level records
34. Sludge Evaluation
❑
❑
❑ 20. Late/missing soils analysis
❑ 21. Crop needs improvement
35. Sludge or Closure Plan
❑
❑
❑ 22. Crop inconsistent with waste plan
36. Sludge removallclosure procedures
❑
❑
37. Waste Structure Evaluation
❑
❑
❑ 23. Irrigation maintenance deficiency
❑ 24. Deficient sprayfield conditions
38. Structure Needs Improvement
❑
❑
39. Operation & Maintenance Improvements
❑
❑
40. Marker checklcalibration
❑
❑
Regulatory Referrals
41. Site evaluation
❑
❑
❑ Referred to DWQ Date:
42. Irrigation Calibration
❑
❑
❑ Referred to NCDA Date:
Irrigation
❑
El
Other...
43. system design/installation
Date:
44. Secure irrigation information (maps, etc.)
❑
❑
LIST IMPROVEMENTS
45. Operating improvements (pull signs, etc.)
❑
❑
MADE BY OPERATION
46. Wettable Acre Determination
❑
❑
1
47. Evaluate WAD certificationlrechecks
❑
❑
48. Crop evaluation/recommendations
❑
❑
2
49. Drainage worklevaluation
❑
❑
50. Land shaping, subsoiling, aeration, etc.
51. Runoff control, stormwater diversion, etc.
❑
❑
❑
❑
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. Croplforage management education
❑
❑
59. Soil and/or waste sampling education
❑
❑
03/10/03

0
IFacility Number 41 - 16 Date: I 4127104 I
COMMENTS:
Waste analysis: 9-26-03 ALS 0.54 Ibs.N11000 gals. I
The last soil sample was dated 9-30-03.
Mr. Humble has applied to Fescue on T5442 field # 1 so far this year.
Facility and records appear to be in compliance.
TECHNICAL SPECIALIST lRocky Durham Millie Langley
SIGNATURE
Date Entered: 130104
Entered By: lRocky Durham
03/10/03

- t ton of Water"Quality' • `'
ivision of Soil and Water Conservation
O Other Agency
L
Visit OO Compliance Inspection Q Operation Review Q t_agoon Evaluation
for Visit © Routine Q Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 41 16 Date of Visit: 09/10/2003 Thile: D940
O 'Not Operational O Below Threshold
Permitted M Certified 13 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: ..... _.
Farm Name: lit:u".&.11MM0....................... ..................... County: Quilfard................................. ?'Y .R....-.
Owner Name: jBruceA,.__________-_-_-- 1lttuibl�-----------_._.------------ Phone No:(331.41:42��rtxc+�'dads_s_.dv1--
Mailing Address: 6b32. imAtltwQoff.�d,........................... ... L,lbttirly..NC............................................................
Facility Contact: Anwa.Rumble...................................Title:............................................... Phone No: 331.685.1)729411)...........
Onsite Representative: �xuGg_L�u1111Z1sw.------------------------------------ Integrator:led@DldQ11.---------------------------..
Certified Operator: a1Cime.. ............................... jIj.UMb.je ............................................ Operator Certification Number: 2.0.3 .2 .............................
Location of Farm:
From WSRO: 140 east to NC Hwy 61 south. Right onto Hwy 62. Left onto Smithwood Road. +
I-
M Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 35 • 54 58 Longitude 79 • F_3T7j1 45
Design Current
Swine Canacitv Ponulation Poultry
Design Current Design Current
Cavacitv Po ulation Cattle Capacity Population
❑ Dairy
❑ Wean to Feeder
❑ Layer
® Feeder to Finish
1470
900
Y
❑ Non -Layer
❑ Farrow to Wean
❑ Farrow to Feeder
— ❑ Other
❑ Farrow to Finish
Total Desi
❑ Gilts
❑ Boars
❑ Non -Dairy
;n Capacity. 1,470
otal SSLW 198,450
Number of Lagoons 2 1 ❑ Subsurface Drains Present ❑ Lagoon Area 10 Spray Field Area
Holding Ponds./ Solid:Traps 0 ❑ No Liquid Waste Management System s
Discharees & Stream Imaacts
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 rya]/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: llWr fire ..._---------- -........... ................-•-----...-----._.._-....--•--•----- -.._.
Freeboard (inches): 0 21
❑ Yes ® No
[:]Yes [:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
® Yes ❑ No
[]Yes ®No
Structure 6
05103101 _* 8'( .rk- Cont ►cued

r
Facility Number: Z 16 I)ate of Inspection 09/10/2003 is
5. Are there any immediate threats to the oin0egrity of any of the structures observed? (ie/ trees, severe erosion, Yes 0 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 Fescue (Graze) Fescue (Hay)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15. Does the receiving crop need improvement?
16. is there a lack of adequate waste application equipment?
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 ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
[]Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
10 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
3. Keep an eye on both cattle crossings. No violations today. Starting to get some streambank erosion. Check next visit.
_
19. Records look good!
19. Don't forget to take waste sample this week for July 2003 applications.
T
Reviewer/Inspector Name ;Meli i R se rack
Reviewer/Inspector Signatures `(� i`r Date:/a Ina
U5/U3/UI I' 'j" Continued

Facility Number: 41-16 104Inspection 09/10/2003
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28, is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Additional Comments and/orDrawings:
05103101
05103101

Division df Water Quallh
",Division of Soil and Water Conservation
O'Other Agency
IType of Visit (Compliance Inspection O Operation Review 0 Lagoon Evaluation I
Reason for Visit (It Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Date of Visit; Q d3 Time:
Facility Number
Not O erational Below Threshold
Permitted Certified 0 Conditionally` Certified 0 Registered Date Last Operated Above T reshold:
Farm Name: +tK` County- LJ r
Owner Name: ` `p 3 �- S� ca4 I�-q p} .NU. L ) �� a
Tailing Address: 16ru e- 3 P
Facility Contact: (IJ % _. ��t1J_I i Lditle: Phone No: ' �` + 0C
Onsite Representative: U L� I e- Integrator: `'may t' W2
Certified Operator: r U �- Operator Certification Number:
Location of Farm:
Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude ®' ° •' Longitude 0 ®° u
Design Current
Design Current
Design Current
Swine Capacity Population
Poultry
Capacity Population Cattle
Capacity Population
❑ Wean to Feeder
1
10 Layer
❑ Dairy
Feeder to Finish
❑ Non -La er
❑ Non -Dairy
arrow to Wean
❑Other
❑ Farrow to Feeder
❑ Farrow to Finish
Total Design Capacity
❑ Gilts
Total SSLW
0
❑ Boars
I Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area 10 s rav Field Area I
Holding Ponds / Solid Traps ❑ No Liquid Waste Mana ement 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 1 tructure 2 . tructure 3 Structure 4
Identifier:
Freeboard (inches):
05103101
Structure 5
❑ Yes 9No
❑ Yes [--]No
❑ Yes [--]No
❑ Yes
❑ No
❑ Yes
No
AYes91No
❑ Yes
L�N0
`
Structure 6
/
Continued

Facility Number: L. — Date of Inspection fJ
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, No
seepage, [ 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
S. Does any part of the waste management system other than waste structures require main tenancclimprovement? ❑ Yes )�No
9. Do anv stuctures lack adequate, gauged markers with required maximum and minimum liquid level ,(
elevation markings? ❑ Yes �J No
Waste Alinfication
10. Are there any buffers that need maintenanceiimprovement? ❑ Yes IMNo
1€ . Is there evidence of over application? ❑ Excessive Ponding ❑ PAN Hydraulic Overload El Yes hlo
12. Crop type , L�
13.
Do the receiving crops differ with those designated in the CertifiedlAnimal Waste Management Plan (CAVG'MP)?
❑ Yes
No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
o
ia) Does the facility need a wettable acre determination?
❑Yeso
c) This facility is pended for a wettable acre determination?
❑ Yes
INo
15.
Does the receiving crop need improvement?
❑ Yeso
16.
is there a lack of adequate waste application equipment?
ElYeso
Required
17.
Records & Documents
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 W Management lan readily available?
Oe/ NVUP, checklists. design. maps, etc.) � / ✓/ y
❑ Yes
[)(No
19.
Does record keeping need improvement? (iel irrigation, freeboard, waste analysis & soil soil sample reports)
❑ Yes
No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
'o
21.
Did the facility- fail to have a actively certified operator in charge?
❑ Yes
No
22.
Fall to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
❑ Yes
No
23_
Did Reviewer/Inspector fail to discuss reyiewiinspection 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
No
Lam. No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Cornmeirts (refer fa giiesfiiizi #).--Eiplaiiri.any YES° answers!and%or'an:recommendations .comments r
Use drawings of facility to better explsm situations. (use additional pares as necessan) , . Field Copy ❑Final Notes
d°S.-_L•-... i:�1"S'J�iRSts..*,]�. `,•. �.C:2..' .^K`w%�._ac? i..�-.1.:» .-.+.fin:§-i .. f ,yrw ow FM �.m _ �r,.�'n".0 w-^-�-J%_}y^�-..r.-...._:vim..--_.^e•:o
RevieweriInspector Name
ReAewerAnspector Signature: Date:
05103101 Y r Co> di ued

Facility Number: — Date of Inspection
Odor Issues,
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atior 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 permanentitemporary cover?
and/or
o__ -
❑ Yes No
❑ Yes No
❑ Yes �No
❑ Yes No
❑ Yes No
❑ Yes No
05103101

ision of WatersQuality •
0ivision of Soil and Water Conservation
0 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 41 16 Date of Visit: 10/9/2002 Time: 13U0
0 Not Operational Q Below Threshold
® Permitted ® Certified 0 Conditionally Certified [3 Registered Date Last Operated or Above Threshold:...... ..............
Farm Name: HrMrxA..RWn]tbtC...................................................................................... ... County: G.ui11,Qrd............................................ W. .SR ........
Owner Name: Brun.C.tlx................................ Hmuthir ....................................................... Phone No:Q3.(jj.fi8Sr.4.�bt........................................................
Mailing Address: fiG.Silc4lxtx�Y(ltHi.Rd.......................................................................... 1. btxV..NC......................................................:..... 2729..#..............
Facility Contact: Hztalre.Rutmble...............................................Title:................................................................ Phone No:...................................................
Onsite Representative: Brur.C.HLIMble.................. . Integrator: J.udependc at.................... ...............................................................................................
Certified Operator:jU=c:t:.A................................. Rumble.................... .... Operator Certification Number:,ZQ3&.
.................... ............................
Location of Farm:
From WSRO: 140 east to NC Hwy 61 south. Right onto Hwy 62. Left onto Smithwood Road. A
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 35 • 54 4 58 " Longitude 79 • 33 4 45 64
Design Current
Swine CaBacity Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
850
❑ Farrow to Wean
® Farrow to Feeder
140
0
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 140
Total SSLW 73,080
Number of Lagoons 2 ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding'Ponds / Solid Traps 0 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated 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: .....U.pµea:.Stage..... .... Loser.Setage............................................................................................................... .......
Freeboard (inches): 12 21
❑ Yes ® No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
❑ No
❑ Yes
® No
❑ Yes
® No
❑ Yes
® No
Structure 6
05/03/01 Continued

Facility Number: 41-16 0 Date of Inspection ]0/9/2002 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 andlor 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 ADDIlCatiOn
❑ Yes
® No
❑ Yes
® No
® Yes
❑ No
® Yes
❑ No
❑ Yes
® No
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 (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? ❑ Yes ® No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes ® No
b) Does the facility need a wettable acre determination? ❑ Yes ® No
c) This facility is pended for a wettable acre determination? ❑ Yes ® No
15.
Does the receiving crop need improvement?
® Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
® Yes
❑ No
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/. WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
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) , Y.
1 ❑ Field Copy ® Final Notes
:.;
4. Need to pump soon since waste is only 3 inches below the maximum liquid level.
AL
7. Need to pull goats off dams since spillway of #2 lagoon is especially bare.
8. Need to repair leak in overflow pipe of flush system.
15. Fields next to lagoons are mostly goosegrass and bermuda. Operator sowed fescue and oats here last week and it is starting to come
up now.
16. Operator is to replace the suction pipe on the pump intake soon.
13/02 waste analysis=1.4 lbs. N11000 gal.
Reviewer/Inspector Name iMeli s Ro ebrock
Reviewer/Inspector Signature. Date: JA
I
05103101 Continued

Facility Number: 41_16 t*f Inspection F 10/9/2002 •
Odor Issueti
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours?
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
31. Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
❑ Yes ❑ No
❑ Yes ❑ No
[-]Yes [:]No
❑ Yes ❑ No
❑ Yes []No
❑ Yes ❑ No
[:]Yes [:]No
Additional Comments and/orDrawings:
r
05103101

Pe+rrnl
Division of Water Quality
Division of Soil.and' Water Conservation
Q Other Agency
Type of Visit P C pliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit Routine O Complaint O Follow up O Emergency Notification O Other Denied Access
Facilih• Number
Date of Visit: ,me: L-K L.bL I
hot Operational 0 Below Threshold
0 Permitted [Certified E3 Conditi nalhC rtifzed ❑ Registered Date Last Operated or A oN Threshold:
Farm Name: U County: a
Owner Name: i�U T! ' I Phone No: 6 TV . 7' a to I�,,,
Mailin- Address: 3 C-�_
Facilitv Contact: IALT itIe: Phone No:
Onsite Representative: Integrator: :t P" P,.nc6 1+
Certified Operator: tt1/t-�1 P Operator Certification Number: 03 V
Location of Farm:
Swine ❑ Poultry • ❑ Cattle ❑ horse Latitude �" Longitude EWE'
Design Current Design Current Design Current
Swine Capacity Poj2ulation Poultry Capacity Population Cattle Ca seity Pa ulation
❑ Wean to Feeder ❑ Laver ❑ Dairy
eder Feto Finish ❑ Non -Layer ❑ Non -Dairy
-
❑ Farrow to Wean
Farrow to Feeder it❑ Other -
Farrow to Finish Total Design Ca acloy
❑ Gilts SSL� 1 CK 4:0
❑ Boars Total SSLW
Number of Lagoons ❑ Subsurface Drains Present ❑ Lagoon Area ❑ S rav Field Area '
Holding Ponds /Spud Traps ❑ No Tiquid 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
«'ante Collection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate?�Zpillway ❑ YesX"'40
� 1 Struucrur Stru tore 2 tructure 3 Structure 4 Structure 5 Structure 6
Identifier: U e.t
Freeboard (inches):
05103101 Continued

Facility Number: 41— Date of Inspection
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees. severe erosion,
seepage. etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
S. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any sructures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
«'ante Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of ovej application? / ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crop type .�/D A?I A d /6.'O A.n_PAY 1
13. Do the receiving crops differ with thoslesignat{ll in-n Certified Animal Waste Management Plan (CAWMP)?
14. a) Does the facility tack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement?
16. Is there a lack of adequate waste application equipment?
Required Records & Documents
17. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
18. Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP. checklists, design, maps, etc.)
19. Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
20. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
21. Did the facility fail to have a actively certified operator in charge?
22. Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
23. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
24. Does facility require a follow-up visit by same agency?
25. Were any additional problems noted which cause noncompliance of the Certified AV4rMP?
❑ Yes XNO
❑ Yes ANO
Yes )4 -
9Yes ❑ No
❑ Yes KNO
❑ Yes *0
❑ Yes IX No
❑ Yes
No
❑ Yes
kNo
❑ Yes
No
❑ Yes
[ �No
Yes
❑ No
XYes �N�
❑ Yes X No
❑ Yes No
❑ Yes ��,,,,,//No
El Yes Y_` 110
❑ Yes f XNo
❑ Yes No
ElYes11N
No
❑ YesNo
❑ Yeso
IU No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit. I
Comments (refer to question ##): Explain any'YES, answers and/or any recommendations or any hercomments.
Use drawings of facility to better explain situations: (use additional, pages as necessary): _
Field Cory ❑ Final Notes
0_�_
a--�
Reviewer/Inspector Name
Reviewer/Inspector Signature: Pro �[ / Date: Q
n ainzin r

• !
Facility Number: — Date of inspection
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
liquid level of lagoon or storage pond with no agitation?
27. are there any dead animals not disposed of properly within 24 hours?
29, is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon?
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts. missing or
or broken fan blade(s), inoperable shutters, etc.)
3 l . Do the animals feed storage bins fail to have appropriate cover?
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Additional Comments and/or Drawings:
SLAX- bij
14
e .
�� Co a
N = I.4- t 65-. KV 16C)OOf-P
❑ Yes X11 0
❑ Yes Akio
❑ Yes XNo
El Yes ``No
El Yes No
❑ Yes No
Mi
05103101

_Afttston of Water Quality r'
lision of Soil and Water Conservation
Q' Other Agency
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit @ Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 41 16 ')ate of Visit: 411fi/2002 Time: 13:25
Not O erational O Below Threshold
® Permitted ® Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .............
Farm Name: Ur.u!~. A.,.Butt]tbh......................................... ................................................ County: G.u.Uf9x-.d ........................................... W,$RQ........
Owner Name: Urtur.,�..Ax................. I.............. Humble...........
Mailing Address: {.6.325ith-An.od.Rd..............................
FacilityContact: .........................................................................
Onsite Representative: ��u��.H��bl�...................
................................. I..... Phone No: ( 1. 5.:4�61........................................................
....................................... Uhlk ity..NG........................................................... 2.7.29.8 .............
Title: ................................................................ Phone No:...................................................
Integrator:laftt,jademt............................................
Certified Operator:B.r ce.A................................. Ruxuble ............................................ Operator Certification Number:203.82 .............................
Location of Farm:
rake Hwy 62 south of Burlington, turn onto Smithwood Road. Farm is approx. 4 miles east of 62. A
w
® Swine ❑ Poultry []Cattle []Horse Latitude 35 • 54 6 58 « Longitude 79 • 33 { 45 «
Design Current
Swine Canacitv Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
900
❑ Farrow to Wean
® Farrow to Feeder
140
❑ Farrow to Finish
❑ Gilts
❑ soars
EE
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
❑ Other
Total Design Capacity 140
- Total SSLW 73,080
Number of Lagoons L 2 10 Subsurface Drains Present ❑ Lagoon Area JE1 Spray Field Area
Holding Ponds / Solid Traps JE] 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 I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: ..........BEimary.......... .Secandary.....................................................................................................................................................
Freeboard (inches): 13 24
05103101 Continued

Facility Number: 41-16 Date of Inspection 4/16/2002
5. Are there any immediate threats to the tegrity 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 maintenancelimprovement?
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 Fescue (Graze) Rye
Pearl Millet
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
IT 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?
.n
❑ Yes ® No
[]Yes ® No
❑ Yes ® No
® Yes ❑ No
❑ Yes ® No
❑ Yes ®-No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #): Explain any YES answers and/or any recommendations or any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary): ❑Field Copy ®Final Notes
"_ _
_
$. Need to repair the leak on the flush tank of the upper house. The spillage is contained in a small area around the tanks.
_
he dead hole has been moved to 300 ft. or more from the stream.
Facility is in compliance with the above exception.
Reviewer/Inspector Name Rocky Durham
Reviewer/Inspector Signature: Date:
05103101
Continued

Facility Number: 41-16 D.16Inspection 4/16/2002 0
Odor Issue'
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?
itiona Comments and/or Drawings:
aste analysis: 4-03-02 ALS 1.4 Ibs.N/1000 gals. I
9-11 -0 1 ALS 1.1
analysis was logged in 4-8-02.
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
J
O5103101

i0 'vision of Water Quality GOision of Soil and Water Conservation
07,17ther Agency ". f Fir r,
Type of Visit O Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit *Routine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number 41 16 Date of Visit: 9/13/2001 'time: 1115 Printed on: 9/14/2001
0 Permitted ® Certified 0 Conditionally -Certified 0 Registered paw Last Operated or Above. Thresho{d:
F=MrN=M= lfzxt t'<;, t ttumtbft; _ Eomew- SAMtriesl_: W,SR4L_
OwnerName: Urmi e-A.................................. HLIMM ...................................................... Phone No: ( ().b.-.42G>1................................. .......................
Mailing Address: �G .Stlaitbt�taS)d.R ........................
Facility Contact: flrM0..Uuit blC.........
Onsite Representative: B.t uCe.k[>aunbl.......
Certified Operator:Rruce...................................... kfumble.....
Location of Farm:
........ I .... I .............. UbeVy..N.C......................
27.29..8 .............
Title:................................:....I....I-- ............... Phone No:.....................................
Integrator: ......................................................................................
Operator Certification Number:293&.............................
Take Hwy 62 south of Burlington, turn onto Smithwood Road. Farm is approx. 4 miles east of 62.
w
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 35 • 54 4 5$46 Longitude 79 • 33 45
Design Current
Swine Canacitv Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
850
❑ Farrow to Wean
0 Farrow to Feeder
140
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer JE1 Non -Dairy
❑ Other
Total Design Capacity 140
Total SSLW 73,080
Number of Lagoons 1 2 1 ❑ Subsurface Drains Present 110 Lagoon Area ID Spray Field Area
Holding Ponds / Solid Traps 0 ❑ No Liquid Waste Management System
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation? ❑ 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 galhnin?
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? 0 Spillway ❑ Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: .... Sxage..Lupper.... .... Stage..2.Iower.................................................................................................................................................
Freeboard (inches):. 12 25
05/03/0I x3 3.0 /� Continued

Facility Number: 417—66 e Date of Inspection 9/13/2001 Printed on: 9/14/2001
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ treepsevere erosion,
❑ Yes
® No
seepage, etc.)
6. Are there structures on -site which are not property 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 maintenattcelimprovement?
C,Yes
Jallo
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
®No
�?ha�lr �poiie�tlpxe-• .
10. Are there any buffers that need maintenance/improvement?
QYes
9No
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
❑ Yes
® No
12. Crop type Fescue (Graze)
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
® No
15. Does the receiving crop need improvement?
❑Yes
® No .
16. Is there a lack of adequate waste application equipment?
❑ Yes
® No
Required Regilrds & D eument
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?
Cl 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 Rev iewerMspector 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
f
r] No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
.Comments (refe Ito question #): E any YaES�answergs and/or a trecom~emendations or any -other r-
Use drawtngs�factlity�to better addrt,onal pages necessary,)
- explamys�tuattons �(u�se
+rr �- ❑ i Id o ®Final Note
Field Copy o
.,..
16. Recommend recalibration of spray gun since it's been several years since this was done. Need to also re -check ring -nozzle wear.
19. Records look real good this year.
27. Need to cease use of current "dead hole" and begin use of one at least 300' from stream.
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector Signature. Date:
05103101 Continued

Ftkility"'.Number: 41_16 Dof Inspection 9/13/2001 • Printed on: 9/14/2001
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ® Yes ❑ 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? CJYes ISNo
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 Cl No
31. Do the animals feed storage bins fail to have appropriate cover? 0 Yes MLNo
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ® No
,&1
J
05103101

.Y t vision of Water Quality
ivision of moll and wager Conservation,
t Q Other Agency =�
of Vlslt aCompliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit % Routine O Complaint O Follow up O Emergency Notification O Other 1 ❑ Denied Access
Facility Number Date of Visit: Time:
OR (Operational Q Below Threshold
Permitted 0 Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold:
Farm Name: 8r}C.e,.1....... 1.0 County:....... ..1 rd................................................
Owner Name:........ .V.G ..!`.:...... RuvIt Phone No: ...J :.. ..° ..�.............. :.
FacilityContact: ....... :..................................................
�.�rt�� � ........................ Phone No:...................................................
Mailing Address:
.1a3..a..... m.� G�r.1. .....1 ..:............ .� .................. ..........................; .� a � �98'
Onsite Representative:.... r.....P...►...HL.................................. Integrator:...............................
Certified Operator:..._.,,t`)r..U.!:ne ................. ..... RU". Operator Certification Number: ; ,
Location of Farm:
FrarAL45P•0 fork T 40615F -b AlaMdt7co orG�) kdl. Take is y 6.7 4&-6ss u y �.
TvC-h ri yh oh+b Z+ nt-bex-r i-- o ` to l;mt°s V I Me YL rig hfon
t4 Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude • ©� ��� Longitude ®• ®� ®«
Design Current
bonne Capacity Population
❑ Wean to Feeder
Feeder to Finish
❑ Farrow to Wean
Faff ow to Feeder.
❑ Farrow to Finish
Gilts
❑ Boars
Design Current Design Current"',
Poultry CapacityCipacity Population Cattle Capacity ' Po `ulatlion
❑ Layer I ❑ Dairy
❑ Non -Layer I I[] Non -Dairy
❑ Other I I— I
Total Design Capacity
Total SSLW
Number of Lagoons ❑Subsurface Drains Present ❑ Lagoon Area
Holding Ponds 1 Solid Traps JE3 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)
❑ Spray Field Area
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
{{S�� tructure iI Structure 2 Structure 3 - Structure 4 Structure 5
Identifier:.....s..l..4................5)..��.{.............. ...................................................................
U)q
Freeboard (inches): p cr
5100 1 �2 A 5
❑ Yes XNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes o
❑ Yes o
0 Yes 0 No
Structure 6
Continued on Lack

Facility,Number: — Date of Inspection I yll� 1
5. Are there any immediate threats to the10grity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes o
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? El yes XNo
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement? ❑ Yes *0
8. Does any part of the waste management system other than waste structures require maintenance/improvement? fifes ® No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level "
elevation markings? ❑ Yes /XNo
Waste Application
10. Are there any buffers that need maintenance/improvement? ❑ Yes ANo
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes XNO
12. Crop type ItaLda
13. Do the receivin ous differ with
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 prob[ems noted which cause noncompliance of the Certified AWMP?
0' �'VQ-yiolatiQris;or- defc�e.>vc�es •r'v�re poted• a><tt:tng �h}s;vis�t; • Yoj� will-i-ec�iye Rio; #'u>�'thgt; • , ,
correspondence aboU this visit:.:::::::::: :. .. .. .... ...............
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes No
❑ Yes XNO
[]Yes §(No
❑ Yes] No
❑ Yes 060
❑ Yes X,No
❑ Yes rXNo
❑ Yes )�&o
❑ Yes *o
❑ Yes %No
❑ Yes XNo
❑ Yes ONO
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� 8 0
I - I f _A_j -
O
I
���� '� - I �p
Reviewer/Inspector Name A 0 1 5�Q iGO � f hid'/
Reviewer/Inspector Signaturet/j/ VI / i 1 yjV4 A, /UA�74 D 1, & j _ Date: y / 0 /(1 1 5100

Facility Number: - e of Inspection
Odor Issues
26.
Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
4-Yes—
Eq No
liquid level of lagoon or storage pond with no agitation?
27,
Are there any dead animals not disposed of properly within 24 hours?
AYes
❑ No
28.
Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
❑ Yes
P(No
roads, building structure, and/or public property)
29.
Is the land application spray system intake not located near the liquid surface of the lagoon?
❑ Yes
XNo
30.
Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.)
❑ Yes
o
90
31.
Do the animals feed storage bins fail to have appropriate cover?
❑ Yes
32.
Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
[] Yes
K No
Additional omments an orDrawings:
ZJas�e SO -Nip de_ 4in 6 o d ayS ? ✓ V�ye id 60 r� esl'ib!l s hid on P/
bead hol e #a 11 ?/�aaol ✓
V 7/oo
(!.O� U'O f I td-oz-4-4
�n
5100

vision of Water Quality
vision of Soil and Water Conservation
0 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
Dale nr Visit: 4/4I20U1 Time: 11a10 Printed on: a/29/2001
41 16
Not O erational 0 Below Threshold
A Permitted 0 Certified ❑ Conditionally Certified ❑ Registered Date Last Operated or Above Threshold: ...............
Farm Name: Urms.o�..A►..tauamble .............................. ..... County: Qaffoxd ............................................ WSW ........
Owner Name: 1,trine..&................................ illmblig...................................................... Phone No:(33.(zl.05-.4.261............................
Mailing Address: bb32.Snufftb Qod.lZsl.......................................................................... i.gibe.jrsy..N.0...................... ...... ........... .................... 27.291 .............
Facility Contact:
Onsite Representative: llrue-e 1jumble ............................
.......Title:................................................................ Phone No:..........
.......................... Integrator: .....................
Certified Operator:li.me-e...................................... Humble............................................. Operator Certification Number: Z03$2..................
Location of Farm:
Cake Hwy 62 south of Burlington, turn onto Smithwood Road. Farm is approx. 4 miles east of 62.
® Swine []Poultry []Cattle ❑ Horse Latitude 35 • 54 58 Longitude 79 • 33 6 45 41
Design Current
Swine Cauacity Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
140
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity population Cattle Capacity Population
❑ Layer FONon-Dairy
Dairy
❑ Non -Layer
❑ Other
Total Design Capacity 140
Total SSLW 1 73,080
Number of Lagoons 2 ❑ Subsurface Drains Present 110 Lagoon Area 10 Spray Field Area
Holding Ponds / Solid Traps ❑ 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. Iti discharge is observed, was the conveyance man-made?
b. if discharge is observed, did it reach Water of the State? (lf' 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)
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? ❑ Yes ® No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? ❑ Yes ® No
Waste Collection & Treatment
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: .......... Stage..l........... .......... Stage.2.......... ................................... ......_...... .
Freeboard (inches): 12 12
05103101 Continued

Facility Number: 41-16 • Date of Inspection 4/4/2001 0 Printed on:
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?
8/29/2001 ' •►,�
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 ADnlicatlon
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
10. Are there any buffers that need maintenance/improvement? ❑ Yes ® No
I I. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes ® No
12. Crop type Fescue (Graze) 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
Required
Records & Documents
17.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
® No
18.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
® No
19.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
® No
20.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
21,
Did the facility fail to have a actively certified operator in charge?
❑ Yes
® No
22.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
® No
23.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
❑ Yes
® No
24.
Does facility require a follow-up visit by same agency?
❑ Yes
® No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
® No
0 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
Comments (refer to question #}: Explain any YES answers and/or any reconunendations or any other comments,
Use drawings of facility to betfer explain situations. (use additional pages as necessary')AM[:]Field Copy ®Final Notes %}
,3
-� a.4 _
4. Liquid level is about 6 inches above the maximum liquid level. There has been a lot of rain during the past week. Mr. Humble is
_
planning on Irrigating as soon as the application fields dry enough to allow.
r. Humble has been keeping weekly freeboard levels. Will need to record in inches.
Reviewer/Inspector Name aRocky Durham
Reviewer/Inspector Signature: Date:
05/03/01 Continued

,r Facility Number: 41-16 10of Inspection 4/4/2001 49 Printed on: 8/29/2001
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.)
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
J

041 on of Water Quality
0 Division of Soil and Water Conservation
0 Other'Age'ncy.
Type of Visit *Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint O Follow up O Emergency Notification O Other © Denied Access
Date of Visit; 9/7/2000 Tfine: 1040 Printed on: 9/8/2000
Fl: acility Number 41 16
0 Not Operational 0 Below Threshold
O Pernvtted 0 Certified 13Conditionally Certified [3Registered Date Last Operated or Above Threshold: .........................
Farm Name: Or.uS.a.A..HfAM419................... ........... ..... G..uxlfQxd............................................ WSRQ ........
.................................................. .... County:
OwnerName: UJMQQ_A... ............................... k .Umb g...................................................... Phone No: 0.5:426.1....................................................................
FacilityContact: U.M..RU,iiAl?1:[................................................Title:................................................................ Phone No:...................................................
Mailing Address: 66 �.Sfxlittxt 9Ad.Rs1,......................................................................... Lftir.ty.—K ........................................................... U228..............
Onsite Representative: RrlAmHumb.11P............................................................................ Integrator:..
....................................................................................
Certified Operator:J3.tU.v:.A................................. Rumble Operator Certification Nuniber:2.Q3.SZ .............................
Location of Farm:
Take Hwy 62 south of Burlington, turn onto Smithwood Road. Farm is approx. 4 miles east of 62. AL
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 35 • 54 58 Longitude 79 ' 33 45 <;
Design Current
Swine CanacitV Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
1150
❑ Farrow to Wean
® Farrow to Feeder
140
30
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Capacity Population Cattle Cat)acitv Population
❑ Layer I I Dairy
❑ Non -Layer I I Non -Dairy
❑ Other
Total Design Capacity 140
Total SSLW 73,080
Number of Lagoons �_ 2 , J❑ Subsurface Drains Present �j❑ Lagoon Area I❑ Spray Field Area
Holding Ponds 1 Solid Traps 0 1 ❑ 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/rain?
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
❑ Yes 0 No
❑ Yes (:]No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
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: ...... Uppcer..stage...... ..... . Lower.sta.ge....................................................................................
Freeboard (inches): 24 18
5100 vv\,_ outinued on back

Facility Number: 41-16 Date of Inspection 9/7/2000 Printed on: 9/8/2000 �•
5. Are there any immediate threats to theegrity of any of the structures observed? (ie/ trees, severe erosion, ❑ Yes ® No
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes ® No
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
® Yes
❑ No
8.
Does any part of the waste management system other than waste structures require maintenance/improvement?
® Yes
❑ No
9.
Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
❑ Yes
® No
lWaste 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 (Graze) Fescue (Hay)
13.
Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
® No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
® No
b) Does the facility need a wettable acre determination?
❑ Yes
® No
c) This facility is pended for a wettable acre determination?
❑ Yes
®No
15.
Does the receiving crop need improvement?
❑ 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/Inspectbr 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 yiol;ations:or de#icieneies ever e;noted :during this, visit. ;You will receive no-furth' e•
correspotidehe'e. abou# this* • .. . . • . • . . . .
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):
7. Try 6to establish vegetation on the dam of #l.
8. Replace cover on flush pit to keep excess water out of lagoon.
4. and 9. Start irrigating out of #2 as soon as possible. Maximum level mark was below waste liquid level. Couldn't see marker.
19. A waste sample was not taken within 60 days of February and March irrigations.
25. Current pit for dead pigs is 75 feet from stream. New pit needs to be at least 100 feet from stream.
IV
Reviewer/Inspector Name Melissa Rosebrock
Reviewer/Inspector 5ignatu±!

. Facility Number: 41-16 Da*uspection 9/7/2000 • Printed on: 9/8/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? ❑ Yes ® No
28. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? ❑ Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes .® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
5100

tIsl
vision of Water Quality
ivision of Soil and Water Conservation
O Other Agency
Type of Visit 9D Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit VRoutine O Complaint O Follow up O Emergency Notification O Other ❑ Denied Access
Facility Number Date of Visit: 1 W16alI'irne: �� Pr-iritud on. 7/21/2000
�Q Not Operational Q BelowThreshold
Permitted VCertified © Conditionally Certified 0 Registered Date Last Operated or Above Threshold
Farm Name: ... &u.c.�r..... A ...... Num...bl.t f_ County: ... i.;.[Ard..................................................
Owner Name: .... gr.... ...,ri..'..... G.r. .bfe ............ ................ Phone No: �.�(�.e...v(.��t.... "� t��_�..................
Facility Contact: . Ge ....H.Ur11.�I7I� .....'Title: Phone No:
.............................. ............................................................. ............... .....................
- r_ • .�..��—
Mailing Address:.... .L............�.. ....................R...7 aQ'
Onsite Representative: ...B uc ,,,,, ,U �, Integrator:.....
Certified Operator :.,,,,,,B.ru,,•,,,,,,:-,-..i~}X��. Operator Certification Number:., 3�
Location of Farm:
loa ot.�h o Burl► pr), -furn on -fa Smt`�Gll, ma .fa- rrn 15 6 nprcK.
m I a 10 A.�-f- N ill, ,o A te.
Swine []Poultry [:]Cattle []Horse Latitude ®•11r Longitude• �' �r
Design Current
Swine Canacitv Pnmrlation
❑ Wean to Feeder
Feeder to Finish
Q
❑ Farrow to Wean
Farrow to Feedcr
-30
❑ Farrow to Finish
SCLt75
❑ Gilts
❑ Boars
Design Current Design . Current
Poultry CapacityCapaMy Population Cattle Capacity Population
❑ Layer I \ ❑ Dairy
❑ Non -Layer ❑ Non -Dairy
5
❑ Other
Total Design -Capacity ] ��
Total SSLW I , 0
Number of Lagoons I o ❑ Subsurface Drains Present ❑ Lavon Area 10 Spray Field Area
Holding Ponds / Solid Traps 1 ❑ No Liquid Waste Management System
Discharges & Stream linpactti
1. Is any discharge observed from any part of the operation? ❑ Yes
Discharge originated at: ❑ Lagoon ❑ Spray Field [:]Other
a. If dischargc is observed, was the conveyance man-made'? ❑ Yes ❑ No
1), If discharge is observed, did it reach Water of €he State'? (II }es, notify D���Q) ❑Yes ❑ No
c. if discharge is ohserved. what is the estimated tlow in gal/min'?
d. Dees discharge bypass a lagoon system'? (If ycs, notify DWQ) ❑ Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? [-]Yes X 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 E"ollection & Treat€nent
4. Is storage capacity (freeboard plus storm storage) less than adequate'? Spillway x Yes ❑ No
Structure; I Structure 2 Structure ; Structure 4 Structure 5 Structure 6
Identifier: .. �.�,1Qli..i, &..... Jll .% .7..�..............................................
F'reehoard (inches): � 411 \%
5100 Continued on back

-. Faeilify Number: — 0 Date of Inspection Printed on: 7/21/2000
5. Are there any immediate threats to the integrity of any of the structures observed'? (ie/(iic/ treeovere 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 �J 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? N11yes ❑ No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes KNo
Waste Application
10. Are there any buffers that need maintenancelimprovement? ❑ Yes jKNo
11. Is there evidence of over application'? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload ❑ Yes >(No
12. Crop type U e-
13.
Do the receiving crops differ wdA
those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14.
a) Does the facility lack adequate acreage for land application?
❑ Yes
IX No
b) Does the facility need a wettable acre determination?
❑ Yes
[XNo
c) This facility is pended for a wettable acre determination?
❑ Yes
6&0
15,
Does the receiving crop need improvement'?
❑ Yes
�(No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
1 0
Required Records & Documents
N/A
17.
Fail to have Certificate of Coverage & General Permit readily available'?
18,
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available'?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
X—No
19.
Does record keeping need improvement'? (ie/ irrigation, freeboard. waste anal sis & soil sample reports)
VYes
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, freehoard problems, over application)
❑ Yes
No
'�J`
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
X
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
es
)(No
0: �Cio•violaticjris;or• iieficiertc�es •rv�ere noted• cluritig phis:visit: • Y:oir ;wiil-receive Rio fui•their � : •
corres�orideike: 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):
A,
r�oo� 0m l
Reviewer/Inspector Name
Reviewer/Inspector Signatur Q/�„f R A Date: i
177 QA 5/00

i
Facility Number: — DO Inspection Q 0 Printed on: 7�21/2000
Odor Issties
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below Vas 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 j INO
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 e1
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes KNO
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? OM j 7 $Ves No
S. t4 Va t- .P,�z� P S I S `1 S' Fro a�r- e a m C u m
e o p{l- r UJ,5 -�z �O e, boo l -From 54ro q, m Q
s maple, o-F
o d
tor C v-. .�-,{}Il(,��,�r l rr+ Q,4� O f15 a
fl
5100
J

`1
F vision of Water Quality
ision of Soil and Water Conservation �.
O ther 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
Date of Visit: 6/14/2000 Time: 13:00 Printed on: 9/6/2000
41 16
O Not O erational O Below Threshold
13 Permitted ® Certified Q Conditionally Certified © Registered Date Last Operated or Above Threshold: ......••........
Farm Name: 0]ruse.&.killuxb1c ...................................................................................... .. County: Guilford ............................................ WSRO........
OwnerName: 13mg.&................................ Humb.1f ....................................................... Phone No: 0.5 426.1....................................................................
FacilityContact:..................:........................................................... Title:................................................................ Phone No:...................................................
Mailing Address: {(� S1�it17�0!?d.Rf3.............................
Onsite Representative: Rmrm.Humble........................................................ Integrator:
Certified Operator: &gve.t1..................... . HuA11bk..................... ... Operator Certification Number:Z03.82,,...
............ .................... ........................
Location of Farm:
rake Hwy 62 south of Burlington, turn onto Smithwood Road Farm is approx. 4 miles east of 62. +
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude 35 • 54 4 58 " Longitude 79 a 33 9 45 46
Design Current
Swine CanaeitV Ponulation
❑ Wean to Feeder
❑ Feeder to Finish
850
❑ Farrow to Wean
® Farrow to Feeder
140
❑ Farrow to Finish
❑ Gilts
❑ Boars
Design Current Design Current
Poultry Cavacitv Population Cattle Capacity Population
❑ Layer ❑ Dairy
❑ Non -Layer ❑Non -Dairy
❑ Other
Total Design Capacity 440
Total SSLW 1 73,080
Number of Lagoons 2 ❑ Subsurface Drains Present ❑ Lagoon Area ID Spray Field Area
Holding Ponds 1 Solid Traps ❑ No Liquid Waste Management System
Discharges &� tream 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: ..:....upper.staage-......:....1o_w.er.stage.... ................... .......... :......... ............. :....................... ........ ...........
..........
Freeboard (inches): 12 25
5100
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Structure 6
Continued on back

Facility Number: Al-16 Date of Inspection 6/14/2000 Printed on: 9/6/2000
5. Are there any immediate threats to the i 19rity of any of the structures observed? (ie/ trewevere erosion,
seepage, etc.)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Application
10. Are there any buffers that need maintenance/improvement?
11. Is there evidence of over application? ❑ Excessive Ponding ❑ PAN ❑ Hydraulic Overload
12. Crap type Fescue (Hay)
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?
0: Ltd-violatioris:oe deficiencies -were noted du>riilg-this: visit.:You:wiil rtCiAv4 •-h6-further-.
.' correspandence.abpuf this.visit. •...'..'. ..........
....'.
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Cl Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ® No
❑ Yes ® No
❑ Yes ❑ No
❑ Yes ® No
[:]Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
❑ Yes ® No
Comm nts(refer;to question #) Ezplam'any°YES answers and/or any recommendations or'any other coinments:� `'" ; `
;_.
Use&drawjngs:oftfacjhty�to,-better'expla�nisttuattons. (use additional pages as necessary):
Will need to take soil samples for 2000. AL
Records looked good.
Suggest going ahead and pumping down lagoon to get through July and Aug. on the Fescue.
Has new certification and WUP for 1470 Feeder to Finish.
1W
Reviewer/Inspector Name Rocky Durham Millie Langley
Reviewer/lnspector Signature: Date: 5100

•ir
'Facility Number: 41-16 Dof inspection 6/14/2000 is
on: 9/6/2000
Odor Issues
26. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below ❑ Yes ❑ No
liquid level of lagoon or storage pond with no agitation?
27. Are there any dead animals not disposed of properly within 24 hours? []Yes ® No
28. is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes ® No
roads, building structure, and/or public property)
29. Is the land application spray system intake not located near the liquid surface of the lagoon? [:]Yes ® No
30. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) [:]Yes ® No
31. Do the animals feed storage bins fail to have appropriate cover? ❑ Yes ® No
32. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? ❑ Yes ❑ No
Additional Comments and/orDrawings:
AL
5100

: � p Division of,St Water Conservation - Operation Review
Division of Sot, nd Water Conservation - Compliance [nsp
Division of Water Quality - Compliance Cspection
p Other Agency - Operation Review
Is Routine O Complaint 0 hollow -up of DNVQ inspection 0 1•ullorti'-up of Uj1i'C reylew 0 Other
Facility Number Dime of Inspeclirin
L I Time of ]nspectioll ® 24 hr. (hh:mm)
o Permitted 0 Certified p Conditionally Certified p Registered In Not Operatrotta Date Last Operated:
Farm Name: Brace.A...Huxnbk......................................................................................... COtinty: Guilford WSRO
OwnerNamc: Hrace.A................................. H.utn.ble...................................................... Phone No: 685- Z61....................................................................
Facility Contact:..................................................................... ......Title: Phone Nu:..............
iMailing Address: ..........................................................................
. .l..i be rty—N.0............................................................ 27298 ..............
OnsiteRepresentative:.......................................................................................... ...... Inteurator'...................................
Certified Operator: Rztuca. ............................... Htumble............................................. Operator Certification Nuniber:20& .............................
Location of Farin:
Latitude ©0®:® Longitude ®0©.
Swine Capacity Population
❑ Weanto Feeder
❑ Feederto tuts
❑ Farrow to Wean
® Farrow to Feeder
140
❑ Farrow to Finish
❑ Gilts
❑ Boars
Poultry Capacity Population Cattle Capacity Population
❑ Layer
❑ Non -Laver
❑ Other
Total Design Capacity 14=
Total SSLW73,0=
Number of Lagoons 2 JE3 SubsurfaceDrains Present p agoon, rea p Spray Field Area
Holding Ponds / Solid Traps ❑ o iqut Waste Management System
ream i m paces
1. Is any discharge observed from any part of the operation? ❑ Yes ® No
Discharge on<sin.aed ar. ❑ Lagoon ❑ Spray Field ❑ Other
a. I f ciischarue is observed. was the conveyance rnan-made? ❑ Yes ❑ No
b. I f dischargc is observed. did it reach Water of the State? (If yes. notify DWQ) ❑ Yes ❑ No
c. I f dischanue is observed. what is the estimated flow in gal/min?
d. Rocs discharge bypass a Lagoon system? (if yes. notify DWQ) p Yes ❑ No
2. Is there evidence of past discharge from any part of the operation? [3 Yes ®No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? p Yes ®No
Waste Collection ,, Treatolent
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ❑ Yes ®No
Structure I Struci uc 2 Structure 3 S11"uCILlre 4 StrnClurC 5 Structure 6
Identifier: ........Lag oian.1................ ....................................... ......................................................................
Frecbonrd(inches):................1.8..........................2?................,..................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
1/b/99
❑ Yes ® No
Continued on back
q 4tq

0 :arty Number: 41—I6 13:r iusluxti�)n
�re there structures on -site which are not properly addressed and/or managed through a wt&anagement or
closure plan? p Yes a 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? p Yes ® No
S. Does any part of the waste management system other than waste structures require maintenance/improvement? ❑ Yes a No
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings? ❑ Yes a No
Waste A v jlication
10. Are there any buffers that need maintenance/improvement? p Yes ® No
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN 0 Yes a No
12. Crop type
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)? p Yes a No
14. a) Does the facility lack adequate acreage for land application? ❑ Yes a No
b) Does the facility need 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 problers, 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?
K • yXo'v1619tioh9.Oe detacCe(WiEes'Wer-e-noted •dafririg: this Wlsit.: • YOO. W1{11 •r`ecerve rio: tUt-ther' .: -
.: co'rcespande' Lice alb•otit ibis -Visit. ... ... ... .. ..... .. .. .. .. ... ..
a Yes ❑ No
❑ Yes a No
p Yes a No
p Yes a No
❑ Yes a No
❑ Yes a No
❑ Yes a No
p Yes a No
❑ Yes a No
❑ Yes a No
❑ Yes a No
p Yes a No
Cbmments (refer to°question #): Explain any -YES answers and/or- any recommendations 6k.any other comments.
Use drawings of facility to better explain situations. (use additional pages as necessary):
IV
Reviewer/inspector Name §Eric Black
Reviewer/inspector Signature: Date:

4
Division of Soil JWWater Conservation ❑ Other
® Division of Water Quality
® Routine 0 Complaint O Follow-up of DWQ inspection 0 Follow -tip of DSWC review 0 Other
Date of Inspection V 3 c
Facility Number
Time of Inspection 9/.r 2.4 hr. (hh:mm)
Registered 11 Certified M Applied for Permit © Permitted [3 Not O erational Date Last Operated:..........................
Farm Name: .......... /..�<4.�........ /V. + 11e County: C511,.14���.................................................
Owner Name :............... di+n� �� Phone No:...� ... I..... .... ....... .............................
r�.. r� c..c ......../.................... �P� �z G�
Facility Contact: ......h!&LCC........ /Jtt4,A`� ............................ Title: OW`tP!,....... Phnne No:.�52-K,) ..................... ..............
Mailing Address:....1 ..7.2......... ............. I ............... ...... �...rAl,-- .r27Z S'8
Onsite Representative :.......... ,CY, 5t...... 5................................... ..... Intel;rator:..........................
Certified Operator;...............(,,J. I LA.......4:�Zf........................................................ Operator Certification Number:...... e.d.9.2 .............
Location of Farm: .
'......'fez ................... ........ 1^!GS s1r.i_ l ...k&..................................................................................................................................................................
............................................ .......... I ....... I..... ...............................................................................
Latitude LTJ°©' S®" Longitude ©'
Design " : CurrenE Design Current 3 ; ; _,Design Current
Swine NCapacity Population Poultry Capacity Population Cattle Capacity .Population.
❑ Wean to Feeder
N Feeder to Finish
/
E—O
�i I
❑ Farrow to Wean
❑ Farrow to Feeder
® Farrow to Finish
/
❑ Gilts
❑ Boars
❑ Layer IffDairy
❑ Non -Layer ❑ Nan-Dair
❑ Other
l Total Design'Capacitys
=` Total SSLW
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes ,�(No
2. Is any discharge observed from any part of the operation? ❑ Yes R1 No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the coni,eyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did 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 A No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes ONO
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes J2.No
maintenance/improvement?
6_ Is facility not in compliance with any applicable setback criteria in effect at the time of design? []Yes ONo
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes 9No
7/25/97

Facility Number: c// — /d 0 0
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes IE�No
Structures (LaQoonsAolding Ponds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Yes kNo
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: srti'......�............�t��..Z..................................................................................................................................................
Freeboard (tt):.......4.�......................../O..,5.................... ......................
10. Is seepage observed from any of the structures? ❑ Yes IENo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ❑ Yes 93 No
12.
Do any of the structures need maintenance/improvement?
❑ Yes V 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
IRNo
Waste Application
14.
Is there physical evidence of over application?
❑ Yes
tl No
(If in excess of WNW, or runoff entering waters of the State, notify DWQ)
15.
Crop type ...r u..t,,,.............*J.,!...ala.�n..'.��?. ?............................. .............. ....................................................................
. .......... .......
..................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
❑ Yes
RNo
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
allo
18.
Does the receiving crop need improvement?
❑ Yes
jo No
19.
Is there a lack of available waste application equipment?
❑ Yes
RNo
20.
Does facility require a follow-up visit by same agency?
❑ Yes
tgNo
21.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
VNo
22.
Does record keeping need improvement?
❑ Yes
q No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
EkNo
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
kNo
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
(gNo
No'violations'or. deficiencies.were-noted-during this: visit'., :You:Will receive�no'-ftirtlier
corrOs06hdence d oiit-this;visit'.; . .
Reviewer/Inspector Name ai%r o7/`% !' " %�54c� �cMr
Reviewer/Inspector Signature: /L.� Date: �,

r.
Routine Q Complaint 0 Follow -tip of DWQ ins ection Q Follow-up of DSWC review Q Other
Facility Number Date of Inspection ' .
Time of Inspection 7 24 hr. (hh:mm)
0 Registered ©Certified 0 Applied for Permit © Permitted JE3 Not Operational Date Last pepa"-J.r�-
FarmName: ...............................................:........................................... Countv:........................ . r............. .....
................ ,ty
Owner Name. Phone No: Mp �
a
.................................................................................. ..l�......�l:1�
FacilityContact:............................................................................. Title ................................................................. Phone No NN: r:C. ............ -`" .:i --P►
MailingAddress: ..............................................................................................................................................................................Ft.E..ta1.1a....�.......�:.
Onsite Representative:......►.,7.!J. L?.. ......... G. ... Integrator:..........................................................
CertifiedOperator................................................................................................................ Operator Certification Number:........---..............................
Location of Farm:
Latitude =• 4 46 Longitude • C]& h.J G{
Design Current :
Desi n Current DestpCuxrent
g �p
F F �Ca act}�fPo}�ulation
Capacity,Papulatiott Poultry Ca}�aci■a�' Po platiori4-
p -J p
0Cattle
eSwitte
❑ Layer
x 3}
❑Dairy R,,
❑ Non -Layer
❑Non Dairy
❑
*y� ^s ' W
Other
YF•. »F ...z ate,, S.
�v
�h
'
Total Design Capacity
4
l
Total>SSLW
8 ,�
,�
Number of Lagoons IHoldtrtg Ponds ❑ Subsurface
Drains Present ❑ Lagoon Area
❑ Spray Field Area
❑ Na Liquid Waste Management System
iA
�4
Wean to Feeder
z ❑Feeder to Finish
[I Farrow to
arrow to Feeder
❑Gilts
❑ 13oars
General
1. Are there any buffers that need maintenance improvement?
2. Is any discharge observed from any part of the operation?
Discharge: originated at: El Lagoon [I Spray Field ❑Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ}
c. If discharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons holding ponds) require
maintenance/improvement?
b. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
7. Did the facility fail to have a certified operator in responsible charge?
7/25/97
❑ Yes ;!(No
❑ Yes ZfNo
❑ Yes )YNo
❑ Yes A No
❑ Yes
o, o
❑ Yes
No
❑ Yes
�No
❑ Yes
� No
❑ Yes
�No
❑ Yes
�No
Continued on back

Facility Number: GI
—
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Laeoons,Holding Ponds, Flush Pits, etc_)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Identifier: AUP1111t..y.... 5y
Freeboard(ft):.........�.. ... .................... L...O.......... ................................... .................................... .............................
.
10. Is seepage observed from any of the structures?
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type-----.f�.4-gr........r%ilQ1� .rr�!lJ .................................................................................
16: Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss reviewlinspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
No.vita[ations•or deficiencies. were' noted- during this:visit.- You:w'ill- i-eceii+e. hwfurther
" correspoudehce EiWit this:visit..
❑ Yes
No
❑ Yes
9'�io
Structure 6
❑ Yes
dNo
❑ Yes
❑ Yes
�10
0
❑ Yes
/No
❑ Yes
21 0
❑ Yes {P40
❑ Yes No
❑ Yes� No
❑ Yes IdN0
❑ Yes�o
❑ Yes o
❑ Yes No
El Yes PNo
❑ Yes RfNo
❑ Yes [d No
Reviewer/Inspector Name
I
7/25/97

Division of Soil MWater Conservation ❑ Other
Division of Water Quality
19 Routine 0 Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection IZ is
Facility Number :� Time of Inspection 000 24 hr. (hh:mm)
13 Registered a Certified 13 Applied for Permit E3 Permitted [3 Not Operational I
� Datee Last Operated:
Farm Name: ... g�yS.t.... :.....1 nnb��....................................................................... County: ........ 1�ut.ttp'.Ci:...................................................
Owner Name: ..... La.... A:....1.4? 7................................................-....................... Phone No: ... �:� �._�oe.,�—....'.:� i.
Facility Contact:...: n, ......4__n' 614....................................... Title: ..... ....0b2ne�.................................... Phone Nola. _Q.3...-.07 .9.......
Mailing Address:....... ...... ,1F ..t st.c�... Rr...................................... ! ,.bo.f,...t...41C............. -�7z.9.'................ ..........................
OnsiteRepresentative: ......,JCuc.a........ .iG........................................................Integrator:.......................................................:..............................
Certified Operator :........ !Kct........ ue............................................................. Operator Certification Number:._a_?.S.:Z.................
Location of Farm:
Latitude FTY-1 • 0` Longitude 7� • 33` E41S"
s ` Design,;, Current '< Design Current Design Current`
'Somme Capacity` Population Poultry Capacity Population . Cattle Capacity, Population
❑ Wean to Feeder ❑ Layer ❑ Dairy
[0Feeder to Finish IsSO ❑ Non -Layer ❑ Non-Dairy
v' ❑ Farrow to Wean -- - - "
❑ Farrow to Feeder ❑Other
0 Farrow to Finish / 0 6 Total Design Capacity
❑ Gilts
❑Boars ..Total SSLW
-Number of Lagoons /HoldingyPonds ❑ Subsurface Drains Presen-]I[] Lagoon Area ❑Spray Field Area-1k
_ ❑ No Liquid Waste Management System b
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes El No
2. Is any discharge observed from any part of the operation? ❑ Yes 0 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 Surface Water? (If yes, notify DWQ) ❑ Yes ❑ No
c. If discharge is observed, what is the estimated Flow in pl/min?
d. Does discharge bypass a lagoon system? (If yes, notit_v DWQ) ❑ Yes ❑ No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes 13 No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes N[ No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ® No
mai ntenan ce/impro vement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 12 No
7. Did the facility fail to have a certified operator in responsible charge? ❑ Yes ZNo
7/25/97 %/%�f

Facility Number: L/
8.
Are there lagoons or storage ponds on site which need to be properly closed?
❑ Yes
❑.No
Structures (Lagoons.11olding Ponds, Flush Pits, etc.)
9.
Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes
RNo
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: ,C,4ec.....�......... ....�,Si�,..a.......... ....................... .................. ............ I........................ ...................................
...................................
Freeboard (ft): 210 .710
...................................................................................................................................................................................................................
10.
Is seepage observed from any of the structures?
❑ Yes
[N No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
❑ Yes
JO 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
($ No
Application
_Waste
14.
Is there physical evidence of over application? c7,,ly /� %aff �P%Cv�ra�
❑ Yes
19 No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop
type s. . ........................................=...................
16.
Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
Yes
❑ No
17.
Does the facility have a lack of adequate acreage for land application?
❑ Yes
No
18.
Does the receiving crop need improvement?
❑ Yes
No
19.
Is there a lack of available waste application equipment?
❑ Yes
No
20.
Does facility require a follow-up visit by same agency?
❑ Yes
G�No
21.
Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
❑ Yes
No
22.
Does record keeping need improvement?
❑ Yes
No
For Certified or Permitted Facilities Only
23.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
❑ Yes
O No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
9 No
25.
Were any additional problems noted which cause noncompliance of the Permit?
❑ Yes
14 No
®• No viQlations•or. deficiencies.were noti d-during this. visit.- .You.will receive no fuirtlier
: • correspotideace ab"out this: visit: • : • :.:::. � ..... , : , ::: � :. � :: : , :. � • :: ' • � ::: :: ' • - : ,
� 16 Pr-1 ►�v/ PI4ti — �^ - P[ar.< <%P� i� N o+- il,cirr l' 'O a
-7&6
/V upr s4b"1.1 bz no
Will -,—a au,�, tI ��sk w�a,�n...���� ��t«�— 44--v_ 4e,/,_A
, v%sL switn1L . —Rt YtOl.,e_ S�I/ lffS
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: t�G fG� _ Date:

[3 Division of Soil anTol
ter Conservation p Other Agency
®Division of Water ity
16 Routine p Complaint p o ow -up of DWQ inspection p o o-w-up ot IJSVVCreview 0 Other
Date of Inspection
Facilih' 1\Tumber
Time of Inspection ® 24 hr. (hh:mm)
® Registered p Certified p Applied for Permit p Permitted JC3 Not Opera= Date Last Operated:
Farm Name: By.mce.A.11umhle................................................................... County: Guilford WSRO
....................... .
OwnerName: B.rucc.A................................. Eluxmble ...................................................... Phone No: 685-.42.G.1....................................................................
Facility Contact: B.race.Humble................................................Title: owner .................................................. Phone No: .9,IW68-5-Uz20.......... ..............
!hailing Address: .66.32.SmithN:ee l.Rd........................................................................... ubsxly...N.0......................................... ................... 2729R ..............
Onsite Representative: Breuer —Humble ........................................................................... Integrator:.......................................................................................
Certified Operator:BrucAA . .............................. HiumbIr............................................. Operator Certification Ntint ber:20.382.............................
Location of Farm:
emitw.oa a .at. mesvt e. oa............................................................................................................................................................................................ L&
:€—
Latitude . Longitude ®• ©= .L
Swine Capacity Population
E3 Wean to Feeder
❑ P eed er to mts
[3 Farrow to Wean
❑ Farrow to Feeder
® Farrow to Finish
p Gilts
❑ Boars
Poultry Capacity Population Cattle Capacity Population
p ayer 1❑ Dairy
❑ Non -Layer I E3 Non -Dairy
p Other
Total Design Capacity 180
Total SSLW255,0=
Number of Lagoons:/ Holding Ponds
❑
u bsur ace
Drains
Present JE3
Lagoon rea ❑ Spray P is d t ren
❑
No Liquid Waste
Management
System
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
® No
2. Is any discharge observed from any part of the operation?
❑ Yes
® No
Dischanze originated at: p Lagoon p Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
[]Yes
® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
® No
c. If discharge is observed, what is the estimated flow in -,,allniin?
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?
El Yes
® No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
p Yes
® No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
® No
7. Did the facility fait to have a certified operator in responsible charge?
p Yes
® No
7/25/97
a

Facility Number: 41 _ 16
8. Are there lagoons or storage ponds on site which need to be properly closed? • p Yes ® No
Structures (Lagoons,Holding Ponds, Plush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? p Yes ® No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: 1 2
Freeboard(ft):..............2.5............................. 2.5............... .............. .2-5............................. 2.5............................. 2.5............................. 2.5...............
10. Is seepage observed from any of the structures? 0 Yes Cl No
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers?
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ....................... EcsC=...................... ......................... Ry.e.............................. T.iM01hy.,..Qr.Ghard..&..B.y.C..
16. Do the receiving crops differ with those designated in the Animal Waste Management Flan (A WMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
Z . . o.vias tlons.or adencees.were.note uring t is visit:. Ylon. will .receive no, further .: .
.•.cojrt6o n�deriee�NiittjisYiSi:.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.-.-...•.•.•.•.•.•.•.•.•.•.•...•.•.•.------------
IZ Yes ® No
p Yes H No
p Yes p No
p Yes ® No
[]Yes Cl No
p Yes ® No
p Yes ®No
© Yes ® No
p Yes ® No
p Yes ® No
p Yes p No
p Yes []No
[]Yes []No
p Yes p No
Comments (refer,to�question=#) �.Ezplatn a-ny YES answers and/or any.recommendationstor anyother comments
',Use drawings'oflfacility tohetterexplain sttuattons (use additional pages as necessary)
a
Lek approx. 20,30' from toe of slope. Liqu
to,
7/25/97
Reviewer/Inspector Name iRon Ltnu�lle
Reviewer/Inspector Signature: Date:

ew •
nspection
® Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Facility Number Date of Inspection O a
Time of Inspection Q pa 24 he (hh:mm)
Total Time (in fraction of hours
Farm Status: Registered ❑ Applied for Permit (ex:1.25 for 1 hr 15 min)) Spent on Review
❑ Certified ❑ Permitted or Inspection includes travel and processing)
❑ Not Operational Date Last Operated: .... _.......... _...............
/ �
Farm Name: _..... ........ 4/JSe.�..../T( c/»/t:: ..1f�_/.....L`Prr._ra � .....
Land Owner Name: ..!6i...V �..._....._....__....._._......_....._
County:..Ll- l�.L..l��. .... ................. _......._...........
Phone No: .... 9.1. f....._4k&= 6/
Facility Conctact:...../i�.t s rc ...C...141-.1//// I£-�%Title: ._.....�.1n1..1a/.� / ...... Phone No: .9 4/,,.�?, —D.i2 V
Mailing Address:....,5 6n3.3-......_zr. %..7t.CUY....._.. ..... .. F/.._L..QT.��x...........G:.........._%...._.7. F1Y......
Onsite Representative: ...... If 5 ....... 11— 4xrr�__.............. _........ Integrator: _. ............. _...... __...._._...._................ __....... - ..... __.
Certified Operator: ..... _ t� l U?............. u�... (�i,,/G ,,,.,,,,,..,.._........... Operator Certification Number:..12':
Location of Farm:
Latitude 33 • ®< :S�S� " Longitude �• �• 0'• .
Type of Operation and Desien CaDacitV
s Des!gn 'Current ` _ ' 'Design Current I' - . £ f ^i Desgn'LC rent �
act ePo ulahon�Paultry, Ca' acitd=Po ulahona Cattle,t , Ca- act '�Po ulatio`ns
❑ Wean to Feeder Layer Layer ' ' ❑ Dairy
❑ Feeder to FinishT`'. ❑ Non -layer ® Non -Da' B-O
Farrow to Wean.
El Farrow to Feeder Total Design `Capacity
.v Farrow to Finish ' ..ram '�'""-` V '
._.�. _..,.�.. ...._.. s
5 [Other y4t� �� /a e a Ttital SSLW �ftft
Number of Lag000/Holdmg Ponds � ; ❑Subsurface Drams Present
s i�' ❑Lagoon Area °�� ❑ Spra}' Field Area
General
1. Are there any buffers that need maintenance/improvement?
2. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray field ❑ Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Surface Water? (If 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)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
4/30/97
maintenance/improvement?
■ r-
❑ Yes jE No
❑ Yes P'No
❑ Yes W'Io
❑ Yes
ONo
❑ Yes
®-No
❑ Yes
,®"No
❑ Yes
®No
Continued on back

Facility Number: ... .-/.--... ..../.A:.
6. Is facility not in compliance with any applise setback criteria in effect at the time of desio*e
7. Did the facility fail to have a certified operator in responsible charge?
S. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (Lagoons and/or Holding Ponds)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Freeboard (ft): Structure I Structure 2 Structure 3 Structure 4
............................ ...... ............................ ..........................
10. Is seepage observed from any of the structures?
❑ Yes ❑ No
❑ Yes 5rNo
❑ Yes Wlo
❑ Yes ,allo
Structure 5 Structure 6
11. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? t
Waste Application
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type Q..�s . ftix. ._.� ..."/e � :... ll�...........................
...
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
1 S. Does the receiving crop need improvement?
19. is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/]nspector fail to discuss review/inspection with on -site representative?
For Certified Facilities Only
22. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
23. Were any additional problems noted which cause noncompliance of the Certified AWMP?
24. Does record keeping need improvement?
❑ Yes RNo
❑ Yes Z]No
❑ Yes R,No
❑ Yes ❑ No
❑ Yes VNo
❑ Yes R'No
❑ Yes �'No
❑ Yes �To
❑ Yes Q No
❑ Yes No
❑ Yes allo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes [:]No
Comments{refer to question Explain'any YES answers and/or.any re commendat►onsor any other comments.
Use drawings of facility to better explain situations �(use additional pages as necessary)
G,� c a jo �,. -� �-- o- s I ado e . 4
10
Reviewer/Inspector Name U.3A�_,- `° = . n- �.
Reviewer/] ns pecto r Signature: w Date: 7o S-y 2_ ( -
-c: Division of Water Oualitv. Water Oualit-, Section. Farility Avvessin Pitt Unit 4/-;0/97

Site Requires imr�te Attention: Z
ty No. 4LIz
DIVISION OF ENVIRONMENTAL MANAGEMENT
ANUAAL FEEDLOT OPERATIONS SITE VISITATION RECORD
DATE: - u c/ , 1995
Time: / z.
Farm Name/Own,
Mailing Address:
County:
Integra►= Phone:
On Site Representative:y w rs Phone: �a 5lZ
Physical AddresslL,ocation: 4!:�c
M�
Type of Operation: Swine Poultry Cattle
DesignCapaci7: d Number of Animals on Site. /Md'o -424' _
DEM Certification Number: ACE DEM Cerdfieation Number: A
Latuude:3S �7 ' S Longitude: 33 �5�� Elevation: meet
Circle Yes or No
Does the Animal Waste Lagoon have sufficient freeboard of 1 Foot + 25 year 24 hour storm event
(approximmately 1 Foot + 7 inches) es or No Actual Freeboard: —_—Ft. inches G
� L
Was any seepage observed from the lagoon(s)? Yes or io Was any erosion observed? Yes or
Is adequate land available far spray? Ye or No Is the cover crop adequate? cs or No
Crop(s) being utilized:
Does the facility meet SCS minimum setback criteria? 200 Feet from Dwellings? esor No
100 Feet from Wells? Ye �r No
Is the animal waste stockpiled within 100 Feet of USGS Blue Line Stream? Yes "'` 0-
Is animal waste land applied or spray irrigated within 25 Feet of a USGS Map Blue Line? Yes o Nod
Is animal waste discharged into waters of the state by man-made ditch, flushing system, or other
similar man-made devices? es � If Yes, Please Explain. Ake,"
Does the facility maintain adequate waste management records (volumes of row 4, land applied,
spray irrigated on specific acreage with cover crop)? Yes No
Additional Comments: Q_ ,o-s: j t. ;eX- ,
Inspector Name
cc: FacWty Assessment Unit
Use Attachments if Needed.
TOTAL P.02

UE(� Pil

''+:�'' 'ti: ti: _ : �ti'•' ti xv titi�_ v wz :'�:''
h }}
- _.? �- _ �2= �Lt} ti-21�:ti-.._}�•}} _<}?�i?v..}- tip• v-`-j2'•_v :} _K�
-
i : �-Z-_ _ti :C2? ti-{-�� ti tit ?{2'-tit -�� - }vti t't�- }{22 •{:.
-
i��}��
Date of Inspection. Time of Inspection
T 0_Use 24.hr. time -
Farm Status: Registered p outine 13 rompiainz p o ow -up
Farm Name: Briucu.A.,.Hu.tuble....................................................................................... County: Guilfbr.d ............................................... WSRO .........
Owner Name: Bruce.A.....
............. HUMIlle,..........
..... Phone No:685-4.26.1.....................................................................
Mailing Address: 6632 Smithweed Rd. Liberty NC 27298
Onsite representative: Rruce.Humttle........................................................................... Integrator:.......................................................................................
Certified Operator Name: Brucr A_ ............................................. Ruxable ...............................................
Location of Farm:
IV
Latitude �•®' ®" Longitude ®• ©�°4
pNot Operational Date Last Operated: ...........................................................................................................................................................
Type of Operation and Design Capacity
1. Are there any buffers that need maintenance/improvement? ❑ Yes ❑ No
2. Is any discharge observed from any part of the operation? []Yes ® No
a. If discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) ❑ Yes ❑ 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 p No
3. Is there evidence of past discharge from any part of the operation? ❑ Yes ❑ No
4. Was there any adverse impacts to the waters of the State other than from a discharge? p Yes ❑ No
5. Does any part of the waste management system (other than lagoons/holding ponds) require ❑ Yes ❑ No
maintenance/improvement?

�. 6.
Is facility not in compliance with any apple setback criteria?
[]Yes
1p No
7.
Did the facility fail to have a certified operator in responsible charge (if inspection after I/l/97)?
p Yes
❑ No
8.
Are there lagoons or storage ponds on site which need to be properly closed?
p Yes
p No
Struct!jrpsJLagoons and/or Holding Ponds
9.
Is structural freeboard less than adequate?
p Yes
p No
Freeboard (ft): Lagoon 1 Lagoon 2 Lagoon 3
Lagoon 4
2
10.
is seepage observed from any of the structures?
p Yes
® No
11.
Is erosion, or any other threats to the integrity of any of the structures observed?
p Yes
® No
12.
Do any of the structures need maintenance/improvement?
p Yes
p 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 adquate markers to identify start and stop pumping levels?
p Yes
p No
Waste Application
14.
Is there physical evidence of over application?
p Yes
p No
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
15.
Crop type
16.
Do the active crops differ with those designated in the Animal Waste Management Plan?
p Yes
p No
17.
Does the facility have a lack of adequate acreage for land application?
p Yes
® No
18.
Does the cover crop need improvement?
[]Yes
® No
19.
Is there a lack of available irrigation equipment?
[]Yes
p No
For Certified Facilities Only
20.
Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
p Yes
p No
21.
Does the facility fail to comply with the Animal Waste Management Plan in any way?
p Yes
p No
22.
Does record keeping need improvement?
p Yes
p No
23.
Does facility require a follow-up visit by same agency?
p Yes
p No
24.
Did Reviewer/Inspector fail to discuss review/inspection with owner or operator in charge?
p Yes
p No
=---_ .•.•.•.•.•I.•.•.•..•.... ...
-------f€ - --_- -------- - ----- ------
........................................................................................................................................
o discharge observed. # 1. lagoon has <6" freeboard by design. 2nd lagoon proveds for sufficient freeboard
Reviewer/Inspector Name
Reviwer/Inspector Signature: Date:

State of North Caroline
Department of Environment,
Health and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
Bruce A. Humble
Bruce A. Humble
6632 Smithweed Rd.
Liberty NC 27298
Dear Mr. Humble:
E."'DENN R
April 3, 1997 1q.0 IDept. of FHNS
APR 0 7 1997
1MClSt n,cxl C���1C9
13egio
SUBJECT: Notice of Violation
Designation of Operator in Charge
Bruce:A. Humble
Facility Number 41--16
Guilford County
You were notified by letter dated November 12, 1996, that you were required to designate a
certified animal waste management system operator as Operator in Charge for the subject facility by
January 1, 1997. Enclosed with that letter was an Operator in Charge Designation Form for your
facility. Our records indicate that this completed Form has not yet been returned to our office.
For your convenience we are sending you another Operator in Charge Designation Form for your
facility. Please return this completed Form to this office as soon as possible but in no case later
than April 25, 1997. This office maintains a list of certified operators in your area if you need
assistance in locating a certified operator.
Please note that failure to designate an Operator in Charge of your animal waste management
system, is a violation of N.C.G.S. 90A-47.2 and you will be assessed a civil penalty unless an
appropriately certified operator is designated. Please be advised that nothing in this letter should be
taken as absolving you of the responsibility and liability for any past or future violations for your
failure to designate an appropriate Operator in Charge by January 1, 1997,
If you have questions concerning this matter, please contact our Technical Assistance and .
Certification Group at [phone].
Sincerely,
71. t
for Steve W. Tedder, Chief
Water Quality Section
bb/awdeslet 1
cc: Winston-Salem Regional Office
Facility File
Enclosure
P.O. Box 29535, 'VA
V ;4 FAX [phone]
Raleigh, North Carolina 27626-0535 �� An Equal Opportunity/Affirmative Action Employer
Telephone [phone]% recycles/ 10% post -consumer paper

State of North Carolina
Department of EnvironAt,
Health and Natural Resources
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
November 13, 1996
Bruce A. Humble
Bruce A. Humble
6632 Smithweed Rd.
Liberty NC 27298
SUBJECT: Operator In Charge Designation
Facility: Bruce A. Humble
Facility ID#: 41-16
Guilford County
Dear Mr. Humble:
RECEIVED
N.C. ®ept. of EHN11
tjOV 21
winsiun-
RegiiaEIal
Senate Bill 1217, An Act to Implement Recommendations of the Blue Ribbon Study
Commission on Agricultural Waste, enacted by the 1996 North Carolina General Assembly,
requires a certified operator for each animal waste management system that serves 250 or more
swine by January 1, 1997. The owner of each animal waste management system must submit a
designation form to the Technical Assistance and Certification Group which designates an
Operator in Charge and is countersigned by the certified operator. The enclosed form must be
submitted by January 1, 1997 for all facilities in operation as of that date. Failure to designate a
certified operator for your animal waste management system is a violation of 15A NCAC 2H
.0224 and may result in the assessment of a civil penalty.
If you have questions concerning operator training or examinations for certification, please
contact your local North Carolina Cooperative Extension Service agent or our office.
Examinations have been offered on an on -going basis in many counties throughout the state for
the past several months and will continue to be offered through December 31, 1996.
Thank you for your cooperation. If you have any questions concerning this requirement please
call Beth Buffington or Barry Huneycutt of our staff at 919/733-0026.
Sincerely,
A. Preston Howard, Jr., P.E., Director
Division of Water Quality
Enclosure
cc: Winston-Salem Regional Office
Water Quality Files
P.O. Box 27687. 1W *
Raleigh, North Carolina 2761 1-7687 �� An Equal Opportunity/Affirmative Action Employer
Voice 919-715-4100 - 50% recycled/100% post -consumer paper
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