760015_INSPECTIONS_20171231

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 7G 15 Date of Visit: 1/31/21I01 Time: 1150
Q Not Operational Q Below Threshold
0 Permitted 0 Certified [3 Conditionally Certified 0 Registered Date Last Operated or Above Threshold: .........................
FarmName: .......................................................................................... County: RandolPh.......................................... ..WSRO.......
OwnerName: Euguac.B . ............................. HarAcli ...................................................... Phone No: ......... ..... ............. I..............................
Facility Contact: .........
Mailing Address:d7..d�ss I1a�lr!tt.IidR....
Onsite Representative:... .......................................
Certified Operator: ..................................................
Location of Farm:
Title:............................................................... Phone No:....................................................
.........................I CAMU&M ........................................................... 27233 ..............
.......... I ....... I .............. Integrator:.....
........ Operator Certification Number:... ......................................
mile east of Hwy. 22 on Jesse Hackett Rd. Farm is located on Jess Hackett Road in Climax Community A
® Swine ❑ Poultry ❑ Cattle ❑ Horse Latitude Longitude 79 • 50 . 1546
Design Current Design Current D sign Current
Swine Ca acit P.o ulation Poultr.Y Ca acit P,o ulation Cattle Ca acit P,o ulation '
to Feeder ❑Layer ❑Dairy
rWean
Feeder to Finish
❑Non -Layer
❑Non -Dairy
Farrow to Wean
® Farrow to Feeder 220
❑ Other
Total Design Capacity 220
z
�,, Total SSI, 114,840
fS
❑ Farrow to Finish
❑ Gilts
❑ Boars
ber ofOLagoons l ❑ Subsurface Drains Present ❑ Lagoon Area ❑ Spray Field Area
Num ,
tHolding Pa / Saud,} raps x " ❑ No Liquid Waste Management System
Discharecs $r Stream Imp
1. Is any discharge observed from any part of the operation? ❑ Yes ❑ No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. li' discharge is observed, was the conveyance man-made? ❑ Yes ❑ No
b. If discharge is observed, (lid it reach Water of the State? (If yes, notify DWQ) ❑ 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? N - rl Yes ❑ No
-- _3TWere there any adverse impacts or potential adverse impacts to the Waters of tite State other than from a discharge? _❑ Yes Lj No
01/01/01 - — Continued

Facility Number: 76-15 • Date of Inspection I/31/2001 •
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: ............................................................................................................................................. ......................................................................
Freeboard(inches): .......................................................................................................................................................................................................................
5.
Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes
❑ No
seepage, etc.)
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
13. Do the receiving crops differ with those designated in the Certified Animal Waste Management Plan (CAWMP)?
❑ Yes
❑ No
14. a) Does the facility lack adequate acreage for land application?
❑ Yes
❑ No
b) Does the facility need a wettable acre determination?
❑ Yes
❑ No
c) This facility is pended for a wettable acre determination?
❑ Yes
❑ No
15. Does the receiving crop need improvement?
❑ Yes
❑ No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
17.
Are rock outcrops present?
❑ Yes
❑ No
18.
Is there a water supply well within 250 feet of the sprayfield boundary? ❑ Unknown
❑ Yes
❑ No
❑ On -site ❑ Off -site
Required
Records & Documents
19.
Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
❑ No
20.
Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(ie/ WUP, checklists, design, maps, etc.)
❑ Yes
❑ No
21.
Does record keeping need improvement? (ie/ irrigation, freeboard, waste analysis & soil sample reports)
❑ Yes
❑ No
22.
Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
❑ No
23.
Did the facility fail to have a actively certified operator in charge?
❑ Yes
❑ No
24.
Fail to notify regional DWQ of emergency situations as required by General Permit?
(ie/ discharge, freeboard problems, over application)
❑ Yes
❑ No
25.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
® Yes
❑ No
26.
Does facility require a follow-up visit by same agency?
® Yes
❑ No
27. Were any additional problems noted which cause noncompliance of the Certified AWMP? ❑ Yes ❑ No
Odor Issues
— 28. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or_below_ _❑ Yes ❑ No "
- - liquid level of lagoon or storage pond with no agitation?-
29. Are there any dead animals not disposed of properly within 24 hours? - ❑ Yes ❑ No
—01/01/01 — __ Continued -- "—

Facility Number: 76-15 1
*of Inspection 1/31/200I •
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the liquid surface of the lagoon?
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan biade(s), inoperable shutters, etc.)
33. Do the animals feed storage bins fail to have appropriate cover?
34. Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover?
Printed on: 1/31/2001
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
No violations or deficiencies were noted during this visit. You will receive no Further correspondence about this visit.
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 IN Final Notes
Attempted to count animals to confirm numbers to remove facility from inspection database. Have called this facility several times and
they have not returned our calls. No one was at home or at swine houses. Farm was gated and posted. Several large dogs loose at
owner's home and at farm. Did not get out of vehicle.
a
Reviewer/Inspector Name
—Reviewer/Inspector Signature: Date:

Type of Visit Compliance Inspection O Operation Review O Lagoon Evaluation
Reason for Visit O Routine O Complaint kollow up O Emergency Notification O Other ❑ Denied Access
Facility Number llate of Visit: D 13 I Time:
0 Not Operational Q Below Threshold
13 Permitted © Certified 13 Conditionally Certified © Registered Date Last Operated or Above Threshold: .........................
n .............
Farm Name: f"t �.�.��..�.�.!..� Fay:lY.l....�........................................................ County: t�-�-1.!:.i(�d.�...�.C.1...........................................
...... . .......
I n 1I �j q
Owner Name: ..P...Iflip.... A..c ivaegi........7kr.�.....� �.G... '............. Phone No:.. J�.....:..i r •... .T....Fa l?�i..R7..d-bs
Facility Contact: ...1.1.11 �Lp....Fa.uc.e.11.Q:......................Title:............................................................... Phone No:.. ..3. �... �i
Mailing Address .......... 7. .. 5... 1` e.ra..... p ........1 . .... .... .. lraua.n
Onsite Representative:.. ...t�L: .c�1lQ. .................... Integrator: .... N..eo..... Au..r.T..Fa_r. h�....
Certified Operator: �. r ti„��'e� Operator Certification Number:
Location of Farm:
from 0L as tVj Colvrid e fck�le !o? Ct�st J ivy i e on -ha at urn on
1z - e r In I I �=
b(Swlne []Poultry []Cattle ❑ Horse Latitude• ©��� Longitude �• ®®�
Design Current
Swine C'anacity Ponnlatian
❑ Wean to Feeder
Weeder to Finish
Q Q
❑ Farrow to Wean
❑ Farrow to Feeder
❑ Farrow to Finish
ElGilts
❑ Soars
Design Current Design Current
Poultry Capacity Population Cattle Ca acit Population
❑ Layer ❑ Dairy
❑ Non -Layer I ❑ Non -Dairy
❑ Other
Total Design Capacity of 00
' E Total SSLW7 416On
Number of+Lagoons. f ` j', r ❑Subsurface Drains Present ❑ Lagoon Area ❑ Spray Fieldem
Arco
5
Holding Ponds /Soled Traps , 1 ' , ❑ No Liquid Waste Management Syst
-.. .....r,_ _. :.,,
Discharges & Stream Impact
✓ 1. Is any discharge observed from any part of the operation?
Discharge originated at: ❑ Lagoon ❑ Spray Field [IOther
a. if discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State'? (Ii' yes, notify DWQ)
c. If discharge is observed; what is the estimated flow in gal/min?
d. Does discharge hypass a lagoon system`? (,If yes, notify DWQ)
2. Is there evidence of past discharge from any part of the operation?
❑ Yes'NNo
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ElNo
,Yes ❑ No
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge? []Yes 5�'No
01/01/01 Continued

Facility Number: a — 3 0 Date of Inspection D d •
Waste Collection & Treatment
V/4. Is storage capacity (freeboard plus storm storage) less than adequate? XSpillway V �94<
❑ Yes
KNO
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5
Structure 6
Identifier: .........0 }............... ........ ..............------.............................................................
I............
Freeboard(inches): ......................5................
..................................................................................................------........................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
❑ Yes 1KNo
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
❑Yes
�(No
immediate public health or environmental threat, notify DWQ)
❑ Yes
>(No
V 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?
❑ Yes
Po
✓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?
ElYes
No
V/11. Is there evidence of over application? []Excessive Ponding ❑ PAN ❑ Hydraulic Overload milleA
❑ Yes
No
12. Crop type
eft✓ U Q e QS
13. Do the receiving crops differ with those Acsignated in the Certified Animal Waste anagement Plan (CA P)?
❑ 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
XNo
c) This facility is pended for a wettable acre determination?
❑ Yes
[XNo
15. Does the receiving crop need improvement?
❑ Yes
XNo
16. Is there a lack of adequate waste application equipment?
❑ Yes
No
17. Are rock outcrops present?
❑ Yes
No
18. Is there a water supply well within 250 feet of the sprayfield boundary? Unknown
❑ Yes
❑ No
❑ On -site ❑ Off -site
Required Records & Documents
19. Fail to have Certificate of Coverage & General Permit or other Permit readily available?
❑ Yes
�(No
20. Does the facility fait to have all components of the Certified Animal Waste Management Plan readily available?
/ (ie/ WUP, checklists, design, maps, etc.)
❑ Yes
k q0
V 21. Does record keepingtPed irt�rtc�rovem nL (ie�( ttrRation, freeboard waste analysis & soil sam l r orts)
t ire, , 004- Q_ t' t-5 W. U p 0-C r cs 7 1 'to 7
22. Is facility in in design
❑ Yes XNo
❑ Yes �{ No
not compliance with any applicable setback criteria effect at the time of .
Kul
✓ 23. Did the facility fail to have a actively certified operator in charge?
❑ Yes
*o
24. Fail to notify regional DWQ of emergency situations as required by General Permit?
❑ Yes
XNo
(ie/ discharge, freeboard problems, over application)
25, Did Reviewerfinspector fail to discuss review/inspection with on -site representative?
❑ Yes
5(No
26. Does facility require a follow-up visit by same agency?
❑ Yes
V,No
27. Were any additional problems noted which cause noncompliance of the Certified AWMP?
❑ Yes
VNo
Odor Issues
28. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge at/or below
❑ Yes
[ o
liquid level of lagoon or storage pond with no agitation?
29. Are there any dead animals not disposed of properly within 24 hours?
❑ Yes
XNo
01/01/01
Continued

Facility Number: — Q31 of Inspection .Printed on: 1/4/2001
30. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt, ❑ Yes *50
roads, building structure, and/or public property)
31. Is the land application spray system intake not located near the Iiquid surface of the lagoon? ❑ Yes WNa
32. Were any major maintenance problems with the ventilation fan(s) noted? (i.e. broken fan belts, missing or
or broken fan blade(s), inoperable shutters, etc.) ❑ Yes JTo
33, Do the animals feed storage bins fail to have appropriate cover? ❑ Yes No
34, Do the flush tanks lack a submerged fill pipe or a permanent/temporary cover? A Yes ❑ No
113 No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
❑ Field Copy JZ Final Notes
&4k) JA4.#
ptu
3� 11W a ro blem,
a 4-7. con +; r) u e eT m r+,5 �,o �4, 1ea kS a..(-o utJ h ou5�5
as %e � occur. v's )oo rV oo d at nJ w ex�
m a.d ePrOAAP41 , k'p-s In dawn �,h w� r `ne-e
y
9 • ou'' boo 900d q- Vlne6 re I Uire Menf5 ,
a9 . One, we or-W'i 11N+e-d -6 be ic.l, J up +,J
a3.
r� e_� � o p w rQ.� r �o r n� �o r r. FQuCe ffe -I1 Co & �e fe
f o �e At Free d 15 b e i Imo. Lo'l 115erd P rftt�
41 Wp LKV r"ecod V'e-q 1,Y�qV 0
Acres e 6s4tP-r6e-,5 have en eorrpcej.
j ki tl& hal as have- h'en rom oveJ Front Vv'01A
Reviewer/Inspector Name
Reviewer/Inspector
Date: 01/31l o
01/01/01

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■ Q Y r
ompI' Inspection
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:.14 ther`;:�Agenev-.Ooeration�Review�..d.,E ... ... 'I �.,ba. _ .... �.. •� , �s., +�
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Facility Number irate or Inspection
'rime or In"huctir►n ® 24 hr. (hh:mm)
p Permitted p Certified p Conditionally Certified p Registered p Not OperoUona Date Last Operated:
Barra Name: Gene's.Livestock.................. ............................ County: Randolph WSRO
............................................ .
OwnerName: EugeneA............................. ibr-ken ...................................................... Phone No: 82.4 25.47....................................................................
hac'ility Contact: Genne.HACketL.................................................Title: O.W.Mer .................................................. Phone No: 82.4-25.47 ................................
Mailing Address: J8.37..xlesse..EUckc1t.Rd...................................................................... Climax..NC............................................................. 27233 ..............
Oa►site Representative: Gco.e.Hackett............................................................................. Inter!rrlor:.......................................................................................
Certified Operator: ................. I ................................ ............Oper.ttot' CCr101C.ttion Number:
..........................................................................................
Location of F.7rnt:
..;.....i.... ast;a..;H.ry;.;;..2Qin;tl..sS..;;...aI..1......k.Rid.:::...axml;is;..n at..r..;Au?;...Ies......-------------
Latitude ©0 © & L.ongitude ®• ®
Design Current Design Current Design Current
Swine Capacity Population Poultry Capacity Population Cattle Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
® Farrow to Feeder
❑ Farrow to Finish
❑Gits
❑ Boars
❑ Layer p airy
❑ Non -Layer I I IC3 on- airy
❑ Other
Total Design Capacity, 220
Total SSLW 114,840
Number of Lagoons IjEj Subsurface Drains Present p lagoon rea p Spray re r rca
Hold in Ponds,l Solid'Traps 113 No liquid Waste Management system
Mwharces & Strenna lmpacts
1. Is any discharge observed from any part of the operation? p Yes ® No
Discharge or'iginmed it: ❑ Lagoon p Spray Field ❑ Other
a. ll'discharge is observed. eras flu conveyance nuin-made`? ❑ Yes ❑ No
h. ll'discharge is observed, did it reach Water ol'thc Slate`? (11'ycs. notiN DWQ;) p Yes ❑ No
C. II dischal-C Is ob.wi-Ved, What is Ilie eslirraated tlmv in vaal/rnin?
d. [acts ciischnr�e bypass a Iagaon system'? (if ors. noiif} D1VQ'1 ❑ 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 & Trealmenl
4. Is storage capacity (freeboard plus storm storage) less than adequate? ❑ Spillway ® Yes ❑ No
Structure I s(ruclure ? SIRICIurc 3 Structure 4 Su-ucture 5 Siructurc G
identifier:
...................................................................................................................................................................................................................
Freeboard(inches): ......... 1.2..inchec...........................................................................................................................................................................................
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion, ® Yes ❑ No
seepage, etc.)
3/23/99 Continued on back

Facility Number. 76-15 • • +�I'111spuctim)
6. Are there structures on -site which are not properly addressed and/or managed through a waste management or
closure plan? ❑ Yes N No
(if any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7.
Do any of the structures need maintenance/improvement?
N 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 AyOicalion
10.
Are there any buffers that need maintenance/improvement?
❑ Yes
® No
11.
Is there evidence of over application? ❑ Excessive Ponding ❑ PAN
❑ Yes
❑ No
12.
Crop type 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?
p Yes
❑ No
15.
Does the receiving crop need improvement?
p Yes
p No
16.
Is there a lack of adequate waste application equipment?
❑ Yes
❑ No
Required Records & Docnments
17.
Fail to have Certificate of Coverage & General Permit readily available?
p 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)
M Yes
p 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?
M 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?
M Yes
❑ No
25.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
p Yes
p No
U; XO.viiotatioits-or• [ie cien'Cie's.Wel'e:st-'tedl :during•this Vlsit. ; VUU: will :Feceivle no further. • -, -
cotresparldeke A.out this:visit; : : : : ,
Comments.{refer, to question #) Explain any YIE; i answers and/or any recom_ mendations,or, any other Comments:
n s of fitcd�t 'to better ex lain i "''
LJse draws g y p situations i(use addit'onal'pages as necessary) 6. , �; ,,Ei� l',?
t
** Letter sent Nov. 3, 1998 regarding how many sows can be maintained at below threshold number. That number was set at 62
sows. Response was requested by Nov. 16, 1998. No response was received by the WSRO - WQ.
KA
Reviewer/inspector Name �W Corey Basmgera
Reviewer/Inspector Signature. Date:

#4-Lagoon level is currently at one (1) foot below spillway.
#5-Spillway is eroded and will require approximately eight (8) inches of appropriate fill material.
#7-See #5 above and markers need to be set correctly.
#8-No waste or soil samples taken recently.
#9-Markers need to be set such that at least 18 inches of freeboard is maintained below spillway.
#11-No waste samples taken recently. It is unclear whether or not there has been an over
application of waste.
#13-Does not have a CAWMP
914-Needs to be recalculated for 62 sows
#15-See #11 above
#16-Irrigation system currently consists of 1-1/2 inch flexible pipe and a 3/4 hp pump to irrigate
on field approximately 700 feet away.
#17-Currently not certified. Does not have a plan.
#18-See #17 above.
#19-Pumping hours is the only type records that are kept.
#21-Facility does not currently have a certified operator. However, owner has agreed to reduce
swine numbers to not more than 62 sows. This will be below the threshold number.
#24-Follow up required by W SRO-WQ to check lagoon level.
#25-No certified AWMP
* * * Mr. Hackett has agreed to reduce numbers to NOT MORE THAN 62 SOWS. This will
allow the facility to be under the threshold for swine. Facility will not be required to meet
certification requirements. However, facility must still maintain lagoon freeboard and not over
apply waste.

[j Division of SolPd Water Conservation ❑ Other AWcy
EPivision of Water Quality
wn[Routine O Complaint O Follow-up of DWQ inspection O Follow-up of DSWC review O Other
Date of Inspection S 4
Facility Number �-Cv I S Time of Inspection :04 24 hr. (hh:mm)
13Registered Mertified 0 Applied for Permit 0 Permitted 0 Not O erattonal Date Last Operated:
• W !2o
Farm Name: .►-1.I'ss 1av x.. ...--.-- County:,Re.�r3o�PN...................................5.............
Owner Name:......r ucx ► E.....!�� :........ .k*c.,-o-!r............................................ Phone No• ..33c.- a �4--Zs.................................
.....
cxL 0; 4)
Facility Contact: � � .... Title: �+� "� Z4--- ZS""¢�.............................
..........................................................................................h:�l��......................................... Phone No: �
Mailing Address: I1ffSse Zo�p e.�.�..n..x,,.....!. �..�.�..............................
Onsite Representative: ................. �........ ....... ........ I......................... Integrator....................
...................................................................
Certified Operator;............................................................................................................... Operator Certification Number;..................
Location of Farm:
.........M.r[.6 cRST..of ...................�L..Z.....o �........ �G`5 51z-...... .....�71......r.��...�.........................................................................................
!gar. ,tom..
Latitude -35 • ®� Oa-. �� Longitude ®• ©' 3!41
General
1. Are there any buffers that need maintenance/improvement? ❑ Yes Z"No
2. Is any discharge observed from any part of the operation? ❑ Yes EfNo
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 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 I.No
4. Were there any adverse impacts to the waters of the State other than from a discharge? ❑ Yes [5No
5. Does any part of the waste management system (other than lagoons/holding ponds) require KYes ❑ No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? ❑ Yes 9No
7. Did the facility fail to have a certified operator in responsible charge? OYes ❑ No
7/25/97

Facility Number: =Jtp— I r� • •
8. Are there lagoons or storage ponds on site which need to be properly closed? ❑ Yes IM No
Structures (Laeoons.Holdine Ponds. Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate? Z Yes ❑ No
Structure I Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier: '# i
...................................................................................................................................................................................................................
Freeboard (ft): .............L��..........................................................
...................... .................................... .................................... ...................... .............
10. Is seepage observed from any of the structures? ❑ Yes EU-No
11. Is erosion, or any other threats to the integrity of any of the structures observed? ErYes ❑ No
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 Ievel 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.......FESGuE.....................
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 Iack 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?
[3 • No:violationsor. deficiencies: were noted du' ring this; visit. ' You :will receive no ftirtt%er
c0r6000deko 6hout this;vWt. :. . .
,Yes ❑ No
Yes ❑ No
❑ Yes ❑ No
❑ Yes Er No
❑ Yes IR No
❑ Yes r_1 No
❑ Yes ❑ No
,Yes ❑ No
❑ Yes -M No
E9 Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
AL.ETIe 9-VeAjr
nla ✓ 3� l99g Ilefarcl v how rriaRy 5a w s
cafe he
-71 be.lo &4
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of GZ
50•,u5, 2espay,se was
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by Alo✓. I6, 1Cr4 S. AJo 0'"A ,sa &04S
rcCelvcal
(vy W5R-6 -Wu'? .
,ems )W&E
7/25/97
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:

'Facility Number:.. .......1.5..... I &of Inspection: 5 4.7 97 1•
Additional Comments and/or Drawings
�D EU 2S `i4P(ttkt4l r-CLN*lt-fl 4
44, Ates l & et.t rre+� � tea �r� a cc,}-Fr� 2c� .►�� f��,
.1� I'�� % !s Gcrrr�i� belowsT 11w�tc�.
1- (��dDr AevG
x • 6 ,;, a� � ll
/I T�
J*/Z 5re Z61/ Gc
1#13 Mires
(WeAs
1
¢ A! wile 6a-inales --h k&l lice � cc,1. if rs urn c f�Q,�
,-i a �'
-I� j�e � e►fe I' c Qpl �r a r-�vo
/
' L
! d y►66[
3f� h Pu'nP�Q-l^iGf�s art t'
P
r+llaa) gp /� [►red
,7Z
is `�t-e
o�
1 e�rGQS
�/( I1a5 Ct r [,� ✓t,d �`
�,� Ly�i!l rtllbw 'f�t� -iizLi �� 'lz' �iG
-�- (�Z Souls �
`� �L
�e ►-�4 �.-' r Qom, f �,
I "-A-,O
wa.{e .
4/30/97

3 Division of Soul Water Conservation ❑ Other AlMey
Division of Water Quality
y.�^. ���°i. %tYl«xs. ...:.... .... . .......�'+�... .Y^ns?... �ua9., ..•s9 .. .:"TM^?^�:.✓ .!C �. '�,,. ... �, .",�, .`3.°�''�.'.s`.
outiue O Com taint O Follow-u of DW ins ection O Follow-up of DSWC review O Other
FDate of Inspection O
Facility Number ���
me of Inspection 24 hr. (hh:mm)
Registered [3 Certified 13 Applied for Permit [3 Permitted 113 Not Operational Date Last Operated:
Farm Name:........ County: ... ..... I` f1-4DDLP4 ws ko
............................................................................
Owner Name: ....�.1..G . �lC l3. l-�CS.I�.E...................................... Phone No:...�.�...o ^ �.24 — 254-�
Facility Contact: ................'� 4.(! ......... Title:........( .1 .JIG ............I ................ Phone No:.. 8Z4 ..�..ZS.4- -.......
Mailing Address:... ? g.3� �5se= t!�4e . Ela.'...............................................tom`AX�.. `1 L....................................... Z4 2 33
..... ..6...........
Onsite Representative:.........G ^/E .'f�%1............................................ Integrator: .................................. ............................. I......................
...................................
Certified Operator;............................................................................................................... Operator Certification Number, ................. .............. 6.........
Location of Farm:
Latitude ©'=, D©" Longitude ®• ®I 3)
Design Current
Design
Current K Design Current
Capacity Population;
Poultry _z.
Capacity
Population', Cattle , CapacityPopalation
�Swme
"K
❑ Layer
Y
❑ Dairy
' �s
❑ Non -Layer
❑ Non-Dairy
w
❑ Other.''
a
Total Design Capacity; z2!
.
-
M �.
Total SSLw �= ll4 84fl
�n -oa �
�Niunber of Lagoons / Holding Ponds � ❑Subsurface Drains Present ❑Lagoon Area ❑Spray Field Area -
h
❑ No Liquid Waste Management System r +
t.,.
❑ Wean to Feeder
❑ Feeder [o Finish
❑ Farrow to Wean
Farrow to Feeder
Z y o
135
❑ Farrow to Finish
❑ Gilts
❑ Boars
General
1. Are there any buffers that need maintenance/improvement?
❑ Yes
&No
2. Is any discharge observed from any part of the operation?
❑ Yes
IN No
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. If discharge is observed, was the conveyance man-made?
❑ Yes
Q No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ)
❑ Yes
tNo
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
pt No
3. Is there evidence of past discharge from any pan of the operation?
❑ Yes
�y No
4. Were there any adverse impacts to the waters of the State other than from a discharge?
❑ Yes
® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
jr No
7. Did the facility fail to have a certified operator in responsible charge?
XYes
,#No
7/25/97

Facility Number: —Efz7— �S
8. Are there lagoons or storage ponds on site which need to be properly closed?
Structures (_LagoonsJlolding fonds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
❑ Yes V No
❑ Yes ;8No
Structure 1 Structure 2 Structure 3 Structure 4 Structure 5 Structure 6
Identifier:
Freeboard(ft): ........... i ./.:............................................. ................................... .................................... .................................... ....................................
10. Is seepage observed from any of the structures? ❑ Yes XNo
11. Is erosion, or any other threats to the integrity of any of the structures observed? ;0 Yes ❑ No
12. Do any of the structures need maintenancelimprovement? 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?
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
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$. 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?
D-No:vialations•ar derciencies:were-noted aur.i_ng this;visit._Y_ ou.will receive n6ltirther.:
correspoddeht about this: viAL
❑ Yes WNo
❑ Yes )ZNo
❑ Yes ❑ No
❑ Yes JO No
❑ Yes IM No
❑ Yes �g No
❑ Yes No
❑ Yes trNo
_:E4'Ybs ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No

F
-fi
plOther'Agency :' Operation Review ;a'
19 Routine p Complaint p 7 ow -up of DWQ inspection p
Faeility Number
0 Registered p Certified p Applied for Permit p Permitted
Farm Name: Gene!.Uivcs1oek.........................................................................
Owner Namc: Eugene.& ....................... --
Facility Contact: Gene..Nackett............
.. Rackett ...............................
yd � <S� pia
� F
@CtiOn
r
I1�
-up of il�we; review p viner
Date of Inspection
Tiure of Inslicction ® 24 hr. (hh:mm)
In Not 01er atroria hate Last Operated:
County: Randolph WSRO
........ Phone No: ffi4-25.47....................................................................
Tit1c: Owner ................................................. PI►oue No: M i-,8Z4.-.254.7........................
Mailing Address: 38.17-,BesseHackelt.Rd............................................................. I........ climal-kic ............................................................ 27Z33 ..............
OnsiteRepresentative: G.epe.Elackett............................................................................. Intel;rator:.......................................................................................
Certified Operator: .................................................. .............................................................. Operator Certification Numhcr•:................
.........................
Location of Farm:
Latitude ©* ®F ©. Longitude ®0 ®1 ©•1
Swine Capacity Population
p Wean to ee er"
p Feeder to Finish
p Farrow to Wean
® Farrow to ee er
p Farrow to Finis
p Gilts
p Boars
Poultry Capacity Population Cattle Capacity Population
p Layer p airy
p Non -Layer 113 Non -Dairy
p Other
Total Design Capacity 220
Total SSLW 114,840
Number of Lagoons/ Holding Ponds p Subsurface Drains resen p Lagoon Area [3pray ie rea
0
o Liquiuvaste Management Sys em
(:e•ucr:�l
I. Are there any buffers that need maintenance/improvement? p Yes ® No
2. Is any discharge observed from any part of the operation? p Yes ® No
Discharge originated at: p Lagoon p Spray Field p Other
a. I I'd isch arge is observed, was the conveyance man-made? p Yes ® No
b, I1'discharge is observed, did it reach Surface Water? Of'yes, notit'y DWQ) p Yes ®No
c, If dtscharge is observed, what is the estimated I'low in gal/min?
d. Does discharg bypass a lagoon system? (If yes, notify DWQ) Yes ®No
3. Is there evidence of past discharge from any part of the operation? p Yes ® No
4. Were there any adverse impacts to the waters of the State other than from a discharge? p Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require p Yes N No
maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? p Yes ® No
7. Did the facility fail to have a certified operator in responsible charge? ® Yes p No
7/25/97

act y um er: 76_15 DaicAich
pecdoo
8. Are there lagoons or storage ponds on need to be ro erl closed?
gproperly Y
Structures { Lalmons,hlolding Pr►r)ds, Flush fits, etc_)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Stl'lletfn•e I Structure 2 Structure 3 Structure 4
IdentiI er:
Freeboard (I)): 2..
............... ...............................................................
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)
Structure 5
15. Crop type ....................... fts=tw...................... ..................................................................................
....................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
ca. �Nq �viat 1ons.or i�cren.cies'were.np a uring rs visit: You. wY .receive nafurther.-.
flt'zespa�l�erie�abQu :t.. •f... •.•.. .... ..... .
p Yes ® No
p Yes ® No
Structure 6
Yes ® No
N Yes p No
M Yes p No
p Yes M No
p Yes ® No
p Yes p No
p Yes ® No
p Yes N No
p Yes ®No
p Yes ®No
p Yes ®No
N Yes p No
Cl Yes p No
p Yes p No
p Yes p No
( refer to,q) � uestion # EExnplain =anyES;answers and/oyr an ::Erecolmmengdations or anY other comments
;Cum""menul ,'
d}>. § F y,.,,,3. €i.'.E
P
Use deawings,of facility to.better explai.n situations (use�addttiona:<.:
l pages as necessary}: Y
nji 3n »a„�,_r,.wire.., .�. �..3P,i-. ,,EA.,
7. OWNER HAS NO ATTENDED CLASS OR TAKEN TEST YET. NEES SPECIAL ATTENTION.
44
11,12 SPILLWAY NEEDS IMPROVEMENT. NEW SOIL NEEDS TO BE LEVELED OUT SOME TO PREVENT EROSION
2. NO RECORDS KEPT. INFORMED OWNER TO BEGIN KEEPING SOME TYPE OF RECORDS.
** OWNER HAS HAD FINANCIAL PROBLEMS AND IS UNABLE TO PAY HIS 25% FOR AG -COST SHARE.
HE WANTS TO COMPLY, BUT NEEDS ASSISTANCE. HE MAY REDUCE BELOW THRESHOLD OF GO
OUT OF BUSINESS AND CLOSE LAGOON.
Reviewer/Inspector Name
Reviewer/Inspector Signature: Date:

•
Mr. Gene Hackett
Gene's Livestock
3837 Jesse Hackett Road
Climax, NC 27233
r NORTH CAROLINA DEPARTMENT OF
ENVIRONMENT AND NATURAL RESOURCES
WINSTON-SALEM REGIONAL OFFICE
DIVISION OF WATER QUALITY
3 November I998
SUBJECT: Certification Requirements
Gene's Livestock
Facility No. 76-15
Randolph County
Dear Mr. Hackett:
At your request, I am providing you with the information concerning exactly how many swine
can be maintained at your facility without exceeding the threshold limit. The current threshold number
is 250 swine for most swine facilities. However, since your facility is a farrow to feeder operation,
that number is slightly different. In order for you to remain under the threshold limit for swine, you
must have NO MORE THAN 62 SOWS. If you have no more than 62 sows, you will be considered
to be less than the threshold number for swine and therefore not be required to be certified.
Please be reminded that even if you decide to maintain less than 62 sows, you must still
comply with all rules, regulations, and laws that apply to an animal operation with less than the
threshold number. You must still maintain at least eighteen (18) inches of freeboard in your lagoon,
and ensure that no runoff occurs during or after waste application.
Should you decide to maintain NO MORE THAN 62 SOWS, you must contact the Randolph
County Soil and Water Conservation District (Barton Roberson 336-318-6490) and the Division of
Water Quality (Corey Basinger 336-771-4600), no later than November 16, 1998. I have also
included a form for you to complete if you decide to maintain no more than 62 sows. This form must
be completed and signed as soon as possible, and mailed to address shown.
If you have any questions or concerns regarding this matter, please contact me as soon as
possible at [phone], Thank you in advance for your prompt attention to this matter.
Sincerely,
?W. Corey Basinger
Environmental Engineer
cc: Barton Roberson, SWCD
Shannon Langley, Central Office
Central Files
11WPS R4"
585 WAUGHTOWN STREET, WINSTON-SALEM, NORTH CAROLINA 27107
PHONE [phone] FAX[phone]
AN EQUAL OPPORTUNITY /AFFIRMATIVE ACTION EMPLOYER - 50 n RECYCLED/10% POST -CONSUMER PAPER

:,,.,: , m....._...
❑ DSWC Ani 1 Feedlot Operation Review
® DWQ Animal Feedlot Operation Site Inspection
Routine O Com laint O Fullo%v-u of I)wf ins ection O Follow-up of DSIVC review O Other
Date ot'Inspectia
Facility Number n
Time of Inspection OD 24 hr. (hh:mm)
�gistered l3 Certified © Applied for Permit 0 Permitted 10 Not Operational I Date Last Operated: ......
Farm Name: 0,0 F1G S (--%0G3Ti C.V_- RANDO LPP, _
................................................................................................................. County:.., ................................... 0.......,......l S.�.
Owner Name:.......El1c_i_:�PLe i3,,.. ,., AC+GtsTl` Phone No:.,glb-8z4—7544-.................................
....................
Facility Contact: ...... C"5 ,_ ... 5 ......... ... Title: Cic.JAlter- Phone No:.,..,�....z.c9 .__...,.......
Mailing Address: 383-' asp=-5c *,Ck.C`TI (an-f/I .,..%.Cr........................................ .2 .. �J ......................J
OnsiteRepresentative..... ..........i`4........!6,V..F ....................................................... lntegrator:......................................................................................
Certified Operator:............................................................................................... .....: Operator Certification Number..............................
Location of Farm:
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
I../n-le eas7- o. .e<.:...ZZ....... ' �55e ,4GteV- Pam,
........ ................ .........
Latitude Longitude ®• �/ ` 3l "
Design Current
Swine Capacity Population
❑ Wean to Feeder
❑ Feeder to Finish
❑ Farrow to Wean
Farrow to Feeder
ZZo
% Q
❑ Farrow to Finish.
❑ Gilts
❑ Boars
Design Current
Poultry Capacity Population Cattle
❑ Layer T= JE1 Dairy
❑ Non -Layer I 1 10 Non -Dail
❑ Other I I
Total Design Capacity
Total SSLW
Population
Number of Lagoons / Holding Ponds JE1 Subsurface Drains Present ❑ Lat!oon Area ❑ Spray field Area
❑ No Liquid Waste Management System
General
I.
Are there any buffers that need maintenance/improvement'?
❑ Yes
-;i�o
2.
Is any discharge observed from any part of the operation?
❑ Yes
J IVo
Discharge originated at: ❑ Lagoon ❑ Spray Field ❑ Other
a. if discharge is observed, was the conveyance man-made?
❑ Yes
Wo
b. II'discharge is observed, did it reach Surface Water? (it' yes, nutit;v DWQ)
❑Yes
PS[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
CVo
3.
Is there evidence of past discharge from any part of the operation?
❑ Yes
E&
4.
Were there any adverse impacts to the waters of the State other than from a discharge'?
❑ Yes
MNo
5.
Does any part of the waste management system (other than lagoons/holding ponds) require
❑ Yes
e-19 No
maintenance/improvement?
6,
is facility not in compliance with any applicable setback criteria in effect at the time of design?
❑ Yes
)R'No
7.
Did the facility fail to have a certified operator in responsible charge'?
9Yes
❑ No
7/25/97
Continued on back

s Facility Number:
8. Are there lagoons or storage ponds on site which need to be properly closed'?
Structures (Lagoons.tIolding fonds, Flush Pits, etc.)
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure l Structure 2 Structure 3 Structure 4 Structure 5
Identifier:
Freeboard(ft): .................................................... ...............................................................................................................
10. Is seepage observed from any of the structures?
1 I . 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 situations 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 ..................rim...... r�............................................................................ ............................................................
16. Do the receiving crops differ with those designated in the Animal Waste Management Plan (AWMP)?
17. Does the facility have a lack of adequate acreage for land application?
18. Does the receiving crop need improvement?
19. is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
22. Does record keeping need improvement'?
For Certified or Permitted Facilities Only
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified AWMP?
25. Were any additional problems noted which cause noncompliance of the Permit'?
0- No.violations or deficiencies. were noted during'this. visit.:You.'will receive no further
correspondence aboat this'visit
❑ Yes Ao
❑ Yes _r�W0
Structure 0
❑ Yes �`Na
❑ Yes KVo
❑ Yes �No
❑ Yes ❑ No
❑ Yes �No
❑ Yes ❑ No
❑ Yes �do
❑ Yes ENo
❑ Yes 4 No
❑ Yes ,rNo
❑ Yes �ff No
❑ Yes C—
❑ Yes ❑ No
❑ Yes ❑ No
❑ Yes ❑ No
AJkOSAW C Ne r
7/25/97
01
Reviewerfinspector Name
Reviewer/Inspector Signature: �' ` ,�� Date:

Routine p Complaint p Follow-up of DWQ inspection p o ow -up of 139M review p Other
Date of Inspection
Facility Number
Time of Inspection �i�7F6� 24 br. (hh:mm)
E Registered p Certified p Applied for Permit p Permitted in Not Date Last Operated:
Farm Name: Gate.'s.Lxxeskorck.......................................................................................... County: Randolph WSRO
OwnerName: Eugene.B,. ............................. 11arkelt ...................................................... Phone No:&2.4-2,5.47 ...................................................................
Facility Contact: Gera.Uackekt.................................................Title: 0maer ................................................ Phone No:(9.10.).824r2547 ....................
MailingAddress: ...................................................................... CIimx..NC ............................................................ 27.2321..............
Onsite Representative: G.en.e.H clwU.........
Certified Operator:......... .........................................
Location of Farm:
.............Integrator:.......................................................................................
Operator Certification Number :.........................................
Latitude ©a®& ®" Longitude ®• ®6 F-37"
General
1. Are there any buffers that need maintenance/improvement? p Yes ® No
2. Is any discharge observed from any part of the operation? p Yes ® No
Discharge originated at: p Lagoon p Spray Field p Other
a. If discharge is observed, was the conveyance man-made? p Yes ® No
b. If discharge is observed, did it reach Surface Water? (If yes, notify DWQ) p Yes ® No
c. If discharge is observed, what is the estimated flow in gal/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? p Yes ® No
4. Were there any adverse impacts to the waters of the State other than from a discharge? p Yes ® No
5. Does any part of the waste management system (other than lagoons/holding ponds) require p Yes ®No
. maintenance/improvement?
6. Is facility not in compliance with any applicable setback criteria in effect at the time of design? p Yes ®No
7. Did the facility fail to have a certified operator in responsible charge? ® Yes p No
7/25/97

aci R y. Number., 76_15 0
8. Are there lagoons or storage ponds on site which need to be properly closed? p Yes ® No
Structures (La oons,Holding Ponds, Flush 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:
i
Freeboard(ft): ............ l.5.ft............. .............................................................................................................................................................................
10. Is seepage observed from any of the structures? p Yes N No
11. Is erosion, or any other threats to the integrity of any of the structures observed? p Yes H No
12. Do any of the structures need maintenance/improvement? p Yes N No
(If any of questions 9-12 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
13. Do any of the structures lack adequate minimum or maximum liquid level markers? p Yes p No
Waste Application
14. Is there physical evidence of over application? p Yes ® No
(if in excess of WMP, or runoff entering waters of the State, notify DWQ)
15. Crop type ....................... E.eagm...................... ......................................................................................................................
4
16. Do the receiving crops differ`with those designated in the Animal Waste Management Plan (AWMP)? p Yes p No
17. Does the facility have a lack of adequate acreage for land application? p Yes H No
i
18. Does the receiving crop need improvement? p 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?
p Yes
® No
21.
Did Reviewer/Inspector fail to discuss review/inspection with on -site representative?
p Yes
M No
22.
Does record keeping need improvement?
p 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?
p Yes
p No
24.
Were any additional problems noted which cause noncompliance of the Certified AWMP?
p Yes
p No
25.
Were any additional problems noted which cause noncompliance of the Permit?
p Yes
p No
a. �Np-via ions.or crencies•were.noo during is vise tau wi.receive no'further. .
izor esgonkOR a u�tii$yisi:: •.•.•. .•.•.•.•.•.•.
ReviewerlInspector Name
Reviewer/Inspector Signature: ! �y W Date: